The Urban Health and Demographic Surveillance System: Slums of Dhaka (N & S) and Gazipur City Corporations, Bangladesh.
Why was the urban HDSS set up?
Urban population in Bangladesh was negligible until early 1970s, however currently it is slightly over 30%. According to UN (2014), population of Bangladesh will increase from 158 million in 2014 to roughly 185 million by 2030; bringing the urban population from about 50 million to nearly 83 million. By middle of the century, Bangladesh will be more urban than rural; one third of urban residents will dwell in slum settlements.
High growth of urban population in Bangladesh is mainly through migration of the rural poor. Such rapid urbanization has made the task difficult for the government of Bangladesh to provide employment, housing, health services, education along with other utilities/services.
To improve the health status of the urban people, especially the poor, the Local Government Division, Government of the People’s Republic of Bangladesh has been implementing Urban Primary Health Care Project to deliver primary health-care services through urban local bodies and partner NGOs . The goal of the project is to improve the health status through improved access to and utilization of efficient, effective, and sustainable primary health-care services.
To monitor health care services those being provided by partner NGOs and local bodies of the Urban Primary Health Care Project, icddr,b with support from GoB/Embassy of Sweden/ADB has recently established the Health and Demographic Surveillance System in the selected slums of Dhaka (N & S) and Gazipur City Corporations.
What does it cover now?
The HDSS area covers selected slums of Dhaka (N & S) and Gazipur City Corporations. In the 2015 baseline population census, 121,912 people were living in 31,577 slum households. In Dhaka North City Corporation, 10,297 households were included from Korail slum and 6,278 households from Mirpur slum. In Dhaka South City Corporation, 2,082 households were included from Dhalpur slum and 2,398 households from Shayampur slum. In case of Gazipur City Corporation, 3,190 households were included from Tongi slum and 7,332 households from Ershad Nagar slum.
Since January 2016, the surveillance system has been collecting the following data: pregnancy outcome (livebirth, stillbirth, miscarriage induced and miscarriage spontaneous), death, marriage and divorce, migrations (in-, out-, and internal-), household split and head change, safe motherhood practice and fertility regulation; A geographical information system (not complete yet) of recording geo-locations of household, source of drinking water, toilet, health facilities, educational institutes, mosques/temples, and roads. A list of variables recorded by the HDSS is given in Table 1.
In fact, Field Research Assistants are responsible for monitoring quality of data collects by the female Field Workers. The Field Research Assistants are also responsible to re-interview 2% households per day. After receiving the data from the field, the Computer Programmer edites the data and updates the master database.