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INDEPTH to get a new URBAN HDSS site in Asia

We are delighted to inform the Network that our member centre in Bangladesh, icddr,b has established a new URBAN HDSS sites, the SLUMS OF DHAKA. This is the fourth HDSS site run by icddr,b. The SLUMS OF DHAKA joins the following urban HDSS sites in INDEPTH: Harar HDSS in Ethiopia (Haramaya University), Nairobi HDSS in Kenya (APHRC) and Ouagadougou HDSS in Burkina Faso (ISSP, University of Ouagadougou). Read more about the new HDSS site in Bangladesh.

Summary of Key Findings and Implications – The Slums of Dhaka

The population of Bangladesh is expected to increase from 158 million in 2014 to roughly 185 million by 2030 (UN 2014); three-fourth of that growth will occur in urban areas. It has also been estimated that Bangladesh will be more urban than rural by the middle of this century; more than a third of these urban residents will dwell in slum settlements.

To address the urban health challenge, the Government of Bangladesh with assistance from donors (ADB, Embassy of Sweden, and UNFPA) has been implementing the Urban Primary Health Care Services Delivery Project (UPHCSDP). The ultimateaim of the UPHCSDP is to improve health status of the urban poor, especially women and children. 

The overall objective of the Operations Research (Service Package No. S-4.1) is to set up a Health and Demographic Surveillance System (HDSS) in selected slums of Dhaka (North and South) and Gazipur City Corporations. In fact, the baseline population and socioeconomic census is a pre-requisite where a HDSS is to be set up. The specific objective of the baseline census is to collect data on the following: 

  • Demographic characteristics (each individual)
  • Socioeconomic data (individual and household level)
  • Migration characteristics (household head)

Main findings of the baseline population and socioeconomic census are reported below (see Appendix A: Key Findings- Baseline Population and Socioeconomic Census, 2015-16):

  • 31.6% population was below age 15 years, while 2.6% at age 65 or more years.
  • Family size was 3.8.
  • 82.3% households were headed by males.
  • 91% slums were built on government lands.
  • 67.9% occupants were tenants.
  • 81.6% households possessed one bedroom; mean dwelling area was  119.4 sq. ft.
  • Roof material was mostly tin (94.0%), while about 70% wall material was tin; 88% floor materials were brick/cement.
  • About 95% households used pipe water for drinking; 92% households shared source of  drinking water.
  • 30% households had sanitary latrine flash to sewerage/septic tank, while 60% households had sanitary latrine flash to elsewhere; 90% households shared latrine.
  • Use of electricity as a source of light was universal (99.6%).
  • Slightly over 50% households used gas from gas line for cooking and 35% used  solid fuel; 60% household’s shared cooking place.
  • For about 50% cases, garbage was dumped in open space outside the house, while for 47.2% cases garbage kept at home or dumped in the bin outside the home.
  • For about 40% cases, garbage was collected daily, while for 37% cases garbage was never  collected.
  • Among adult (aged 15 or more years), 36.2% males and 42.3% females did not have any schooling.
  • Among children (aged 6-14 years), 14.1% boys and 8.9% girls did not have any schooling.
  • Among aged 8 or more years, 73.5% males were involved in income generating activities compared to 39.6% among females.
  • Most households had electric fan (96%), and mobile phone (85%). About 60% households had television and khat.
  • Mean household expenditure (total) was Taka 11,981 during last month; about 50% households spent Taka 5,000-9,999 during last month.
  • Mean household expenditure on food was Taka 6,291 during last month; about 65% households spent Taka 5,000-9,999 during last month.
  • Mean expenditure on education was Taka 604 during last month; 58% households did not spend any money on education during last month.
  • Mean expenditure on health was Taka 1,276 during last month; 35% households did not  spend any money on health during last month.
  • Mean saving was Taka 527 during last month; majority of the households (72%) were unable to save any money during last month.
  • For 35% cases, the household heads migrated 20 years or more ago, followed by 14% migrated within the last 5 years; 8.6% did not migrate (since birth).
  • The majority of household heads migrated for work (62.4%), followed by 19.9% migrated to join family.
  • 50% household heads migrated from Dhaka division, while 20% from Barisal division.

For establishing HDSS in a defined geographical area, a baseline population and socioeconomic census is essential, as such data is used as a basis for identifying subsequent events (birth, death, migration, etc.) as well as for adjusting denominator (person-year) for calculating rates/ratios of various population and health indicators. In fact, adjusted baseline census is also used as a sampling frame for designing cross-sectional as well as longitudinal studies. Moreover, HDSS platform provides tools/data for monitoring and evaluating the impacts of various social, economic and health interventions.