Mr Md Nuruzzaman Khan

Mr Md Nuruzzaman Khan

Research student

Career Summary

Biography

Md Nuruzzaman Khan is a PhD student at the Research Centre for Generational Health and Aging, Faculty of Health and Medicine, University of Newcastle, Australia. Before commencing his PhD, he had been lecturing in the Department of Population Sciences at the Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh and currently on study leave. Mr Khan completed his Bachelor of Science (B.Sc.) and Master of Science (M.Sc) in Population Science and Human Resource Development from the University of Rajshahi, Bangladesh. He has been actively engaged in public health research since 2014 and develop a significant record of accomplishment in understanding the complex health and social outcomes for the women and child. Mr Khan has a particular interest in women health, including problems associated with reproductive health, and healthcare services utilization in low- and lower-middle income countries.   


Keywords

  • Burden of nutrition
  • Maternal and child health
  • Non-communicable diseases
  • Population modelling
  • Universal health coverage

Languages

  • Bengali (Mother)
  • English (Fluent)

Fields of Research

Code Description Percentage
111799 Public Health and Health Services not elsewhere classified 55
111104 Public Nutrition Intervention 30
080702 Health Informatics 15

Professional Experience

Teaching appointment

Dates Title Organisation / Department
14/6/2017 -  PhD Student Faculty of Health and Medicine, University of Newcastle
School of Medicine and Public Health
Australia

Teaching

Code Course Role Duration
PS101, PS103 Population Health, Demography
Jatiya Kabi Kazi Nazrul Islam University
Lecturer 5/2/2017 - 7/7/2019
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (22 outputs)

Year Citation Altmetrics Link
2020 Khan MN, Harris M, Loxton D, 'Modern Contraceptive Use Following an Unplanned Birth in Bangladesh: An Analysis of National Survey Data', International perspectives on sexual and reproductive health, 46 77-87 (2020)

CONTEXT: Ineffective use or nonuse of contraceptives following an unplanned birth can contribute to the risk of a subsequent unintended pregnancy; however, the literature on the r... [more]

CONTEXT: Ineffective use or nonuse of contraceptives following an unplanned birth can contribute to the risk of a subsequent unintended pregnancy; however, the literature on the relationship between unintended pregnancy and postpartum contraceptive use is sparse, especially in low- and middle-income countries. METHODS: Data on 4,493 women from the 2014 Bangladesh Demographic and Health Survey were analyzed; the subjects of the analysis had had a live birth in the three years prior to the survey and were currently at risk of pregnancy. Multilevel logistic regression analysis was used to examine associations between the intendedness of a woman's last pregnancy resulting in a live birth and her current modern contraceptive use adjusting for individual, household and community-level variables. RESULTS: Twenty-six percent of women reported that their last pregnancy resulting in a live birth had been unintended (15% mistimed and 11% unwanted); 61% reported current use of a modern contraceptive method. Compared with women who reported the pregnancy as having been wanted, those who reported the pregnancy as mistimed had greater odds of current modern contraceptive use (odds ratio, 1.6); no association was found between having had an unwanted pregnancy and subsequent modern contraceptive use. Other important correlates of modern contraceptive use included women's autonomy and desire for children, time since last birth and community-level poverty. CONCLUSIONS: Bangladeshi women who experience an unwanted pregnancy may have an elevated risk of subsequent unintended pregnancy. Broader coverage of family planning services, and integration of family planning with maternal health care, may increase modern contraceptive use following an unplanned birth.

DOI 10.1363/46e8820
Co-authors Deborah Loxton, Melissa Harris
2020 Troeger CE, Khalil IA, Blacker BF, Biehl MH, Albertson SB, Zimsen SRM, et al., 'Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years: an analysis of the Global Burden of Disease Study 2017', The Lancet Infectious Diseases, 20 37-59 (2020)

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Many countries have shown marked declines in diarrhoeal dis... [more]

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods: This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings: Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162¿593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1¿87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1¿74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2¿15·5), childhood wasting (9·9% decrease, 9·6¿10·2), and low use of oral rehydration solution (6·9% decrease, 4·8¿8·4). Interpretation: Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors¿particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution¿appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding: Bill & Melinda Gates Foundation.

DOI 10.1016/S1473-3099(19)30401-3
Citations Scopus - 4
2020 Troeger CE, Khalil IA, Blacker BF, Biehl MH, Albertson SB, Zimsen SRM, et al., 'Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017', The Lancet Infectious Diseases, 20 60-79 (2020)

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4·0 license Background: Despite large reductions in under-5 lower respiratory infec... [more]

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4·0 license Background: Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods: We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings: In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286¿873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5¿68·5) and in mortality rate (from 362·7 deaths [330·1¿392·0] per 100 000 children to 118·9 deaths [109·8¿128·3] per 100 000 children; 67·2% decrease, 63·5¿70·1). LRI incidence declined globally (32·4% decrease, 27·2¿37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0¿24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1¿6·3), and reductions in household air pollution (8·4%, 6·8¿9·2). Interpretation: Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. Funding: Bill & Melinda Gates Foundation.

DOI 10.1016/S1473-3099(19)30410-4
Citations Scopus - 4
2020 Khan MMA, Khan MN, Mustagir MG, Rana J, Haque MR, Rahman MM, 'COVID-19 infection during pregnancy: A systematic review to summarize possible symptoms, treatments, and pregnancy outcomes (2020)
DOI 10.1101/2020.03.31.20049304
2020 Khan MN, Kumar P, Rahman MM, Islam Mondal MN, Islam MM, 'Inequalities in Utilization of Maternal Reproductive Health Care Services in Urban Bangladesh: A Population-Based Study', SAGE Open, 10 (2020)

© The Author(s) 2020. This study examined inequalities in the utilization of maternal reproductive health care services in urban Bangladesh. Data of 6,617 urban women were extract... [more]

© The Author(s) 2020. This study examined inequalities in the utilization of maternal reproductive health care services in urban Bangladesh. Data of 6,617 urban women were extracted from most recent two rounds of Bangladesh Demographic and Health Survey, conducted in the years 2011 and 2014. Inequalities in the utilization of antenatal checkup, receiving care from a skilled birth attendant, delivery in health care facilities, and postnatal care were investigated through concentration index. Contributions of selected predictors to inequalities were estimated by using the regression-based decomposition method. Noticeable inequalities were observed. Concentration index for utilization of at least one antenatal care visit was 0.09, four or more antenatal visits was 0.17, care from skilled birth attendant was 0.16, delivery care in health care facilities was 0.17, and postnatal care within 2 days of delivery was 0.19. Exposure to mass media, educational status of women and their spouses, wealth status, employment, birth order, and age of pregnancy were significant determinants of inequalities. There was a gradient in the utilization of services when examined across wealth status. Those with unfavorable social determinants of health reported low levels of utilization. Alongside providing tailored health care services to urban poor women, efforts should be made to reduce inequalities in social determinants of health.

DOI 10.1177/2158244020914394
Co-authors Mdmijanur Rahman Uon
2019 Oni HT, Khan MN, Abdel-Latif M, Buultjens M, Islam MM, 'Short-term health outcomes of newborn infants of substance-using mothers in Australia and New Zealand: A systematic review', Journal of Obstetrics and Gynaecology Research, 45 1783-1795 (2019) [C1]

© 2019 Japan Society of Obstetrics and Gynecology Aim: Substance use is not unusual among women of childbearing age. Pregnant women who use a substance and the consequent impacts ... [more]

© 2019 Japan Society of Obstetrics and Gynecology Aim: Substance use is not unusual among women of childbearing age. Pregnant women who use a substance and the consequent impacts on a newborn vary across studies and settings. We reviewed New Zealand and Australian literature to examine the short-term health outcomes of newborn of substance-using mothers and their demographic characteristics. Methods: Five medical/nursing databases and google scholar were searched in April 2017. Studies were considered eligible if they described outcomes of newborn of substance-using mothers. Mixed Methods Appraisal Tool was used for quality assessment of candidate studies. Relevant data were extracted and analyzed using narrative synthesis. Based on data availability, a subset of studies was included in meta-analysis. Results: Although findings of individual studies vary, there are some evidence that the infants born to substance-using mothers were likely to have preterm birth, low birthweight, small-for-gestational age, low Apgar score, and admission to neo-natal intensive care unit. The likelihood of adverse health outcomes was much higher for newborns of polysubstance-using mothers, than newborns of mothers using a single substance. Pregnant women who use illicit substance are predominantly socially disadvantaged, in their twenties and or of Aboriginal descent. Conclusion: Infants of substance-using mothers suffer a range of adverse health outcomes. Multidisciplinary and integrated approach of services that ensure supportive social determinants of health may result in a better outcome for newborn and positive behavioral change among mothers.

DOI 10.1111/jog.14051
Citations Scopus - 1Web of Science - 1
2019 Reiner RC, Olsen HE, Ikeda CT, Echko MM, Ballestreros KE, Manguerra H, et al., 'Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017 Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study', JAMA PEDIATRICS, 173 (2019) [C1]
DOI 10.1001/jamapediatrics.2019.0337
Citations Scopus - 12Web of Science - 13
2019 James SL, Lucchesi LR, Bisignano C, Castle CD, Dingels ZV, Fox JT, et al., 'Morbidity and mortality from road injuries: Results from the Global Burden of Disease Study 2017', Injury Prevention, (2019)

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. Background: The global burden of road injuries is known to follow complex geographical, te... [more]

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. Background: The global burden of road injuries is known to follow complex geographical, temporal and demographic patterns. While health loss from road injuries is a major topic of global importance, there has been no recent comprehensive assessment that includes estimates for every age group, sex and country over recent years. Methods: We used results from the Global Burden of Disease (GBD) 2017 study to report incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years for all locations in the GBD 2017 hierarchy from 1990 to 2017 for road injuries. Second, we measured mortality-to-incidence ratios by location. Third, we assessed the distribution of the natures of injury (eg, traumatic brain injury) that result from each road injury. Results: Globally, 1 243 068 (95% uncertainty interval 1 191 889 to 1 276 940) people died from road injuries in 2017 out of 54 192 330 (47 381 583 to 61 645 891) new cases of road injuries. Age-standardised incidence rates of road injuries increased between 1990 and 2017, while mortality rates decreased. Regionally, age-standardised mortality rates decreased in all but two regions, South Asia and Southern Latin America, where rates did not change significantly. Nine of 21 GBD regions experienced significant increases in age-standardised incidence rates, while 10 experienced significant decreases and two experienced no significant change. Conclusions: While road injury mortality has improved in recent decades, there are worsening rates of incidence and significant geographical heterogeneity. These findings indicate that more research is needed to better understand how road injuries can be prevented.

DOI 10.1136/injuryprev-2019-043302
Citations Scopus - 1
2019 Islam MM, Khan MN, Mondal MNI, 'Does parental migration have any impact on nutritional disorders among left-behind children in Bangladesh?', Public Health Nutrition, 22 95-103 (2019)

© The Authors 2018. Objective Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of pa... [more]

© The Authors 2018. Objective Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of parental migration on nutritional disorders of LBC in Bangladesh.Design We analysed data from the nationally representative cross-sectional Multiple Indicator Cluster Survey 2012-2013. Child stunting, wasting and underweight were used as measures of nutritional disorders. Descriptive statistics were used to describe characteristics of the respondents and to compare nutritional outcomes based on status of parental migration. Multivariate logistic regression models were used to examine the associations between parental migration and child nutritional disorders.Setting Bangladesh.Participants Data of 23 402 children (aged <5 years), their parents and households.Results In the unadjusted models, parental migration was found significantly protective for stunting, wasting and underweight - both separately and jointly. After potential confounders were controlled for, no difference was found between LBC and non-LBC in any of these three nutritional outcome measures. Household wealth status and maternal educational status were found to significantly influence the nutritional development of the children.Conclusions At the population level there is no negative impact of parental migration on stunting, wasting and underweight of LBC in Bangladesh. Remittance from parental migration might enhance affordability of better foods, health care and supplies for a cleaner environment. This affordability is crucial for the poorest section of the society.

DOI 10.1017/S1368980018002963
Citations Scopus - 1
2019 Troeger CE, Blacker BF, Khalil IA, Zimsen SRM, Albertson SB, Abate D, et al., 'Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017', The Lancet Respiratory Medicine, 7 69-89 (2019)

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Although the burden of influenza is often discussed in the ... [more]

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza. Methods: We modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza. Findings: Influenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000¿200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16·4 deaths per 100 000 [95% UI 11·6¿21·9]), and the highest rate among all ages was in eastern Europe (5·2 per 100 000 population [95% UI 3·5¿7·2]). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000¿22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000¿259 851 000). We estimated that 11·5% (95% UI 10·0¿12·9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000¿73 864 000) episodes and 8 172 000 severe episodes (5 000 000¿13 296 000). Interpretation: This comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed. Funding: Bill & Melinda Gates Foundation.

DOI 10.1016/S2213-2600(18)30496-X
Citations Scopus - 26
2019 Khan MN, Harris ML, Shifti DM, Laar AS, Loxton D, 'Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis', International Journal of Public Health, 64 743-754 (2019) [C1]

© 2019, Swiss School of Public Health (SSPH+). Objectives: To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-m... [more]

© 2019, Swiss School of Public Health (SSPH+). Objectives: To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-middle-income countries. Methods: A systematic literature search of Medline, Cinahl, Embase, PsycINFO, Cochrane Library, Popline, Maternity and Infant Care, and Scopus databases published since the beginning of the Millennium Development Goals (i.e. January 2000) to June 2018 was performed. We estimated the pooled odds ratios using random effect models and performed subgroup analysis by participants and study characteristics. Results: A total of 38 studies were included in the meta-analysis. Our study found the occurrence of unintended pregnancy was associated with a 25¿39% reduction in the use of antenatal, delivery, and postnatal healthcare services. Stratified analysis found the differences of healthcare services utilization across types of pregnancy unintendedness (e.g. mistimed, unwanted). Conclusions: Integrating family planning and maternal healthcare services should be considered to encourage women with unintended pregnancies to access maternal healthcare services.

DOI 10.1007/s00038-019-01238-9
Co-authors Melissa Harris, Deborah Loxton
2019 Chang AY, Cowling K, Micah AE, Chapin A, Chen CS, Ikilezi G, et al., 'Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050', LANCET, 393 2233-2260 (2019) [C1]
DOI 10.1016/S0140-6736(19)30841-4
Citations Scopus - 27Web of Science - 34
2018 Khan MN, Islam MM, Rahman MM, 'Inequality in utilization of cesarean delivery in Bangladesh: a decomposition analysis using nationally representative data', Public Health, 157 111-120 (2018) [C1]

© 2018 The Royal Society for Public Health Objective: This study examined the inequality in cesarean section (CS) utilization and its socio-economic contributors. Study design: Re... [more]

© 2018 The Royal Society for Public Health Objective: This study examined the inequality in cesarean section (CS) utilization and its socio-economic contributors. Study design: Retrospective two-stage stratified sample design. Methods: Data were extracted from two rounds of the Bangladesh Demographic and Health Survey conducted in 2004 and 2014. Concentration Index of CS utilization was calculated using the wealth quintile. Regression-based decomposition method was applied to assess the socio-economic contributors of inequality in CS utilization. Results: The rate of CS utilization increased from 4.98% in 2004 to 24.21% in 2014. The utilization of CS was highly concentrated among the women of higher socio-economic status (SES) in both rounds of the survey. Results of the decomposition models revealed wealth quintile, higher education, higher number of antenatal visits, and being overweight or obese as the critical factors contributing to the inequalities of CS utilization. Conclusion: Bangladesh is now observing a rapid rise in CS utilization and women with higher SES are the main client group of this life saving procedure. There may have inadequate access for those who are relatively less advantaged, even when CS is necessary. Strong initiative from the government is necessary to ensure proper access to this service regardless of women's SES.

DOI 10.1016/j.puhe.2018.01.015
Citations Scopus - 7Web of Science - 6
Co-authors Mdmijanur Rahman Uon
2018 Troeger C, Blacker BF, Khalil IA, Rao PC, Cao S, Zimsen SRM, et al., 'Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016', LANCET INFECTIOUS DISEASES, 18 1191-1210 (2018) [C1]
DOI 10.1016/S1473-3099(18)30310-4
Citations Scopus - 83Web of Science - 63
2018 Fullman N, Yearwood J, Abay SM, Abbafati C, Abd-Allah F, Abdela J, et al., 'Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016', The Lancet, 391 2236-2271 (2018) [C1]

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to qualit... [more]

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher...

DOI 10.1016/S0140-6736(18)30994-2
Citations Scopus - 112Web of Science - 94
Co-authors Dimity Pond
2018 Khan MN, Islam MM, 'Women's attitude towards wife-beating and its relationship with reproductive healthcare seeking behavior: A countrywide population survey in Bangladesh', PLOS ONE, 13 (2018)
DOI 10.1371/journal.pone.0198833
Citations Scopus - 4Web of Science - 11
2018 Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SRM, Tymeson HD, et al., 'Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016', LANCET, 392 1015-1035 (2018)
DOI 10.1016/S0140-6736(18)31310-2
Citations Scopus - 388Web of Science - 343
Co-authors Addisushunu Beyene Uon
2017 Khan MN, B Nurs CZ, Islam MM, Islam MR, Rahman MM, 'Household air pollution from cooking and risk of adverse health and birth outcomes in Bangladesh: a nationwide population-based study', Environmental Health, 16 (2017)
DOI 10.1186/s12940-017-0272-y
Citations Scopus - 24Web of Science - 23
2017 Khan MN, Islam MM, 'Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: a nationally representative study', BMC PUBLIC HEALTH, 17 (2017)
DOI 10.1186/s12889-017-4913-4
Citations Scopus - 9Web of Science - 6
2017 Khan MN, Islam MM, Shariff AA, Alam MM, Rahman MM, 'Socio-demographic predictors and average annual rates of caesarean section in Bangladesh between 2004 and 2014', PLOS ONE, 12 (2017)
DOI 10.1371/journal.pone.0177579
Citations Scopus - 22Web of Science - 29
2017 Khan M, Rahman MM, Shariff AA, Rahman MM, Rahman MS, Rahman MA, 'Maternal undernutrition and excessive body weight and risk of birth and health outcomes', Archives of Public Health, 75 (2017)
DOI 10.1186/s13690-017-0181-0
Citations Scopus - 16Web of Science - 16
2015 Khan M, Mondal MNI, Islam MR, Al-Mamun MA, Shitan M, 'Trends in Body Mass Index and Its Determinants Among Ever-married Non-pregnant Women in Bangladesh', Malaysian Journal of Nutrition, 21 191-205 (2015)
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Mr Md Nuruzzaman Khan

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