A substantial body of evidence exists to answer many of the questions asked by policymakers and development partners in low and middle income countries (LMIC). However, evidence is often scattered, inaccessible, and rarely presented in a form that provides an indication of the quality of evidence. Systematic reviews in all sectors have the potential to contribute to improving the evidence base from which policies and interventions can be developed and implemented. The principles that underpin the international effort to prepare and use systematic reviews of controlled trials for evaluating clinical practice, particularly in high-income countries can be similarly applied to the challenges of poverty reduction and development in LMIC. more…

The recent debate in Washington about birth control being mandated for coverage by employers or by health insurance as well as the 101st celebration of International Women’s Day makes me feel empowered to write about a women’s health related issue that I am experiencing now as part of life in the widow-hood.

When the Colonel died in August, I was surprised by how many friends were quick to mention that I would have sex again but with other people. Protocol-wise, there is little written about what to say to the recently widowed but this seems to fall outside of Oretha B. Schwartz’s “Service Etiquette” 4th edition, which suggests the rather limited conversation: “I am so sorry for your loss,” to which the response is, “Thank you.” more…

A report released by the World Bank on 29 February highlighted that, despite the global recession, the number of people living on $1.25 per day has reduced across all regions of the world. For South Asia in general the bank reported that the poverty rate fell from 61 percent to 39 percent between 1981 and 2005 and fell a further 3 percentage points between 2005 and 2008. The proportion of the population living in extreme poverty is now the lowest since 1981. The world has achieved the Millennium Development Goal 1 (MDG 1) to reduce extreme poverty by half, years ahead of the 2015 deadline, despite the economic downturn and slow recovery in the United States and Europe. more…

Systematic reviews have something of an image problem. To the uninitiated, they can be considered too effete because they run on for hundreds of pages, with lots of forest plots and risk of bias calculations. And what is a GRADE table? I know that I generally head straight for the conclusion section of the abstract—does it work? How much do I take? Of course, I have drunk the Kool Aid and come clean about my status as a Cochrane reviewer yet I am always aware of the reaction of one of my senior and greatly esteemed colleagues who upon hearing of me bringing in a grant to develop a centre for systematic review at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) cornered me and demanded, “Is this how you use your powers? For bad!” more…

Martin Luther King day provides an opportunity to reflect on the civil rights movement as well as the broader issue of inequalities that face every nation. Because King’s “I have a dream” speech is so ubiquitously placed in two generations of middle and high school education, it is hard for many people my age or younger to remember that during his life he was a controversial figure. King espoused the Gandi’s non-violent approach and started what can be considered the original “occupy” movement. more…

This week I have had the pleasure of attending a workshop in Honolulu with the centre for excellence for disaster management and humanitarian assistance (CoE-DMHA). The CoE is interested in thinking about resiliency and support for relief and rebuilding from a multi-lateral perspective. With its partners from the Oak Ridge and Argonne National Laboratories, the CoE is polishing up its efforts to develop a system by which all players in a disaster can share and receive information. more…

On 17 October, I was fortunate to attend a daylong seminar at BMA House on “the health and security perspectives of climate change.” Uniquely, this programme pulled together medical and military professionals along with climatologists, zoologists, and politicians. The morning focused on threats to global climate, health, and security whereas the afternoon sessions focused on the way forward.

The health risks from climate change might seem more obvious than the security risks, but what I learnt is that situations in Darfur and Somalia are the perfect storm examples of the intersection of climate change, health and security. In Bangladesh, if we project forward to a world without improvement and with increased violent weather and rising sea levels, we will encounter a situation in which some 75 million Bangladeshi people (half of the population) are at risk of displacement along with the stability of the nation despite long term excellence in disaster planning and management. more…

¡Hola! from Madrid where the 19th Cochrane Colloquium was hosted last week by the IberoAmerican Cochrane Centre. The theme of this year’s meeting was “scientific evidence for healthcare quality and patient safety.” As all of us – at one time or another – are patients of the healthcare system, the synthesis of interventions to reduce adverse events that impact health and healthcare has universal importance. More than 2300 Cochranites attended the colloquium this year, which featured 126 meetings, 84 workshops, and 514 posters. There was definitely something for everyone; as a health systems scientist, the plenary session that had me rapt was on Friday morning and about “Using evidence to improve health systems.” more…

It is hard to follow up from my last blog about the Colonel’s unexpected death on the streets of Jakarta so rather than charging into a vaguely academic or policy related blog, I want to pause and give thanks. Thank you to everyone who posted a comment to the blog for your willingness to so publicly share your thoughts. Also, I wish to express my awe and thanks to the shockingly large number of BMJ readers who tracked down my e-mail address and then wrote to me privately. You have shared your experience, prayers, and strength with me and the boys. All of which has been helpful in terms of getting my head around what happened and in terms of thinking about how to move forward. Thank you. more…

On 11 June 2011, 44 schoolboys died when the truck they were travelling in flipped into a canal in Chittagong, Bangladesh. The boys were from three villages and were riding in an open truck on their way back from a football competition. I was haunted by the image of the devastated village parents, who no doubt had joyously sent their sons to a day of sports competition.

On 13 August 2011, eminent film maker Tareq Masud, and Mishuk Munir, ATN news chief executive officer (CEO), died along with three friends in a car crash outside of Dhaka. The loss of such talent is keenly felt by all in Bangladesh. more…