Matlab (Bangladesh)

Matlab is a former thana of the Chandpur district of Bangladesh, situated 55 km southeast of Dhaka. its total area in regards to the HDSS is 184 km2. Three seasons are typical: monsoon, cool-dry, and hot-dry, and the climate is sub-tropical. It is subject to annual flooding due to its position within low-lying flatlands. Average annual rainfall is approximately 2159mm, concentrated mainly during monsoon season (June to September). ==Inception, structure and procedure==

During its inception, 132 villages were included and 101 villages were added in 1968. Traditional Birth Attendants (dais, elderly illiterate women mostly) used to work to detect and record data of the vital events through weekly household visit. Health Assistants (HA) along with the Dais visited households every six weeks with standard registration forms. In 1977, major modification of field structure and programme activities were made, leading to the exclusion of 84 villages and the retention of 149 villages. The Family Planning and Health Services Project was then launched in 70 villages with the remaining 79 villages not included intentionally to serve as a comparison area. The Dais of both treated areas and comparison areas were eventually replaced by female Community Health Workers (CHW). In 1993, due to river erosion, 7 villages within the comparison area disappeared, reducing the project to 142 villages. However, the majority of villagers resettled within nearby villages still participating in the HDSS. A typical village in Bangladesh consists of several baris – groups of houses centered around courtyards – which function as economic and social units. The HDSS system covers all houses within these areas. Data is collected from individuals who are regular residents (either permanent or those who have resided continuously within these areas for at least 6 months). Birth, death, and migrations have been recorded since 1966, and the recording of marriages and divorces began in 1975. Recording of split households and changes in family type began after the 1993 census. Data is collected within treatment and comparison areas through the Record Keeping System (RKS). The health data currently covers married women of reproductive age (data includes reproductive status, contraception, tetanus, etc.) and children under 5 (immunization, diarrhea, acute lower respiratory infection, breastfeeding, etc.). The Geographical Information System (GIS) was introduced in 1993. In HDSS's administrative term, three projects are running in the area: DSS, RKS and GIS. The system also collects socioeconomic data. ==Field procedures==

a) Initial census and regular update rounds - CHWs collect data through monthly household visits. They also provide health services to mothers and children in treatment areas, while in comparison areas they simply advise residents to visit government health facilities. b) Continuous surveys - CHWs enquire about demographic events which have occurred since their last visit. Special forms and record keeping books (RKBs) are used to keep health data. c) Supervision and quality control - field research assistants supervise CHWs, while overall field activities are supervised by field managers. ==Priority research area==

Fertility, reproductive health, maternal and child health, child morbidity and causes of death, health equity, and climate change. ==Impact of Matlab on public health==

The development of oral rehydration saline. Family planning: the introduction of CHWs in 1970 greatly increased contraceptive use and reduced fertility. These methods were later adopted internationally. Immunization: Matlab showed that 63% of childhood deaths were due to vaccine-preventable disease and could be prevented by effective immunization campaigns. Child health and family planning: child mortality has been reduced by about 75% within the last 25 years due to the combined efforts of childhood health and family planning programmes. ==References==