Choudhury et al. BMC Public Health 2012, 12:791
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RESEARCH ARTICLE Open Access
Beliefs and practices during pregnancy and
childbirth in urban slums of Dhaka, Bangladesh
Nuzhat Choudhury1,2*, Allisyn C Moran2,3, M Ashraful Alam2,4, Karar Zunaid Ahsan5, Sabina F Rashid6
and Peter Kim Streatfield2
Abstract
Background: Worldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest
and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal
indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non
governmental organization, works to improve maternal, newborn, and child health in the urban slums of
Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides
baseline information for the Manoshi program.
Methods: This is a descriptive study where data were collected using both quantitative and qualitative methods.
The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers
with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six
in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi
program areas among currently pregnant women who had also previously given births (n = 18); and recently
delivered women (n = 18).
Results: The baseline survey revealed that one quarter of the recently delivered women received at least four
antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of
deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth
attendants. The women mostly relied on their landladies for information and support. Members of the slum
community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and
practices also reinforced this behavior, including home delivery without skilled assistance.
Conclusions: Behavioral change messages are needed to increase the numbers of antenatal and postnatal care
visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas
should also consider interventions to improve social support for key influential persons in the community,
particularly landladies who serve as advisors and decision-makers.
Keywords: Beliefs and practices, Maternal care, Urban-slum, Bangladesh
Background coupled with the growth of urban slums, is likely to have
Global urbanization has become a crucial issue in recent profound implications on its health profile, especially on
years. The urban population is expected to increase by maternal and child health [2]. Maternal and child health
84 percent, from 3.4 billion in 2009 to 6.3 billion in is strongly associated with beliefs and practices around
2050 [1]. Bangladesh, along with other Asian countries, pregnancy and childbirth which has implications for the
has experienced rapid urban growth in the recent health of the child and mother after the birth.
decades [2,3]. This rapid urbanization in Bangladesh, The maternal mortality ratio (MMR) in Bangladesh
was 320 per 100,000 live births in 2001 which decreased
* Correspondence: nuzhat@icddrb.org to 194 per 100, 000 live births in 2010 [4,5]. Bangladesh
1
Research and Evaluation Division, BRAC, Dhaka 1212, Bangladesh
2
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b),
is presently on track to achieve the primary target of
Dhaka 1212, Bangladesh MDG −5 with a goal to reduce maternal mortality.
Full list of author information is available at the end of the article
© 2012 Choudhury et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
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Despite this achievement the condition in urban slums with an infant and currently living in the same slum
is worse compared to urban non-slum areas with respect were randomly selected (n = 672). The qualitative com-
to antenatal care consisting of a medically trained provider ponent explored beliefs and practices around maternal
(62% vs. 85%), delivery at a facility (12% vs. 46%), and care. Thirty six in-depth semi-structured interviews
skilled assistance at delivery (18% vs. 56%) respectively [2]. were conducted in two slums in Dhaka city between
This makes urban health issues, especially of the slum March and October 2007 (Korail and Kamrangir Char).
dwellers, a high priority. It is therefore crucial to address The Korail slum is one of the biggest slums in the centre
maternal health of the urban slum dwellers in Bangladesh. of Dhaka metropolitan area with a population of about
Usually in urban slums, the maternal services are offered 30,000; whereas, Kamrangir Char is in the southern part
at home or in static service delivery sites operated by of Dhaka city and has a population of about 98,000. A
non-governmental organization (NGO) field workers. In total of 18 currently pregnant women who have had
some instances, services are available at clinics or previous live births and 18 women with a recent delivery
dispensaries managed by NGOs, the government or the but who were not currently pregnant were randomly
private sector [2]. selected from program records from these two slum
Keeping this in mind, BRAC (formerly known as the areas to assess the perceptions and beliefs during pregnancy
Bangladesh Rural Advancement Committee), a large and the postnatal period. The study was approved by the
indigenous NGO, initiated a comprehensive Maternal, BRAC internal review committees and icddr,b Institutional
Newborn and Child Health (MNCH) program in the Review Board (IRB). All participants gave informed consent
urban slums, known as Manoshi, in 2007 [6]. The prior to completing the quantitative survey and qualitative
program aims to reduce childbirth and pregnancy related interviews.
morbidity and mortality among women, newborns, and
children in the urban slums of Bangladesh [6,7]. During Data collection and analysis
the inception phase of Manoshi, a baseline survey and a For the baseline survey, trained interviewers collected
qualitative research study were conducted in Dhaka city information on reproductive history, knowledge and
slums [6,8]. As a part of formative research, the qualitative perception on pregnancy, delivery, and post-partum care.
data collection explored perceptions around maternal care The survey data were analyzed using SPSS v 13 and Stata
while the quantitative study provided baseline information v 9.1. For the qualitative component, three interviewers
on key indicators. Other large scale national surveys, such trained in social science interviewed the respondents.
as the Demographic and Health Surveys do not disaggre- Beliefs and practices relating to various aspects of mater-
gate data by urban slum and non-slum areas. However, nal care were explored by engaging in conversations with
the findings of this paper will be used to compare the key the respondents using a semi-structured interview guide.
indicators with the endline data to assess the program The topics of discussion included: perceptions and
effectiveness and to garner support for the expansion of practices pertaining to antenatal care, postnatal care, and
such programs. The objective of this paper is to describe delivery care, care practices during pregnancy, birth
baseline information on different aspects of maternal care. preparedness as well as the persons influencing maternal
This paper is the second of its kind in a part of two papers care decisions. The research team reviewed the tran-
on the Manoshi program on care practices. The first paper scripts to develop a code list for the topics related to the
outlined the newborn care practices and was published research questions. Codes were applied manually to the
elsewhere [9]. transcripts by the interviewers [10]. The text pertaining
to the codes were organized in a matrix and translated
Methods into English.
This study utilized both quantitative and qualitative
methods [8,9]. The quantitative and qualitative parts Results
were carried out concurrently but independently. The The background characteristics of respondents in the
quantitative component employed a cross sectional baseline baseline survey are presented in Table 1. Ninety-three
survey in the six Manoshi program slum areas (Gulshan, percent of the respondents were married before reaching
Shyampur, Kamrangir Char, Shabujbag, Mohammadpur, the age of 20, having a median age of 16 years during
and Uttara) between August and October 2007. The marriage. The majority of the respondents (81%) were
sampling strategy followed a two-stage random cluster between 15 and 29 years. Half of the respondents
design. Each cluster was comprised of 175 households reported as receiving education either from formal or
(an identifiable segment of a patty/block). Fifty clusters religious schools. More than half of the respondents
from each area were selected by probability proportional (52%) were living in the slum for two years or less at the
to the size in terms of the slum population. In the time of the interview. Regular exposure to the electronic
second stage, from each cluster, around twelve women media, such as the television, was widespread among the
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Table 1 Baseline characteristics of the sample from the Table 2 Percent distribution of women who had a live
cross sectional survey birth in the last one year by antenatal care, delivery care
Characteristics n % and postnatal care for the most recent birth
Electricity in household 601 89.4 n % CI
Piped drinking water in household 376 56 Received any antenatal care during 507 75.4 72.0-78.5
the last pregnancy
Ever attended school/madrassa 361 53.7
Received 4+ antenatal care during 179 26.6 23.2-29.9
Religion (Islam) 663 98.7 the last pregnancy
Marital status (currently married) 663 98.7 Place of last antenatal care visit
Currently employed 116 17.3 No antenatal care visit 165 24.6 21.2-27.8
Number of children ever born Home 16 2.4 1.2-3.5
1–2 396 58.9 Birthing Hut 37 5.5 3.7-7.2
3–4 189 28.1 Government hospital 101 15.0 12.3-17.7
5 or more 87 13.0 NGO 271 40.3 36.6-44.0
Total N=672 100.0 Pharmacy/Chamber/Private clinic 82 12.2 9.7-14.6
Services received during antenatal care visit*
respondents; 86 percent of respondents reported watching Height/weight measured 293 43.6 39.8-47.3
television at least once a week. Blood pressure measured 183 27.2 24.0-30.7
Blood tested 77 11.5 9.2-14.0
Antenatal care
Findings from the baseline survey revealed that three of Urine tested 121 18.0 15.2-21.0
every four women (75%) had received at least one Abdomen examined 409 60.9 57.1-64.4
antenatal care visit for the most recent birth, with 27 Internal examination 5 .7 0.3-1.7
percent of women having reported as receiving four or Ultrasonic test 95 14.1 11.7-16.9
more antenatal care visits (Table 2). In-depth interviews Tetanus vaccination 61 9.1 7.1-11.4
suggested that most of the women attended antenatal
Iron supplementation 78 11.6 9.4-14.2
care to confirm pregnancy either via urine test or physical
examination. Some women reported as not routinely Place of delivery, Home 567 84.4 81.1-86.7
seeking antenatal care at facilities as they did not see an Assistance during delivery
urgent need for it, except to reconfirm the pregnancy. Self 6 .9 0.1-1.6
Relative/Neighbour 42 6.3 4.4-8.0
Birth preparedness Untrained TBA 390 58.0 54.2-61.7
In the Manoshi program, birth preparedness included
Trained TBA 135 20.1 17.0-23.1
selecting a skilled birth attendant, arranging articles
needed for safe birth, identifying where to go in case of BRAC health worker 8 1.2 0.3-2.0
emergencies, and arranging money and transport during Midwife/Family Welfare Visitor 40 5.9 4.1-7.7
pregnancy. In the in-depth interviews, the respondents MBBS doctor 51 7.6 5.5-9.5
reported having almost no concept of birth preparedness. Received any postnatal care during 160 23.8 20.7-27.1
Many were fatalistic in attitude and placed their trust and the last pregnancy
faith in Allah in the event of an emergency. Total N=672 100%
*Multiple response.
‘We are poor people, Allah will help us; He will never
give us any burden which goes beyond our capacity’ get a loan or borrow money from their landlady if needed.
(Pregnant woman, 26 years old). The women also stated as relying on their landladies for
advice and suggestions during pregnancy.
‘I did not have any plan; I knew that in the event of
the delivery pain, I would be able to call any of the Birth attendants and privacy
neighbours who would bring a ‘dai’ (Traditional birth In the baseline survey, 84 percent of women reported
attendant) for delivery’ (Recently delivered women, giving birth at home assisted by traditional birth atten-
23 years old). dants (TBA) (Table 2). In the in-depth interviews,
women reported widespread preference for TBAs. TBAs
The majority of respondents reported as not saving were low-cost and women preferred to receive care in
money in case of an emergency, citing that they would the home, unless there was a perceived complication.
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‘Dai is less expensive, they are from our same locality All the women reported that they were aware that they
then why should I go to hospital for delivery’ (Recently should not do heavy work for up to 40 days after delivery.
delivered woman, 22 years old). But in reality, this varied depending on support within
the household and place of delivery. Many women
Women reported as having a preference for giving reported initiating normal activity within 10 to 12 days
birth in their natal home, to ensure care and comfort after delivery.
from their families. However, this was not often feasible,
and women often gave birth in the slums. Due to space Influential people in the slum
limitations in the slum setting, each dwelling is usually In the in-depth interviews, the landlady emerged as an
not more than one room. During delivery, male and influential figure. Landladies typically owned large
younger family members typically had left the dwelling compounds within the slum and rented out single rooms.
to give privacy to the delivering woman. However, Slum households are typically comprised of nuclear
women reported that it was difficult to retain this privacy families, with extended family members remaining in
after the delivery, as family members needed to return. native rural areas. Women reported relying on their
landlady for pregnancy and delivery-related decisions,
Postnatal care and for credits/loans if needed.
In this study, postnatal care is defined as a visit to a health
facility or a health worker coming to the house to check on “I know a local dai, but do not contact her unless my
the woman and her baby after the birth. In the baseline Bariwali (landlady) introduces me to the local dai.
survey, about one quarter (24%) of the women reported Bariwali is very helpful, in case of emergency I can
receiving postnatal care, with five percent reported four or borrow money from her because she has her own
more postnatal care visits. In the in-depth interviews, money and can manage giving money without asking
women reported remaining on the floor, usually on a mat her husband” (Pregnant woman, 26 years old).
after the birth of the baby until the TBA cut the umbilical
cord and delivered the placenta. The woman was then Landladies were perceived to be socially empowered,
washed, especially the lower part of the body, by the TBA as they had resided in the slum for long periods of time
or close relatives such as the mother or sister-in-law. The and had knowledge of reliable and available TBAs to assist
TBA usually helped the woman for the first day after birth; with birth. In fact, the landlady’s name was widely used to
then the woman relied on family members and/or her identify the respondent’s household.
landlady. Sixteen out of 18 women who had recently deliv-
ered reported that they did not receive any postnatal care. Discussion
These women reported not seeking care because they did There is a difference in maternal health indicators for
not perceive any major health problems. Minor headaches urban slum areas when compared with the urban non
and body aches were part of the delivery procedure which slum areas. It is therefore essential to understand mater-
did not create demand for seeking postnatal care. nal health behaviours and practices in an effort to im-
prove maternal health indicators. This study combines
Restrictions during post-partum period both quantitative and qualitative methods to understand
In-depth interviews revealed that women’s diets were the maternal care practices to inform the comprehensive
rigidly controlled after birth. Women were advised to MNCH program- Manoshi.
eat dry food which was cooked without water, and rice Findings from this study are similar to maternal
with mashed potato and black cumin seed. These foods practices and behaviours in the rural areas of Bangladesh
were believed to keep the stomach of a woman cool and [11-16]. Although there is increased access to health
initiate the production of breast milk. Most of the services in urban areas (including pharmacies, and
women in the in-depth interviews mentioned that after private and public health facilities), women in this study
giving birth, the flesh inside became flaccid and soft and maintained practices and behaviours similar to those in
therefore, the mother must avoid ‘hard’ foods. Women the rural areas. This may be due to the fact that these
reported that family members, primarily elderly women women had only been living in the urban slum on an
or landladies advocated for traditional practices with average of two years and that these behaviours have been
regard to food restrictions. deeply ingrained, culturally accepted, and difficult to
change over the years. It is believed that cultural concerns
“It is good to follow the elderly women in taking food in South Asia could be important barriers for seeking
especially after the delivery, this restriction at least antenatal care [12,13]. Other research findings from South
will not be harmful for me” (A recently delivered Asia and Africa suggest that community health workers
woman, 19 years old). (CHWs) and women’s group influence care-seeking
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practices [11,16-18]. Despite common cultural barriers, provide social support in future programs. As this study
women in other studies are more likely to seek antenatal was conducted during Manoshi’s inception phase, these
care after a home visit during pregnancy by a CHW [18]. workers were not yet perceived to be influential.
In the Hala trial in Pakistan, women with at least one home There are some limitations that need to be considered
visit by a CHW during pregnancy reported increases in use when interpreting the findings. The findings are based
of antenatal care and facility-based delivery [17]. Behaviour on self-reported maternal care practices, and may there-
change, however, may take time and interventions should fore differ from actual practices. In addition, we did not
run for an appropriate length of time to promote consistent include primi gravidas in the qualitative part and were
information [19]. Several studies have indicated that unable to capture their beliefs and perceptions. The
training and supervision of CHWs are critical for success- baseline survey included women with children under the
ful implementation [20]. Thus, training CHWs should be age of one year who might not have delivered in the
a key strategy for the Manoshi program to improve the study area and therefore the results may not reflect
demand for routine care, promoting birth preparedness, behaviours of all women in the slums of this study.
and the uptake of the recommended number of antenatal However, given the consistency of findings in both the
care and postnatal care visits. quantitative survey and qualitative interviews, we are
Key findings of this study point to issues with regard confident that the findings represent actual practices
to privacy and lack of space during delivery. In South and are representative of the urban slum maternal care
Asia including Bangladesh, the mother and the child are practices.
usually isolated immediately after delivery due to beliefs Our findings on maternal care behaviours and
about pollution and impurity linked to the delivery practices have implications for the design of slum-based
process. In addition, after delivery, the mother and baby maternal and neonatal child health programs for
are considered to be in a vulnerable state [13,21-23]. Manoshi. Our research findings are quite similar with
Confinement of the mother and baby is believed to Urban Health Survey 2006 for most of the maternal
protect them from exposure to disease and evil spirits. health indicators [2]. This study demonstrated that
The period of seclusion and confinement varies across although maternal practices are similar in the urban slum
regions [13,24]. In many regions, the confinement period and rural areas, women have less social support in urban
can last up to 40 days. In this study, women were found slums. Women received assistance from traditional birth
to have desired privacy during delivery as well as after attendants and/or landladies during delivery. Programs in
the birth, but could not maintain this practice due to urban areas, especially in urban slums, should consider
space constraints. The Manoshi program has initiated a interventions to include training and behavioral change
‘delivery centre’ in each slum to ensure access to clean messages for women like landladies to ensure proper
delivery assisted by trained TBAs as well as privacy maternal care throughout the pregnancy, delivery and
during delivery and after birth. This approach will be postpartum periods.
evaluated at the end of the program to determine
acceptability, feasibility, and cost-effectiveness as a strategy
to expand to other urban slum settings.
Conclusions
Behavioral change interventions to increase the numbers
Social support is an important element for pregnancy
of antennal care and postnatal care visits, knowledge of
and delivery. A recent study summarising a number of
birth preparedness, and ensuring skilled care and privacy
Manoshi formative research studies demonstrated strong
at delivery are needed. Programs in urban slum areas
social networks for responding to social and economic
should also consider interventions to improve support
problems, but less effective social networks for health
for women during this vulnerable period, particularly
related problems [6]. In rural areas, female family
landladies who provide financial and social support.
members were found to provide extensive support
These interventions may improve maternal care practices
during pregnancy, delivery and in the care of the mother
in urban slum settings.
and newborn after birth. In the present study we found
that slum women often live in nuclear families, often at
Competing interests
great distances from their female family members and
The authors declare that they have no competing interests.
that is why women relied heavily on their landladies for
support. Landladies played a significant supportive role
Authors’ contributions
in terms of helping women with loans and/or credit, NC, ACM, MAA and SFR conceived of the qualitative study, participated in its
participating in childbirth, and helping the woman and design, coordination, data collection, and data analysis. ZAK and PKS
child during the postpartum period. In future programs, participated in design of the quantitative study, coordination, data collection
and data analysis. NC, ACM and MAA drafted and finalized the manuscript.
they could be targeted for health education messages. In ACM was also involved in editing of the manuscript. All authors read and
addition, CHW, such as BRAC’s Shasthya Shebika could approved the final manuscript.
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Acknowledgements 15. Chakrabarty N, Islam MA, Chowdhury RI, Bari W: Utilization of postnatal
The Manoshi project was developed by BRAC and was funded by Bill and care in Bangladesh: evidence from a longitudinal study. Health Soc Care
Melinda Gates Foundation for five years (2007–2012). BRAC Research and Community 2002, 10(6):492–502.
Evaluation Division and icddr,b provided technical assistance to the project 16. Syed U, Asiruddin S, Helal MS, Mannan II, Murray J: Immediate and early
through research support. We especially acknowledge all the research postnatal care for mothers and newborns in rural Bangladesh. J Health
assistants from BRAC and icddr,b who were involved in the formative Popul Nutr 2006, 24(4):508–518.
research and baseline survey for Manoshi. Special thanks to Asia Alam 17. Bhutta ZA, Soofi S, Cousens S, Mohammad S, Memon ZA, Ali I,
Chowdhury for her editorial support. Feroze A, Raza F, Khan A, Wall S, Martines J: Improvement of perinatal
and newborn care in rural Pakistan through community-based
Author details strategies: a cluster-randomised effectiveness trial. Lancet 2011,
1
Research and Evaluation Division, BRAC, Dhaka 1212, Bangladesh. doi:10.1016/S0140-6736(10)62274-X.
2
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 18. Wade A, Osrin D, Shrestha BP, Sen A, Morrison J, Tumbahangphe KM,
Dhaka 1212, Bangladesh. 3Department of International Health, Johns Hopkins Manandhar DS, Costello AML: Behaviour change in perinatal care
Bloomberg School of Public Health, Baltimore, MD, USA. 4Sydney School of practices among rural women exposed to a women's group intervention
Public Health, The University of Sydney, Sydney, Australia. 5South Asian in Nepal. BMC Pregnancy Childbirth 2006, 6:20.
Human Development Sector, World Bank, Dhaka, Bangladesh. 6James P. 19. Hill Z, Taiwah-Agyemang C, Manu A, Okyere E, Kirkwood BR: Keeping
Grant School of Public Health, BRAC University, Dhaka, Bangladesh. newborns warm: beliefs, practices and potential for behaviour change in
rural Ghana. Trop Med and Intl Health 2010, 15(10):1118–1124.
Received: 15 February 2012 Accepted: 12 September 2012 20. Haines A, Sanders D, Lehmann U, Rowe AK, Lawn JE, Jan S, Walker DG,
Published: 17 September 2012 Bhutta Z: Achieving child survival goals: potential contribution of
community health workers. Lancet 2007, 369:2121–2131.
21. National Institute of Population Research and Training (NIPORT), Mitra and
References Associates, Macro International.BDHS: Bangladesh Demographic and Health
1. United Nations: World Urbanization Prospects: The 2009 Revision. New York: Survey 2007, Dhaka; 2009.
United Nations; 2010. 22. Rashid SF, Kal D, Stolen Babies & ‘Blocked Uteruses: Poverty & Infertility
2. NIPORT, MEASURE Evaluation, ICDDR,B, ACPR: 2006 Bangladesh Urban Health Anxieties among Married Adolescent Women Living in a Slum in Dhaka,
Survey. Dhaka, Bangladesh and Chapel Hill/USA: NIPORT, MEASURE Bangladesh. Anthro & Med 2007, 14(2):153–166.
Evaluation, ICDDR,B and ACPR; 2008. 23. Choudhury N, Ahmed SM: Maternal care practices among the ultra poor
3. Uzma A, Underwood P, Atkinson D, Thackrah R: Postpartum health in a households in rural Bangladesh: a qualitative exploratory study. BMC
Dhaka slum. Soc Sci Med 1999, 48:313–320. Pregnancy Childbirth 2011, 11:15.
4. NIPORT, ORC Macro, Johns Hopkins University, and ICDDR,B: Bangladesh 24. Blanchet T: Women, pollution and marginality: meanings and rituals of birth
Maternal Health Services and Maternal Mortality Survey 2001. Dhaka, in rural Bangladesh. Dhaka: University Press; 1984.
Bangladesh and Calverton/Maryland, USA: NIPORT, ORC Macro, Johns
Hopkins University, and ICDDR,B; 2003.
doi:10.1186/1471-2458-12-791
5. USAID, Australian Government Aid program, UNFPA, MEASURE Evaluation,
Cite this article as: Choudhury et al.: Beliefs and practices during
ICDDR,B, and NIPORT: Bangladesh maternal mortality and health care survey pregnancy and childbirth in urban slums of Dhaka, Bangladesh. BMC
2010: Summary of key findings and implications. Dhaka, Bangladesh: USAID, Public Health 2012 12:791.
Australian Government Aid program, UNFPA, MEASURE Evaluation, ICDDR,B,
and NIPORT; 2011.
6. Ahmed SM, Hossain A, Khan MA, Mridha MK, Alam MA, Choudhury N,
Sharmin T, Afsana K, Bhuiya A: Using formative research to develop MNCH
programme in urban slums in Bangladesh: experiences from Manoshi
BRAC. BMC Pub Health 2010, 10:663.
7. Khan MA, Ahmed SM: The “Birthing Hut” facilities of MANOSHI: A two-part
paper, exploring the inception and post-inception phases of Urban Delivery
Centres MANOSHI, Working Paper No. 7. Dhaka: Research and Evaluation
Division, BRAC and ICDDR, B; 2009. http://www.icddrb.org/publication.cfm?
classificationID=62&pubID=10634.
8. Ahsan KZ, Streatfield PK, Ahmed SM: Manoshi: Community health solutions in
Bangladesh: Baseline survey in Dhaka urban slums 2007, Scientific report no.
104. Dhaka: Bangladesh: ICDDR,B and BRAC; 2008.
9. Moran AC, Choudhury N, Zaman NU, Karar ZA, Wahed T, Rashid SF, Alam
MA: Newborn care practices among slum dwellers in Dhaka Bangladesh:
a quantitative and qualitative exploratory study. BMC Pregnancy Childbirth
2009, 9:54.
10. Keenan KF, Teijlingen E, Pitchforth E: The analysis of qualitative research
data in family planning and reproductive health care. J Family Plan
Reprod Health Care 2005, 31(1):40–43.
11. Morrison J, Osrin D, Shrestha B, Tumbahangphe KM, Tamang S, Shrestha D, Submit your next manuscript to BioMed Central
Thapa S, Mesko N, Manandhar DS, Costello A: How did formative research and take full advantage of:
inform the development of a women’s group intervention in rural
Nepal? J Perinatol 2008, 28(Suppl):S14–S22.
• Convenient online submission
12. Bernett S, Azad K, Barua S, Mridha M, Abrar M, Rego A, Khan A, Flatman D,
Costello A: Maternal and newborn-care practices during pregnancy, • Thorough peer review
childbirth, and the postnatal period: a comparison in three districts in • No space constraints or color figure charges
Bangladesh. J Health Popul Nutr 2006, 24(4):394–402.
• Immediate publication on acceptance
13. Goodburn EA, Gazi R, Chowdhury M: Beliefs and practices regarding
delivery and postpartum maternal morbidity in rural Bangladesh. Studies • Inclusion in PubMed, CAS, Scopus and Google Scholar
in Family Planning, The Pop Council 1995, 26(1):22–32. • Research which is freely available for redistribution
14. Maloney C, Aziz KMA, Sarkar PC: Beliefs and fertility in Bangladesh,
Monograph series 2. Dhaka: International Centre for Diarrheal Disease
Research, Bangladesh; 1981. Submit your manuscript at
www.biomedcentral.com/submit