Non Communicable Disease (NCD)

Due to epidemiological transition, the global disease profile is changing at an astonishingly fast rate with a special pace in low and middle income countries like Bangladesh. This is resulting in the changing pattern of mortality and morbidity causes, which are shifting towards more death and disabilities due to chronic and Non Communicable Diseases (NCDs) than that of communicable and infectious diseases. Along with high death toll, NCDs are also identified as major cause of disability, resulting in disability adjusted life years (DALYs) and quality adjusted life years (QALYs).

There are many risk factors for developing NCDs, some of which are modifiable and some are non-modifiable. The most important modifiable risk factors are for developing NCDs are: unhealthy diet and excessive energy intake, physical inactivity and tobacco use. All these causes are expressed through the intermediate risk factors i.e. raised blood pressure, raised level of blood glucose, abnormal blood lipids, overweight and obesity. All NCDs, combined with its intermediate risk factors, have direct costs of health-care resources and non-medical goods and the services consumed in the treatment of NCDs are enormous for even developing countries let alone developing countries like Bangladesh.

Now if we look at the status of NCDs in Bangladesh, among the top 25 cause of death, 12 are directly due to NCDs. A hospital based registry yields the fact that yearly 84,074 people get admitted by various types of cancer of which 53,710 dies. Among all cancer patients about 24.1% male suffers from lung cancer while 23.7% and 22.8% female suffers from breast cancer and cervical cancer respectively. The prevalence for diabetes (≥ 20 years) is 7% rurally and 14.2% in urban areas. One precursor for developing diabetes is metabolic syndrome and around 3% rural female suffers from metabolic syndrome. On the other hand cardio vascular diseases, hypertension and stroke cause around 12.5% (2.4% heart attack/MI, 3.6% stroke and 6.5% other cardio vascular complications) of the total death. Among rural population (≥ 18 year) 13% (9.8% male and 15.6% female) suffers from hypertension (140/90 mm hg). And annually around 5.9% population gets admitted to hospitals due to various COPD’s (except Asthma) and these various COPD’s causes around 3% of the total death. In case of risk factors, the percentage of sedentary lifestyle is 43% rurally and 90% in urban areas. Among total population (>15 year), 43% uses any kind of tobacco (either smoking or chewing or both) and in rural areas 6.5% females and in urban areas 50% female and 31% male are obese.

Within the above mentioned context, Eminence formulated a forum on November 16, 2009 titled “Non Communicable Diseases Forum (NCD-F)” with the objective to create a platform to ensure the participation of civil society organization (CSO) members, key stakeholders, NCD prevention and control workers, activists, media and mass communication workers and act as the policy advocate to prevent and control NCD in Bangladesh. Eminence works as the secretariat of NCD-F.

Moreover, Eminence is undertaking a project titled ‘Slum Based Non-Communicable Diseases Prevention Intervention’ in Baisteki Slums, Mirpur.

Education - Early Childhood Development (ECD)

The Government of Bangladesh spends 2.4% of GNP on education. This is the lowest percentage in the region. Both India and Nepal spend 3.2% of GNP on education. Pakistan spends 2.7%.

There are an estimated 9 million children aged 3-6 in Bangladesh. Although the most recent Government plans include preschool classes in 80% of government schools by 2015, early childhood development has received little attention. Due to severe budget and capacity constraints, it is not currently a government priority. For that reason, it is also not a donor priority, with a few exceptions.

Social Communication

This is a means to find a way out for critical changes in the socio-political arena. Effective communication enable transmitting message profoundly and bring the expected behavior by time.

Governance

“The process of decision-making and the process by which decisions are implemented (or not implemented)”. Bad governance is accused as the root causes of all evils within our society. Thus, governance is the focal point to reach positive outcomes at all levels.

Water and Sanitation

Interventions need to take place where health burden is high and eventually health and hygiene must be ensured. Inadequate access to safe water and sanitation services, coupled with poor hygiene practices kills millions of human potential.

HIV/AIDS

Effective care intervention and essential prevention measures need to be undertaken to combat HIV/AIDS and tuberculosis. Integrating nutrition and food assistance is essential for care intervention program.

Livelihood & Food Security

Majority population in developing nations including Bangladesh heavily depends on agricultural productions and they spend most of their income for arranging food. This theme targets policy and people with regard to livelihood and food security.

Human Rights

To ensure human dignity irrespective differences, rights are essential, which is enshrined by the United Nations’ declaration on human rights. Reducing the gap between duty bearers and rights claimers is the core area of attention.

Environment and Disaster Risk Reduction

Enhancing people’s participation in the knowledge-sharing process of environment as well as disaster risk reduction

Nutrition

Rates of malnutrition in Bangladesh are among the highest in the world. More than 54% of preschool-age children, equivalent to more than 9.5 million children, are stunted, 56% are underweight and more than 17% are wasted. Although all administrative divisions were affected by child malnutrition there were important differences in the prevalence of the three anthropometric indicators. The prevalence of underweight ranged from 49.8% in Khulna to 64.0% in Sylhet which also showed the highest prevalence of stunting (61.4%) and wasting (20.9%). Despite the high levels, rates of stunting have declined steadily over the past 10 years.

Malnutrition among women is also extremely prevalent in Bangladesh. More than 50 percent of women suffer from chronic energy deficiency and studies suggest that there has been little improvement in women's nutritional status over the past 20 years. As observed for children there were important differences in the prevalence of women malnutrition among administrative divisions. The prevalence of women with a BMI<18.5 kg/m2 ranged from 47.6% in Khulna to 59.6% in Sylhet. Clinical VAD is common among women of reproductive age and during pregnancy. Sub-clinical VAD and anemia are also highly prevalent among pregnant and lactating women. Programs in Bangladesh also need to begin to incorporate components for adolescents and school-age children who will also benefit from improvements in nutrition.

The rapid population growth and resulting high and growing food requirements pose a difficult challenge given the limited availability of cultivable land in Bangladesh. Re-occurring disasters further complicate the stability of food production. Recently the Governments of Bangladesh and interested organizations have started to encourage non-cereal food production and consumption along with food self-sufficiency.


Eminence has been working to improve nutritional status by promoting Infant and Young Child feeding (IYCF) practices, exclusive breastfeeding practice and lifestyle modification.

Maternal and Child Health (MCH)

The Maternal Mortality Ratio (MMR) is the number of women, who die from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. Achieving the 5th Millennium Development Goal by reducing maternal mortality and morbidity remains a great challenge for many low-resourced countries, particularly in South Asia. Bangladesh needs to reduce its MMR by three quarters from 574 per 100,000 live births in 1991 to 147 if it is to meet this target by 2015.

Despite the rise in antenatal care, only one in five women receive the recommended four or more antenatal visits during her pregnancy. Less than one in five deliveries are assisted by a trained birth attendant. As a consequence, 35 women are dying each day in giving child birth. Bangladesh should quickly catch up with respect to indicator 17 in MDG 5 – increase the proportion of births attended by skilled health personnel from 5% to 50% by 2015. This goal, in general, has thrown up some steep hurdles, because it is inextricably linked with complex social and economic factors related to health beliefs and practices, education and poverty. The population is relatively young, with 32% of people aged between 10 and 24 years. This makes the challenge of maintaining the MMR reduction harder, particularly given the widespread practice of early marriage.

Eminence works to improve knowledge, effective service delivery and to influence health sector governance (especially in primary and maternal health services) to help reduce MMR in Bangladesh.

Capacity Building

Institutional and vocational trainings are organized by Eminence to improve the health and developmental situation and IT skills that is needed to interpret and utilize information around us in the best possible way. Need-based trainings are formulated to improve the skills and knowledge of the health and developmental activists. Food Security, Human Rights, Public health, Nutrition, Education are the mandate of the organization.

Ongoing Courses

Eminence is presently conducting training program on Non Communicable Diseases, Breast Feeding, and on Human Rights in a regular basis.

Need Based Courses

Eminence, having own qualified researchers and trainers besides resource persons from reputed institutions, is much capable undertaking “need based” courses. Qualified team of Eminence is committed to produce state of the art training modules for an interactive and enriching training environment for professionals.

Need Based Courses are organized in the areas of Non Communicable Diseases, Water Sanitation, Governance, Nutrition, Food Security, Public Administration, Environmental Health, Human Rights, and Climate Change.

Previous Activities

• Training of Data Collectors for Final Evaluation of Community based risk reduction from 25th August, 2010 to 27th August, 2010.
  
• Training of Data Collectors for the Blue Star Program of SMC (Social Marketing Company) from 11th August, 2010 to 18th August, 2010.
  
• Training of Data Collectors for Alive and Thrive Project from 26th May, 2010 to 1st June, 2010.
  
• Training on Research Methodology and Data Management. (Regular Course)
• Training on Occupational Health for the staff of Save the Children (USA) on 2005
• Training on Adolescent Health for the staff of the Save the Children (USA) on 2005
• Training on Communication Skill Development for Save the Children (USA) on 2004