Coastal water salinity and hypertension in Bangladesh
- Bangladesh
- In Progress
- October 2023 – October 2027
- Strengthening Primary Healthcare /Multi-Sectoral Interventions / Empowering people & Communities / RCS / Community Engagement Initiatives
Background
Hypertension is the leading cause of premature deaths and a key modifiable risk factor for cardiovascular and cerebrovascular diseases. Drinking saline water has also been associated with health effects, including increased blood pressure, increased urinary protein excretion leading to progressive kidney disease, preeclampsia, and gestational hypertension in pregnant women. Multiple technologies have been implemented to mitigate drinking water salinity. However, due to a lack of coordination, poor involvement of the community, and inadequate management systems, most of these technologies were not sustained. Moreover, people living in coastal areas are not aware of the health impact of drinking saline water. We intend to conduct formative research for the first phase of the targeted research under the NIHR Global Health Research Centre for NCDs and Environmental Change in Bangladesh. The aim of this formative study is to develop a basket of interventions to mitigate drinking water salinity and strengthen NCD services, especially for cardiovascular disease, diabetes, and chronic kidney disease among vulnerable coastal populations.
Aim
The aim of this study is to co-design interventions to address non-communicable diseases related to environmental changes in the coastal areas of Bangladesh.
Study Objective
Research Methodology
This mixed method formative study will be conducted in Koyra Upazila of Khulna district and Assashuni Upazila of Satkhira district in Bangladesh under two work packages (WPs). The duration of this formative study is 18 months.
Under the WP 1, we will conduct literature review for exploring existing interventions of water salinity mitigation technologies, exploring digital health interventions, rapid mapping of the primary health care system and drinking water resources and qualitative assessment of the multiple stakeholders. We will conduct the desk review for the exploring the existing water salinity interventions and GIS mapping of drinking water sources in the selected areas. All primary health care centres in the study areas including Community Clinics and Upazila Health Complexes will be GIS mapped. We will also assess the existing workforce, infrastructure and digital capabilities (use of devices, internet connection), supplies of medicines and equipment. For qualitative assessment, NCD patients, health managers and doctors, government community health workers will be recruited from the Upazila Health Complex of Koyra and Assasuni. We will also interview community leaders, NGO personnel, officials from DPHE, professional societiesand high-level government officials from DGHS. We anticipate to conduct 60 in-depth interviews, 14 key informant interviews and 6 focus group discussions.
Under the WP2, water hydrology and hydrogeology experts will co-design the drinking water salinity technology following series of workshop and meeting with the community as well as experts. Public health experts, and digital health experts will be engaged in developing digital health intervention platform for NCDs. Health promotion toolkits, prevention and management modules for cardiometabolic and kidney disease will be developed.
Expected Impact
Under this study, the intervention model will be co-developed which will contribute in reducing cardiovascular risks through adressing drinking water salinity.
Conclusion
This formative study will shape the full-scale trial intervention for addressing NCDs linked with environmental change in coastal Bangladesh.
