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  • 1. Akhter, Shaheen
    et al.
    Mannan, Muzharul
    Biswas, Animesh
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Determinants of epilepsy in infancy in Bangladesh: a case-control study2013In: Neurology Asia, ISSN 1823-6138, Vol. 18, no 1, p. 17-22Article in journal (Refereed)
    Abstract [en]

    Background: Very little research has been done on childhood epilepsy in Bangladesh. Greater knowledge on risk factors of epilepsy in the early years of life could help to improve understanding of epilepsy, can tell us about its prognosis and allow early intervention. Objective: This study was designed to explore the determinants of epilepsy in infancy, in Bangladesh. Method: A case-control study involving 63 patients with epilepsy was performed in two specialized hospitals in Bangladesh. Children with epilepsy were the study population. Result: Birth asphyxia, neonatal seizure and history of consanguinity were significantly associated with epilepsy in infancy (OR 7.4, 95% CI 2.37-6.57, OR 4.13, 95% CI 1.67-4.65 and OR 10.85, CI 2.11-41.08 respectively). Complication during antenatal period of pregnancy was found to be higher in children who develop epilepsy in infancy but it was not signifi cant (OR 2.76; 95% CI 1.08-4.89). Coexisting impairments were highly signifi cant in children having seizure onset in infancy (OR 5.9; p=.000); these were -developmental delay, speech and language delay, mental retardation and cerebral palsy. Conclusion: Birth asphyxia, neonatal seizure and parental consanguinity, were significantly associated with epilepsy in infancy in Bangladesh. Antenatal complications were higher in infancy though not signifi cant. Epilepsy starting at this age was significantly associated with neurodevelopmental impairments.

  • 2.
    Andrews-Chavez, Johanna
    et al.
    Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA.
    Biswas, Animesh
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Gifford, Mervyn
    Department of Public Health Sciences, University of Skövde, Skövde, Sweden.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Identifying households with low immunisation completion in Bangladesh2012In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 4, no 11, p. 1088-1097Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate if the mothers’ demographics and household characteristics—including type of use of cooking fuel, energy and toilet facilities—have any implication for complete immunisation rates among their children. A cross-sectional data analysis of a nationally representative sample of 4925 women with at least one child was performed. Chisquared tests and multivariate logistic regression analyses were used. Immunisation coverage was positively associated with the mother’s education and with household characteristics such as toilet facility, electricity and involvement in a microfinance group. These findings indicate the need for further advocacy for increased knowledge on the importance of vaccination and affordable public immunisation programs focusing on higher risk households such as those with pit facilities, lack of electricity and no participation in a microfinance group. Such households warrant further attention and can be targeted for immunisation coverage.

  • 3.
    Biswas, Animesh
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Maternal and Neonatal Death Review System to Improve Maternal and Neonatal Health Care Services in Bangladesh2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Bangladesh has made encouraging progress in reducing maternal and neonatal mortality over the past two decades. However, deaths are much higher than in many other countries. The death reporting system to address maternal, neonatal deaths and stillbirths is still poor. Moreover, cause identification for each of the community and facility deaths is not functional. The overall objective of this thesis is to develop, implement and evaluate the Maternal and Neonatal Death Review (MNDR) system in Bangladesh. The study has been conducted in two districts of Bangladesh. A mixed method is used in studies I and II, whereas a qualitative method is used in studies III-V, and cost of MNDR is calculated in study VI. In-depth interviews, focus group discussions, group discussions, participant observations and document reviews are used as data collection techniques. Quantitative data are collected from the MNDR database. In study I, community death notification in the MNDR system was found to be achievable and acceptable at district level in the existing government health system. A simple death notification process is used to capture community-level maternal and neonatal deaths and stillbirths. It was useful for local-level planning by health managers. In study II, death-notification findings explored dense pocket areas in the district. The health system took local initiatives based on the findings. This resulted in visible and tangible changes in care-seeking and client satisfaction. Death numbers in 2012 were reduced in comparison with 2010 in the specific area. In study III, verbal autopsies at community level enabled the identification of medical and social causes of death, including community delays. Deceased family members cordially provided information on deaths to field-level government health workers. The health managers used the findings for a remedial action plan, which was implemented as per causal findings. In study IV, social autopsy highlights social errors in the community, and promotes discussion based on a maternal or neonatal death, or stillbirth. This was aneffective means to  deliver some important messages and to sensitize the community. Importantly, the community itself plans and decides on what should be done in future to avert such deaths. In study V, facility death review of maternal and neonatal deaths was found to be possible and useful in upazila and district facilities. It not only identified medical causes of death, but also explored gaps and challenges in facilities that can be resolved. The findings of facility death reviews were helpful to local health mangers and planners in order to develop appropriate action plans and improve quality of care at facility level. Finally, in study VI, the initial piloting costs required for MNDR implementation were estimated, including large capacity development and other developmental costs. However, in the following year, costs were reduced. Unit cost per activity was 3070 BDT in 2010, but, in the following years, 1887 BDT and 2207 BDT, in 2011 and 2012 respectively.

    List of papers
    1. Community Notification of Maternal, Neonatal Deaths and Still Births in Maternal and Neonatal Death Review (MNDR) System: Experiences in Bangladesh
    Open this publication in new window or tab >>Community Notification of Maternal, Neonatal Deaths and Still Births in Maternal and Neonatal Death Review (MNDR) System: Experiences in Bangladesh
    2014 (English)In: Health, ISSN 1949-5005, Vol. 6, no 16, p. 2218-2226Article in journal (Refereed) Published
    Abstract [en]

    Objectives: The aim of the study was to examine the process of community maternal, neonatal deaths and still births notification within the Bangladesh government health structure using the Maternal and Neonatal Death Review (MNDR) system. The study also explored the feasibility and acceptance of community death notification in the MNDR system.

    Methods: The study was under-taken in the Thakurgaon district of Bangladesh during 2010. During the study a mix of both qualitative and quantitative information was collected. A review of the documentation process of community death notification was undertaken and focus group discussions (FGDs) with community members, health care providers and managers in a sub-district were conducted, with in-depth interviews (IDIs) with district heath and family planning managers. Quantitative data were collected from community death notifications in the district during January to December 2010.

    Results: The death notification process was implemented by the government health care system within the Thakurgaon district. Field level health and family planning staff collected maternal and neonatal death information, recorded the death on the notification form and reported back to the Upazila (sub-district of the district) focal point at the Upazila health complex (primary health care centre). Community people were encouraged to share their death information to field level health staff. The health and family planning managers in the district periodically discussed the maternal and neonatal deaths and prepared remedial action plans in high death notified areas. In 2010, 59 maternal deaths, 739 neonatal deaths and 633 still births were reported in Thakurgaon district. District health and family planning departments performed community death notification as part of their routine daily work and integrated these procedures with other field level activities.

    Place, publisher, year, edition, pages
    China: Scientific Research Publishing, 2014
    Keywords
    Community death notification, maternal and neonatal death, bangladesh
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:oru:diva-41207 (URN)10.4236/health.2014.616257 (DOI)
    Note

    Available from: 2015-01-13 Created: 2015-01-13 Last updated: 2017-10-17Bibliographically approved
    2. Maternal and neonatal death review (MNDR): A useful approach to identifying appropriate and effective maternal and neonatal health initiatives in Bangladesh
    Open this publication in new window or tab >>Maternal and neonatal death review (MNDR): A useful approach to identifying appropriate and effective maternal and neonatal health initiatives in Bangladesh
    Show others...
    2014 (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To identify the effects of Maternal and Neonatal Death Review (MNDR) in terms of improving maternal and neonatal health at the community level in Bangladesh.

    Methods: Both quan- titative and qualitative methods were undertaken for collecting data in Kashipur Union, Bangla- desh. Death notifications from households, subsequent data collections from a focus-group discus- sion (FGD), a group discussion (GD) and in-depth interviews (IDIs) were obtained using structured tools and guidelines.

    Results: A total of four maternal deaths, 21 neonatal deaths and 15 still births were reported in the MNDR death notification system at Kashipur Union in 2010. Data were presented to local programme managers, who took various initiatives including awareness pro- grammes, pregnancy registration, antenatal care, birth planning, and also the revitalization of a community clinic. The coverage of antenatal care, delivery in clinics, postnatal care and referral of complications increased through the active participation of the community. Community health- care providers, care recipients and members of the community expressed satisfaction with the quality of maternal and neonatal services. In the preceding two years, maternal and neonatal deaths substantially reduced in Kashipur (in 2011 maternal death = 1, neonatal death = 20, still birth = 8; in 2012 maternal death = 1, neonatal death = 8, still birth = 13).

    Conclusions: The MNDR system successfully delivered notification of all maternal and neonatal deaths in the defined area and collected information for the formulation and implementation of specific interventions, which resulted in visible and tangible changes in care-seeking and client satisfaction.

    Keywords
    Maternal and neonatal health, death review, primary healthcare, Bangladesh
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:oru:diva-41213 (URN)
    Available from: 2015-01-13 Created: 2015-01-13 Last updated: 2017-10-18Bibliographically approved
    3. Experiences of Community Verbal Autopsy in Maternal and Newborn Health of Bangladesh
    Open this publication in new window or tab >>Experiences of Community Verbal Autopsy in Maternal and Newborn Health of Bangladesh
    Show others...
    2015 (English)Manuscript (preprint) (Other academic)
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-46529 (URN)
    Available from: 2015-11-18 Created: 2015-11-18 Last updated: 2017-10-18Bibliographically approved
    4. Social Autopsy: A Social Intervention to Generate Community Awareness of Maternal and Neonatal Deaths
    Open this publication in new window or tab >>Social Autopsy: A Social Intervention to Generate Community Awareness of Maternal and Neonatal Deaths
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-46531 (URN)
    Available from: 2015-11-18 Created: 2015-11-18 Last updated: 2017-10-17Bibliographically approved
    5. Facility Death Review of Maternal and Neonatal Deaths in Bangladesh
    Open this publication in new window or tab >>Facility Death Review of Maternal and Neonatal Deaths in Bangladesh
    Show others...
    2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 11, article id e0141902Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To explore the experiences, acceptance, and effects of conducting facility death review (FDR) of maternal and neonatal deaths and stillbirths at or below the district level in Bangladesh.

    Methods This was a qualitative study with healthcare providers involved in FDRs. Two districts were studied: Thakurgaon district (a pilot district) and Jamalpur district (randomly selected from three follow-on study districts). Data were collected between January and November 2011. Data were collected from focus group discussions, in-depth interviews, and document review. Hospital administrators, obstetrics and gynecology consultants, and pediatric consultants and nurses employed in the same departments of the respective facilities participated in the study. Content and thematic analyses were performed.

    Results: FDR for maternal and neonatal deaths and stillbirths can be performed in upazila health complexes at sub-district and district hospital levels. Senior staff nurses took responsibility for notifying each death and conducting death reviews with the support of doctors. Doctors reviewed the FDRs to assign causes of death. Review meetings with doctors, nurses, and health managers at the upazila and district levels supported the preparation of remedial action plans based on FDR findings, and interventions were planned accordingly. There were excellent examples of improved quality of care at facilities as a result of FDR. FDR also identified gaps and challenges to overcome in the near future to improve maternal and newborn health.

    Discussion: FDR of maternal and neonatal deaths is feasible in district and upazila health facilities. FDR not only identifies the medical causes of a maternal or neonatal death but also explores remediable gaps and challenges in the facility. FDR creates an enabled environment in the facility to explore medical causes of deaths, including the gaps and challenges that influence mortality. FDRs mobilize health managers at upazila and district levels to forward plan and improve healthcare delivery.

    Place, publisher, year, edition, pages
    San Francisco, USA: Public Library of Science, 2015
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-46535 (URN)10.1371/journal.pone.0141902 (DOI)000364303800035 ()26540233 (PubMedID)2-s2.0-84951309788 (Scopus ID)
    Note

    Funding Agencies:

    UNICEF, Bangladesh through Canadian CIDA (Department of Foreign Affairs, Trade and Development)

    Department for International Development (DFID) & European Commission (EC)

    Available from: 2015-11-18 Created: 2015-11-18 Last updated: 2018-07-02Bibliographically approved
    6. The economic cost of implementing maternal and neonatal death review in a district of Bangladesh
    Open this publication in new window or tab >>The economic cost of implementing maternal and neonatal death review in a district of Bangladesh
    (English)Manuscript (preprint) (Other academic)
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-46533 (URN)
    Available from: 2015-11-18 Created: 2015-11-18 Last updated: 2017-10-17Bibliographically approved
  • 4.
    Biswas, Animesh
    et al.
    Örebro University, School of Health Sciences. Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health Sciences.
    Abdullah, Abu Sayeed Md
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Gifford, Mervyn
    Örebro University, School of Health Sciences.
    Halim, M.A.
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study2016In: F1000 Research, E-ISSN 2046-1402, Vol. 5, article id 2417Article in journal (Refereed)
    Abstract [en]

    Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community.

    Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed.

    Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications. There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment.

    Conclusions: The rural community lacks adequate knowledge on maternal complications. Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.

  • 5.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh; Deptartment of Public Health Sciences, Region Örebro County, Örebro, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Rahman, Fazlur
    Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Deave, Toity
    Centre for Child & Adolescent Health, Health & Applied Sciences, University of the West of England, Bristol, UK.
    Intimate Partner Violence during pregnancy and victim’s perception on miscarriage2015In: International Journal of Public Health Research, ISSN 2381-4837, Vol. 3, no 2, p. 58-63Article in journal (Refereed)
    Abstract [en]

    Introduction: Women who suffer intimate partner violence (IPV) encounter reproductive health problems including miscarriages. IPV in Bangladeshi women is known to be acute socio- medical problem. The aim of the current study was to determine the prevalence of intimate partner violence from the husband during pregnancy and to explore the victims’ perceptions of IPV and miscarriage.

    Methods: Women who were admitted to a sub-district level hospital in Bangladesh due to miscarriage between July and December 2007 were invited to participate. A cross-sectional study was performed using mixed methods. Descriptive statistics were applied to the quantitative data and the qualitative data were analysed using thematic analysis.

    Results: Majority of women aged between 18 – 30 years (68.4%), more than 38% had no education and most of them had low socio-economic conditions. 43 (56.6%) women reported that they had experienced sexual violence in the last four months. 20 (26.3%) women suffered this once a week and 30% (n=23) faced sexual violence twice or more in a week. 29 (38.2%) women believed that current miscarriage was due to their husband’s sexual violence. The women reported that their husband forced sexual intercourse on them and that they were highly controlling over their day-to-day lives.

    Conclusion: Sexual violence during pregnancy is a hidden health problem for women in rural Bangladesh. Education and information need to be made more widely available to improve maternal health and child survival.

  • 6.
    Biswas, Animesh
    et al.
    Örebro University, School of Health Sciences. Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Halim, Abdul
    Centre for Injury Prevention and Research (CIPRB) , Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research (CIPRB) , Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health Sciences.
    Dalal, Koustuv
    Örebro University, School of Health Sciences.
    The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh2016In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 5, no 3, p. 99-103, article id 729Article, review/survey (Refereed)
    Abstract [en]

    Introduction: Maternal and neonatal death review (MNDR) introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals). This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012.

    Materials and Methods: MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31st Dec 2012.

    Results: Overall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT) in the first year (2010). In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011) and 6,622,166 BDT (270,735 $INT, during 2012). The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT).

    Conclusions: Programmatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.

  • 7.
    Biswas, Animesh
    et al.
    Örebro University, School of Health Sciences. Reproductive and Child Health Unit, Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Halim, M. A.
    Reproductive and Child Health Unit, Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health Sciences.
    Rahman, Fazlur
    Reproductive and Child Health Unit, Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Exploration of social factors associated to maternal deaths due to haemorrhage and convulsions: Analysis of 28 social autopsies in rural Bangladesh2016In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, no 1, article id 659Article in journal (Refereed)
    Abstract [en]

    Background: Social autopsy is an innovative approach to explore social barriers and factors associated to a death in the community. The process also sensitize the community people to avert future deaths. Social autopsy has been introduced in maternal deaths in Bangladesh first time in 2010. This study is to identify the social factors in the rural community associated to maternal deaths. It also looks at how the community responses in social autopsy intervention to prevent future maternal deaths.

    Methods: The study was conducted in the Thakurgaon district of Bangladesh in 2010. We have purposively selected 28 social autopsy cases of which maternal deaths occurred due to either haemorrhage or due to convulsions. The autopsy was conducted by the Government health and family planning first line field supervisors in rural community. Family members and neighbours of the deceased participated in each autopsy and provided their comments and responses.

    Results: A number of social factors including delivery conducted by the untrained birth attendant or family members, delays in understanding about maternal complications, delays in decision making to transfer the mother, lack of proper knowledge, education and traditional myth influences the maternal deaths. The community identified their own problems, shared within them and decide upon rectify themselves for future death prevention.

    Conclusions: Social autopsy is a useful tools to identify social community within the community by discussing the factors that took place during a maternal death. The process supports villagers to think and change their behavioural patterns and commit towards preventing such deaths in the future.

  • 8.
    Biswas, Animesh
    et al.
    Centre for Injury Prevention Research, Dhaka, Bangladesh.
    Rahman, Aminur
    Centre for Injury Prevention Research, Dhaka, Bangladesh.
    Mashreky, Saidur
    Centre for Injury Prevention Research, Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention Research, Dhaka, Bangladesh.
    Dalal, Koustuv
    Department of Medical and Health Sciences, Center for Medical Technology Assessment and Division of Social Medicine and Public Health Sciences, Linköping Universtity, Linköping, Sweden.
    Unintentional injuries and parental violence against children during flood: a study in rural Bangladesh.2010In: Rural and remote health, ISSN 1445-6354, Vol. 10, no 1, p. 1199-Article in journal (Refereed)
    Abstract [en]

    Introduction: Violence and injuries are under-reported in developing countries, especially during natural disasters such as floods. Compounding this, affected areas are isolated from the rest of the country. During 2007 Bangladesh experienced two consecutive floods which affected almost one-third of the country. The objective of this study was to examine unintentional injuries to children in rural Bangladesh and parental violence against them during floods, and also to explore the association of socioeconomic characteristics.

    Methods: A cross-sectional rural household survey was conducted in the worst flood-affected areas. A group of 638 randomly selected married women of reproductive age with at least one child at home were interviewed face-to-face using pre-tested structured questionnaires. The chi2 test and logistic regression were used for data analysis.

    Results: The majority of families (90%) were affected by the flood and were struggling to find food and shelter, resulting in the parents becoming violent towards their children and other family members in the home. Cuts (38%), falls (22%) and near drowning (21%) comprised the majority of unintentional injuries affecting children during the floods. A large number of children were abused by their parents during the floods (70% by mothers and 40% by fathers). The incidence of child injuries and parental violence against children was higher among families living in poor socio-economic conditions, whose parents were of low occupational status and had micro-credit loans during the floods.

    Conclusions: Floods can have significant effects on childhood injury and parental violence against children. The improvement of socio-economic conditions would assist in preventing child injuries and parental violence.

  • 9.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh; Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh; WHO Collaborating Centre On Community Safety Promotion, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Rahman, Aminur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman Mashkreky, Saidur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Humaira, Tasnuva
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Rescue and emergency management of a man-made disaster: Lesson learnt from a collapse factory building, Bangladesh2015In: Scientific World Journal, ISSN 1537-744X, E-ISSN 1537-744X, article id 136434Article in journal (Refereed)
    Abstract [en]

    A tragic disaster occurred on April 24, 2013, in Bangladesh, when a nine storied building in a suburban area collapsed and killed 1115 people and injured many more.The study describes the process of rescue operation and emergency management services provided in the event. Data were collected using qualitative methods including in-depth interviews and a focus group discussion with the involved medical students, doctors, volunteers, and local people. Immediately after the disaster, rescue teams came to the place from Bangladesh Armed Forces, Bangladesh Navy, Bangladesh Air Force, and Dhaka Metropolitan and local Police and doctors, medical students, and nurses fromnearbymedical college hospitals and private hospitals and students fromcolleges and universities including local civil people. Doctors and medical students provided 24-hour services at the disaster place and in hospitals. Minor injured patients were treated at health camps and major injured patients were immediately carried to nearby hospital. Despite the limitations of a low resource setting, Bangladesh faced a tremendous challenge to manage the man-made disaster and experienced enormous support from different sectors of society to manage the disaster carefully and saved thousands of lives. This effort could help to develop a standard emergency management system applicable to Bangladesh and other counties with similar settings.

  • 10.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Rahman, F.
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Maternal and neonatal death review (MNDR): A useful approach in identifying appropriate and effective maternal and neonatal health initiative in Bangladesh2014In: Health, ISSN 1949-5005, Vol. 6, p. 1669-1679Article in journal (Refereed)
    Abstract [en]

    Objectives: To identify the effects of Maternal and Neonatal Death Review (MNDR) in terms of improving maternal and neonatal health at the community level in Bangladesh.

    Methods: Both quantitative and qualitative methods were undertaken for collecting data in Kashipur Union, Bangladesh. Death notifications from households, subsequent data collections from a focus-group discussion (FGD), a group discussion (GD) and in-depth interviews (IDIs) were obtained using structured tools and guidelines.

    Results: A total of four maternal deaths, 21 neonatal deaths and 15 still birthswere reported in the MNDR death notification system at Kashipur Union in 2010. Data were presented to local programme managers, who took various initiatives including awareness programmes, pregnancy registration, antenatal care, birth planning, and also the revitalization of a community clinic. The coverage of antenatal care, delivery in clinics, postnatal care and referral of complications increased through the active participation of the community. Community healthcare providers, care recipients and members of the community expressed satisfaction with the quality of maternal and neonatal services. In the preceding two years, maternal and neonatal deaths substantially reduced in Kashipur (in 2011 maternal death = 1, neonatal death = 20, stillbirth = 8; in 2012 maternal death = 1, neonatal death = 8, still birth = 13).

    Conclusions: The MNDR system successfully delivered notification of all maternal and neonatal deaths in the defined area and collected information for the formulation and implementation of specific interventions, which resulted in visible and tangible changes in care-seeking and client satisfaction.

  • 11.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Community Notification of Maternal, Neonatal Deaths and Still Births in Maternal and Neonatal Death Review (MNDR) System: Experiences in Bangladesh2014In: Health, ISSN 1949-5005, Vol. 6, no 16, p. 2218-2226Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to examine the process of community maternal, neonatal deaths and still births notification within the Bangladesh government health structure using the Maternal and Neonatal Death Review (MNDR) system. The study also explored the feasibility and acceptance of community death notification in the MNDR system.

    Methods: The study was under-taken in the Thakurgaon district of Bangladesh during 2010. During the study a mix of both qualitative and quantitative information was collected. A review of the documentation process of community death notification was undertaken and focus group discussions (FGDs) with community members, health care providers and managers in a sub-district were conducted, with in-depth interviews (IDIs) with district heath and family planning managers. Quantitative data were collected from community death notifications in the district during January to December 2010.

    Results: The death notification process was implemented by the government health care system within the Thakurgaon district. Field level health and family planning staff collected maternal and neonatal death information, recorded the death on the notification form and reported back to the Upazila (sub-district of the district) focal point at the Upazila health complex (primary health care centre). Community people were encouraged to share their death information to field level health staff. The health and family planning managers in the district periodically discussed the maternal and neonatal deaths and prepared remedial action plans in high death notified areas. In 2010, 59 maternal deaths, 739 neonatal deaths and 633 still births were reported in Thakurgaon district. District health and family planning departments performed community death notification as part of their routine daily work and integrated these procedures with other field level activities.

  • 12.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The economic cost of implementing maternal and neonatal death review in a district of BangladeshManuscript (preprint) (Other academic)
  • 13.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Halim, Abdul
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Facility Death Review of Maternal and Neonatal Deaths in Bangladesh2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 11, article id e0141902Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore the experiences, acceptance, and effects of conducting facility death review (FDR) of maternal and neonatal deaths and stillbirths at or below the district level in Bangladesh.

    Methods This was a qualitative study with healthcare providers involved in FDRs. Two districts were studied: Thakurgaon district (a pilot district) and Jamalpur district (randomly selected from three follow-on study districts). Data were collected between January and November 2011. Data were collected from focus group discussions, in-depth interviews, and document review. Hospital administrators, obstetrics and gynecology consultants, and pediatric consultants and nurses employed in the same departments of the respective facilities participated in the study. Content and thematic analyses were performed.

    Results: FDR for maternal and neonatal deaths and stillbirths can be performed in upazila health complexes at sub-district and district hospital levels. Senior staff nurses took responsibility for notifying each death and conducting death reviews with the support of doctors. Doctors reviewed the FDRs to assign causes of death. Review meetings with doctors, nurses, and health managers at the upazila and district levels supported the preparation of remedial action plans based on FDR findings, and interventions were planned accordingly. There were excellent examples of improved quality of care at facilities as a result of FDR. FDR also identified gaps and challenges to overcome in the near future to improve maternal and newborn health.

    Discussion: FDR of maternal and neonatal deaths is feasible in district and upazila health facilities. FDR not only identifies the medical causes of a maternal or neonatal death but also explores remediable gaps and challenges in the facility. FDR creates an enabled environment in the facility to explore medical causes of deaths, including the gaps and challenges that influence mortality. FDRs mobilize health managers at upazila and district levels to forward plan and improve healthcare delivery.

  • 14.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Halim, Abdul
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Social Autopsy: A Social Intervention to Generate Community Awareness of Maternal and Neonatal DeathsManuscript (preprint) (Other academic)
  • 15.
    Biswas, Animesh
    et al.
    Örebro University, School of Health Sciences. Centre for Injury Prevention and Research, Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health Sciences.
    Halim, Abdul
    Centre for Injury Prevention and Research, Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health Sciences.
    Social Autopsy of maternal, neonatal deaths and stillbirths in rural Bangladesh: qualitative exploration of its effect and community acceptance2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 8, article id e010490Article in journal (Refereed)
    Abstract [en]

    Objectives: Social Autopsy (SA) is an innovative strategy where a trained facilitator leads community groups through a structured, standardised analysis of the physical, environmental, cultural and social factors contributing to a serious, non-fatal health event or death. The discussion stimulated by the formal process of SA determines the causes and suggests preventative measures that are appropriate and achievable in the community. Here we explored individual experiences of SA, including acceptance and participant learning, and its effect on rural communities in Bangladesh. The present study had explored the experiences gained while undertaking SA of maternal and neonatal deaths and stillbirths in rural Bangladesh.

    Design: Qualitative assessment of documents, observations, focus group discussions, group discussions and in-depth interviews by content and thematic analyses.

    Results: Each community's maternal and neonatal death was a unique, sad story. SA undertaken by government field-level health workers were well accepted by rural communities. SA had the capability to explore the social reasons behind the medical cause of the death without apportioning blame to any individual or group. SA was a useful instrument to raise awareness and encourage community responses to errors within the society that contributed to the death. People participating in SA showed commitment to future preventative measures and devised their own solutions for the future prevention of maternal and neonatal deaths.

    Conclusions: SA highlights societal errors and promotes discussion around maternal or newborn death. SA is an effective means to deliver important preventative messages and to sensitise the community to death issues. Importantly, the community itself is enabled to devise future strategies to avert future maternal and neonatal deaths in Bangladesh.

  • 16.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Halim, Abdul
    Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Experiences of community verbal autopsy in maternal and newborn health in Bangladesh2015In: HealthMed, ISSN 1840-2291, E-ISSN 1986-8103, Vol. 9, no 8, p. 329-338Article in journal (Refereed)
    Abstract [en]

    Introduction: Verbal autopsy in maternal and neonatal deaths is commonly used in developing countries to understand the medical and social causes of death in the community. Bangladesh first undertook a community verbal autopsy program in 2010. This was implemented under the maternal and neonatal death review (MNDR) system.

    Objectives: To know the process of implementation of community verbal autopsy, its acceptability and effect in maternal and neonatal health, Bangladesh.

    Methods: A qualitative study was performed In two districts of Bangladesh in 2011. A review of documents, observations, focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted with health care providers from different systems. Data were analysed using a thematic approach

    Results: Community verbal autopsy was developed in Bangladesh using existing available tools and guidelines. First line field supervisors from health and family planning departments conducted verbal autopsies at the deceased’s home. It has been adopted within the government health system and is able to identify medical and social causes, including delays within the community that are the major contributing factors of maternal and neonatal deaths. Verbal autopsy findings are shared at the Upazila level (sub-district) and these influence the development and implementation of local action plans. Recall bias and hard to reach areas are still challenges to be overcome in the conduction of verbal autopsies.

    Conclusions: The use of community verbal autopsy to identify medical and social causes of maternal and neonatal deaths is possible in an encouraging country context. The Government health system can comfortably conduct autopsies within the community. The findings of autopsy can be an effective tool and can be used by the local health and family planning managers to take the initiative at local level to improve health status of the mother and newborn.

  • 17.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research, Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research, Dhaka, Bangladesh.
    Halim, Abdul
    Centre for Injury Prevention and Research, Dhaka, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Experiences of Community Verbal Autopsy in Maternal and Newborn Health of Bangladesh2015Manuscript (preprint) (Other academic)
  • 18.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh.
    Halim, Abdul
    Centre for Injury Prevention and Research (CIPRB), Dhaka, Bangladesh; Department of Obstetrics and Gynaecology, Kumudini Women’s Medical College, Tangail, Bangladesh.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Maternal and neonatal death review (MNDR): A useful approach to identifying appropriate and effective maternal and neonatal health initiatives in Bangladesh2014Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To identify the effects of Maternal and Neonatal Death Review (MNDR) in terms of improving maternal and neonatal health at the community level in Bangladesh.

    Methods: Both quan- titative and qualitative methods were undertaken for collecting data in Kashipur Union, Bangla- desh. Death notifications from households, subsequent data collections from a focus-group discus- sion (FGD), a group discussion (GD) and in-depth interviews (IDIs) were obtained using structured tools and guidelines.

    Results: A total of four maternal deaths, 21 neonatal deaths and 15 still births were reported in the MNDR death notification system at Kashipur Union in 2010. Data were presented to local programme managers, who took various initiatives including awareness pro- grammes, pregnancy registration, antenatal care, birth planning, and also the revitalization of a community clinic. The coverage of antenatal care, delivery in clinics, postnatal care and referral of complications increased through the active participation of the community. Community health- care providers, care recipients and members of the community expressed satisfaction with the quality of maternal and neonatal services. In the preceding two years, maternal and neonatal deaths substantially reduced in Kashipur (in 2011 maternal death = 1, neonatal death = 20, still birth = 8; in 2012 maternal death = 1, neonatal death = 8, still birth = 13).

    Conclusions: The MNDR system successfully delivered notification of all maternal and neonatal deaths in the defined area and collected information for the formulation and implementation of specific interventions, which resulted in visible and tangible changes in care-seeking and client satisfaction.

  • 19.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman Mashkreky, Saidur
    Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Abdullah, Abu Sayeed Md
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    A manmade urban disaster caused a child death: Experience and lessons learnt from a tragic case study in Bangladesh2015In: International Journal of Current Research, ISSN 0975-833X, E-ISSN 0975-833X, Vol. 7, no 6, p. 17383-17386Article in journal (Refereed)
  • 20.
    Biswas, Animesh
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Rahman Mashreky, Saidur
    Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Deave, Toity
    Centre for Child & Adolescent Health, University of the West of England, Bristol, UK.
    Response to an earthquake in Bangladesh: Experiences and Lesson Learnt2016In: Open Journal of Earthquake Research, ISSN 2169-9631, Vol. 5, p. 1-6Article in journal (Refereed)
    Abstract [en]

    A powerful earthquake occurred in Nepal on 25th April 2015 where the highest measure of the tremor was 7.9 on the Richter scale with a minimum of 6.6. The death toll was around 3000 and thousands were injured in the devastation of the disaster. The earthquake and subsequent earth tremors were also felt in other South East Asian countries including Bangladesh, India and China. Bangladesh was jolted twice by tremors and, although the tremor was not as severe, it was reported to be between 4 and 5 on the Richter scale. Aftershocks over the next few days were also experienced and these ranged around 5 on the Richter scale. In Bangladesh, six lives were lost, and more than 200 people were injured and were taken to hospital. There were also many buildings that collapsed in the mega city Dhaka and its surrounding areas. This study describes the country’s response to the earthquake. This experience and the lessons learnt highlight the importance for national earthquake-proof building regulations and systems to lessen the damage and devastation of any future earthquake.

  • 21.
    Dalal, Koustuv
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Public Health Science, Örebro University, Örebro, Sweden.
    Shabnam, Jahan
    Independent Researcher, Copenhagen, Denmark.
    Biswas, Animesh
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Public Health Science, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Condom using perception among sex-buying men in India2015In: Science Journal of Public Health, ISSN 2328-7950, Vol. 3, no 6, p. 825-829Article in journal (Refereed)
    Abstract [en]

    Aims: The study explores condom use among sex-buying men in India. The study also identifies the level of knowledge regarding the contraction of sexually transmitted diseases (STD’s) and AIDS in relation to condom use.

    Methods: The observational study has designed in where purposively 156 Men were selected who reported that they paid for sex and used a condom during in the last 12 months. Respondents were from 29 Indian states during 2005-2006. Descriptive analysis was performed using SPSS Statistics version 20.0 for window for statistical analysis.

    Results: Majority of sex buyers were found in between 25-34 years age group, middle and higher income group were found more to buy sex than poor group. 77% of the participants used condoms every time they had paid sex with the female partner, majority of men had a good knowledge on AIDS ( 89%) and 78.8% has a believe that condom using can reduce risk of contaminated with HIV.

    Conclusion: Middle aged men in India with a high socio-economic status and educational background have a better perception, knowledge and attitude towards using condom during sex buying and have knowledge on HIV, however low poverty level men are vulnerable and they are expose to contamination with HIV AIDS.

  • 22.
    Halim, Abdul
    et al.
    Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Dewez, Juan Emmanuel
    Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
    Biswas, Animesh
    Örebro University, School of Health Sciences. Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    Rahman, Fazlur
    Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh.
    White, Sarah
    Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
    van den Broek, Nynke
    Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
    When, Where, and Why Are Babies Dying?: Neonatal Death Surveillance and Review in Bangladesh2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 8, article id e0159388Article in journal (Refereed)
    Abstract [en]

    Background: Better data on cause of, and factors contributing to, neonatal deaths are needed to improve interventions aimed at reducing neonatal mortality in low-and middle-income countries.

    Methods: Community surveillance to identify all neonatal deaths across four districts in Bangladesh. Verbal autopsy for every fifth case and InterVA-4 used to assign likely cause of death.

    Findings: 6748 neonatal deaths identified, giving a neonatal mortality rate of 24.4 per 1000 live births. Of these, 51.3% occurred in the community and 48.7% at or on the way to a health facility. Almost half (46.1%) occurred within 24 hours of birth with 83.6% of all deaths occurring in the first seven days of life. Birth asphyxia was the leading cause of death (43%), followed by infections (29.3%), and prematurity (22.2%). In 68.3% of cases, care had been provided at a health facility before death occurred. Care-seeking was significantly higher among mothers who were educated (RR 1.18, 95% CI: 1.04-1.35) or who delivered at a health facility (RR 1.48, 95% CI 1.37-1.60) and lower among mothers who had 2-4 previous births (RR 0.89, 95% CI 0.82-0.96), for baby girls (RR 0.87, 95% CI 0.80-0.93), and for low birth weight babies (RR 0.89, 95% CI 0.82-0.96).

    Interpretation: Most parents of neonates who died had accessed and received care from a qualified health-care provider. To further reduce neonatal mortality, it is important that the quality of care provided, particularly skilled birth attendance, emergency obstetric care, and neonatal care during the first month of life is improved, such that it is timely, safe, and effective.

1 - 22 of 22
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