Evidence map›Paper›PMID 40229910›Full record

ArticleArchives of public health = Archives belges de sante publique2025

Reaching the unreachable: a mixed-method evaluation of multidimensional healthcare model addressing the healthcare service gaps in hard-to-reach Northern riverine Bangladesh.

Md Refat Uz Zaman Sajib, Kamrul Hasan, Tanvir Hayder, A M Rumayan Hasan, Md Musfikur Rahman, Saraban Ether, Atia Rahman, Tania Sultana Tanwi, Fariya Rahman, Abu Sayeed and 4 more

Abstract read
In one paragraph

Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Smart assistive technologies for neurodisorders: A review on AI, IoT, and wearable systems for enhanced patient care.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Md Refat Uz Zaman SajibDepartment of Health and Kinesiology, University of Illinois Urbana- Champaign, Urbana, IL, USA.
Kamrul HasanMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Tanvir HayderMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
A M Rumayan HasanMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Md Musfikur RahmanMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Saraban EtherMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Atia RahmanStrathclyde Law School, University of Strathclyde, Glasgow, UK.
Tania Sultana TanwiDalhousie University, Halifax, Canada.
Fariya RahmanMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Abu SayeedMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Sanwarul BariMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Syed Moshfiqur RahmanGlobal Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Shams El ArifeenMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Anisuddin AhmedMaternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. anisuddin.ahmed@kbh.uu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHard-to-reach riverine communities of northern Bangladesh face unique challenges in healthcare services. Friendship, an international social purpose organization, implemented a 3-tier healthcare model addressing these unique challenges over the past 20 years. This study evaluated Friendship's 3-tier healthcare model in the northern riverine area, assessing service-seeking practices, experiences, stakeholders' perceptions, and cost benefits for beneficiaries.

methodsA concurrent mixed-method approach was employed, including desk reviews, a cross-sectional quantitative survey, facility mapping, and qualitative interviews with service recipients, community representatives, healthcare providers, and health managers. Data were collected from five hard-to-reach riverine sub-districts across the Kurigram, Gaibandha, Bogura, Sirajganj, and Jamalpur districts of Bangladesh between April 2022 and July 2023. Data analysis followed major thematic domains for a comprehensive and complementary understanding.

resultsA significant proportion (43.0%) of survey participants had no formal education, were aged 18-35 (57.5%), and earned less than 1,620 USD yearly (66.6%). Friendship's healthcare services at the doorstep through satellite clinics and Female Community Medic Aides were widely accepted and preferred within the community for convenience, affordability (0.05-0.09 USD service charges), and superior quality, particularly the specialized treatments available on the hospital ships.

conclusionFriendship's 3-tier healthcare model made the accessibility and affordability of primary healthcare. Upon implementing a robust referral mechanism, continuing collaboration with the Government of Bangladesh, and expanding community awareness sessions to include topics such as mental health and disaster response, this model has the potential to be effective in similar settings in Bangladesh and other developing countries, as well as during emergency responses.

Indexed as

3-tier healthcare modelBangladeshComprehensive healthcare modelHard-to-reachRiverine low-resource setting

Identifiers

PMID40229910
PMCPMC11995601

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.