Recent and current research
The most recent Government survey found that 41% of children under 5 years of age were underweight, and around 40% stunted in their growth. Lack of adequate nutrition, even prior to birth has lifelong consequences limiting the capabilities and potential of the individuals.
Evidence-Based decision-making made possible by accurate data
The research department has developed an incentive-based system for collecting maternity and newborn statistics in 2 core LAMB Upazillas (Parbatipur and Badarganj) began in April of 2019.
LAMB combined existing maternal and child registers and simplified them to calculate the main indicators - ANC, delivery place and type, maternal and newborn outcomes.
Community Data Collectors are given an incentive for every pregnant woman enrolled in the surveillance system. And for every woman with completed data after delivery, and verbal autopsies on maternal and under 5 years old deaths.
The number of deliveries recorded from January to December 2019 (9 months on new system) was 686 more in Parbatipur and 363 more in Badarganj Upazilla compared to the previous 12 months. This suggests that paying per data rather than a monthly stipend increases motivation to include all mothers.
Pilot Research: LAMB Area Poverty Index (LAPI)
LAMB recognised that the poorest families in communities couldn't access healthcare and weren’t aware of help available to them. A LAMB Area Poverty Index (LAPI) questionnaire was created to identify the poorest families, especially those not able to pay for maternity care.
Since August 2019 newly pregnant women in Parbatipur Upazilla were assessed using the effective and simple LAPI questionnaire. Answers to the questions are measured according to perceived impact on economic solvency and ability to pay. And a cut off is set for the poorest mothers. Women under the cut off are issued a card with their picture, personal identifying details, and a list of free facilities available at their local Safe Delivery Unit, or at LAMB Hospital. To date 163 women now have a card for free care. The plan is to further analyse where card holders deliver and validate the system against the gold standard asset survey in the coming year.
A Plus (Azythromycin for Mothers) Research Project
Maternal infection during pregnancy and the puerperium accounts for approximately 10% of the global maternal deaths. Maternal and neonatal deaths from infections are not decreasing compared with deaths from other frequent causes of mortality.1,2
There is a need for innovative, simple and effective interventions that can be scaled up to reduce maternal and neonatal mortality due to infection.
This research asks whether a single oral dose of the antibiotic azithromycin given to women in labor decreases infections.
LAMB is the only hospital in Bangladesh with the required volume of deliveries (2,500 per year) to carry out this research. LAMB also follows protocols so that doctors are administering antibiotics within specific guidelines.
One of LAMB’s key programmes is Improving Health, especially for women and adolescents. This research is targeting pregnant women and newborns with a low cost, easy to administer intervention that could save lives and money.
Virtues and Dilemmas:
In collaboration with the School of Human Evolution & Social Change, Arizona State University. The initial study, involving interviews and trial sessions, looked at the realities for poor people having to choose between personal, family and common good for allocation of their small income.
Prolonged Labor/ Birth Asphyxia:
The rate of mothers dying while giving birth is high in Bangladesh. So is the death rate for babies. This project has looked at the problems of prolonged and obstructed labour, and birth asphyxia, typically occurring in cases of birth at home without the presence of a skilled attendant.
The 3-year project worked in collaboration with the Center for Research on Maternal and Newborn Survival at Emory University. During the research, information gathered from women and their caregivers was used to develop potential preventative aids, such as a pictorial partogram and labor timing tool. These tools to help women and their families make timely decisions regarding care for and referral of mothers and babies underwent preliminary assessment in the latter part of the work.
The project focused on:
Avoidance of misuse of syntocinon
Recognition of prolonged labor
Timely referral-birth preparedness and crisis recognition skill
Management of babies at home