RESEARCH
Research is a fast growing activity in LAMB, with capacity related to:
- LAMB’s location in a rural area of significant poverty, with its related health and development issues
- the high quality technical/ research capabilities of LAMB in a rural area
- the integrated structure of LAMB which participates in a continuum of care from village to clinic to tertiary level treatment
- a community health staff with links to households, neighborhoods, villages
- management structure allowing integrating research activities into existing field work and monitoring (though additional staff usually required)
- a wealth of hospital and community health data available, linked to socio-economic status allowing equity analysis
The Information and Research Department (MIS-R) aims to:
- Provide resources and support tools for other parts of LAMB to participate in research and to disseminate research results.
- Improve LAMB’s ability to do research by developing a pool of staff with a variety of research skills.
- Develop systems to monitor ongoing work.
- Ensure that research at LAMB is done in a way that respects subjects.
The research is largely carried out in co-operation with and on behalf of major international research organizations, or is sponsored by Governmental organizations.
(Please see the Web page ‘Programs, Research’ for details of current research programs.)
Research is a major integral activity of all Information Services staff. The team focuses on high quality ethical research addressing health and development problems in rural Bangladesh. As necessary, the Research team is supported and supplemented by hospital and community staff for specific activities.
Research range includes maternal child health, non-communicable and communicable disease, health service access and outcomes, development, and justice issues.
The largest proportion of the research currently carried out is community focused. This involves Research staff spending considerable time on data collection in village communities, followed by collation and quality control of data, data analysis, and presentation, often involving translation.
Other research uses the integrated nature of LAMB to provide linked community and hospital data in integrated databases.
There is a small amount of clinical surveillance, e.g. for influenza, included as data for monitoring and research.
LAMB has presented the outcomes of its research at national and international workshops and conferences. This will be an increasing trend, reflecting the growth of the Research activity.
Qualitative Research
As an example of research into perceptions and decision-making, a fascinating study has begun called: Social Closeness, Helping and Neglect: Examining the Roots of Favoritism in Rural Bangladesh. It will assess how individuals and groups perceive closeness in relationships. It is hoped this will contribute to understanding how to increase collaborative local initiatives which can help overcome exclusion and social barriers to health.
Data Sets
Community. Over thirteen years of compiled data on maternal and under 5 years child health outcomes, including antenatal care, birth attendant, and mortality. Since 2010 there have been socio-economic data linked to those sets. Verbal autopsy data is also available (though variably complete prior to 2003) related to causes of maternal and under 5 deaths, including health care providers seen, place of death, and narratives of family perceptions of cause of death and social factors around the time of death. Financial records of income and expense of 28 union-level community clinics (including fee, government, and donation income) are available since 2008, again with caveats of not all variables of equal data quality, due to varying funder reporting requirements over the years.
Hospital. Discharge diagnoses of approx 7-10,000 patients per year since 2006, including kala-azar, typhoid, tuberculosis and other infectious diseases; indicators for caesarian sections, clinical indicators for pre-eclampsia and eclampsia (obstetric complication), obstetric fistula surgical repair patients; records of system for targeted subsidy allocation;
Health System. There are rich opportunity for operations research related to implementation of rural primary-health-oriented health system, including hospital applying appropriate technology and low-cost care; community-financed community clinics; ethics and values input to training and wholistic clinical practice.
