Md Amzad Hossain University of Virginia Moogdho Mazhab Univeristy of Virginia Study Overview Infectious diseases are a pervasive menace worldwide developing countries in particular account for about one fifth of total neonatal deaths in Bangladesh ID: 1045925
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1. Impact of Community Clinics on Health outcome: Evidence from a Natural Experiment in BangladeshMd Amzad Hossain, University of VirginiaMoogdho Mazhab, Univeristy of Virginia
2. Study OverviewInfectious diseases are a pervasive menace worldwide, developing countries in particularaccount for about one fifth of total neo-natal deaths in BangladeshTo improve health outcomes, Bangladesh created one community clinic for every 6k people that were also within 1/2 hour of walking distance. Did this improve health care? Were the costs worth the investment? Is this a good model that should be continued and expanded upon?Results: Based on preliminary results, immunizations were significantly higher in those populations served by these community clinics.
3. Research QuestionDoes access to community clinics improve Health outcome?Neonatal and under 5 Child Morality LateMaternal Mortality RateImmunization against infectious diseasesNutritional OutcomeOther health outcomes e.g., reproductive healthCost-Benefit Analysis (if data permits)
4. Contributions of this Study Providing evidence based recommendations on the impacts (health outcomes/cost effectiveness)Strengths of the StudyVery large-level community-based interventions Natural experiment where we exploit a exogenous policy change
5. What was the Policy Change?
6. Community ClinicsFormationTwo rooms with drinking water and lavatory facilities, and a covered waiting area. Based on Private-Public Partnership.Funds for building the clinics were provided centrally, but communities had to donate land.The staff and medicine supplies were provided by the government. Each clinic should have at least two staffs: one health assistant and one family welfare assistant.
7. Community ClinicsAvailable services: Maternal & neonatal health care services (ANC/PNC); Integrated Management of Childhood Illness (IMCI); Reproductive Health and FP services; Expanded Program on Immunization (EPI); Nutritional education and micro-nutrient supplements; Health education & counseling; Screening of Chronic Non Communicable Diseases Treatment of minor ailments, common diseases & first aid Establishing referral linkage with higher facilities
8. Community Clinics: Service Outreach
9. DataDifferent rounds of Bangladesh Demographic and Health SurveyAdministrative dataMinistry of Health and Family Welfare, Government of the People's Republic of Bangladesh Revitalization of Community Health Care Initiatives in Bangladesh (RCHCIB)
10. Results: Impact on Immunization (1) (2) (3) (4)VARIABLESReceived BCG VaccineReceived DPT vaccineReceived Polio vaccineReceived Measles Vaccine Aware of community clinic0.00981*0.0161*0.0175**0.0282**(0.00582)(0.00903)(0.00892)(0.0111)Control Mean0.939***0.841***0.845***0.725***(0.00321)(0.00498)(0.00492)(0.00610)Observations7,563 7,555 7,555 7,535Standard errors in parentheses*** p<0.01, ** p<0.05, * p<0.1
11. Work in ProgressImpact on Neonatal and under 5 Child Morality LateMaternal Mortality RatePrevalence of Infectious DiseasesOther health outcomes e.g., reproductive healthCost-Benefit AnalysisCost of the intervention per infant life saved or maternal lives savedHow does it compare in terms of cost effectiveness compared to other interventions ?
12. AcknowledgementsGlobal Infectious Disease Institute (GIDI)Sheetal Sekhri, Department of Economics, UVADavid Garcia, UVA Global Infectious Diseases Institute