Browsing by Author "Vyas, Priyanka"
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Item Role of Spatial Tools in Public Health Policymaking of Bangladesh: Opportunities and ChallengesKim, Dohyeong; Sarker, Malabika; Vyas, PriyankaIn spite of the increasing efforts to gather spatial data in developing countries, the use of maps is mostly for visualization of health indicators rather than informed decision-making. Various spatial tools can aid policymakers to allocate resources effectively, predict patterns in communicable or infectious diseases, and provide insights into geographical factors which are associated with utilization or adequacy of health services. In Bangladesh, the launch of District Health Information System 2, along with recent efforts to gather spatial data of facilities location, provides an interesting opportunity to study the current landscape and the potential barriers in advancing the use of spatial tools for informed decision making. This study assessed the current level of map usage and spatial tools for health sector planning in Bangladesh, focusing on investigating why map usage and spatial tools remained at a basic level for the purpose of health policy. The study design involved in-depth interviews, followed by an expert survey (n = 39) obtained through snowball sampling. Our survey revealed that assessing areas with shortage of community health workers emerged as the top most for basic map usage or primarily for visualization purpose, while planning for emergency and obstetric care services, and disease mapping was the most frequent category for intermediate and advanced map usage, respectively. Furthermore, we found lack of inter-institutional collaboration, lack of continuous availability of trained personnel, and lack of awareness on the use of geographic information system (GIS) as a decision-making tool as three most critical barriers in the current landscape. Our findings highlight the barriers in increasing the adoption of spatial tools for health policymaking and planning in Bangladesh.Item Understanding Spatial and Contextual Factors Influencing Intraregional Differences in Child Vaccination Coverage in Bangladesh(Sage Publications Inc, 2018-11-30) Vyas, Priyanka; Kim, Dohyeong; Adams, Alayne; 0000-0002-1428-1451 (Kim, D); Kim, DohyeongIn Bangladesh, policy discourse has mostly focused on regional inequities in health, including child immunization coverage. Knowledge of local geographical and contextual factors within regions, however, becomes pertinent in efforts to address these inequities. We used the Bangladesh Demographic and Health Survey 2011 to examine factors that influence intraregional differences in vaccination coverage using a multilevel analysis. We found that in spite of the provision of health facilities at each level of administrative governance, only distance to the Upazilla Health Complex was a consistent predictor for each dose of vaccine, highlighting the remote locations of the communities that remain underserved. Our analysis demonstrates the value of subregional analyses that identify the characteristics of communities that are vulnerable to incomplete immunization coverage. Unless specific policy actions are taken to increase coverage in these remote areas, geographic inequities are likely to persist within regions, and desired targets will not be achieved.