Matlab and its impact on public health

Matlab is our major rural field site and a global public health resource. Research carried out at Matlab has had a profound impact on policy and practice nationally and internationally.

At Matlab, a rural area of Bangladesh some 75 km south of Dhaka, we maintain one of the developing world’s richest, most comprehensive and longest-running longitudinal data resources. Detailed and high-quality demographic and health data representative of rural Bangladesh are collected from Matlab residents on a regular basis. Some 50 years of continuous demographic information has been collected on a population of more than 200,000 people.

Our work at Matlab has generated a wealth of data on the health and health-seeking behaviour of the local population and the factors that affect them. It has also provided a test bed in which interventions can be evaluated, generating evidence that has influenced healthcare policy and practice in Bangladesh and internationally.

The Matlab Health and Demographic Surveillance System

Structured interviews are conducted to register birth, death, marriage, divorce, migration, internal movement and household break-ups every two months in all households in Matlab’s 142 villages. Periodic socioeconomic surveys also collect information on occupation and household assets.

This data set comprises health, demographic and social characteristics, at the individual and household level. These data can be linked a wide range of research and clinical information. This array of interrelated information is invaluable in a country that has no nationwide registration systems and scant resources to develop health information systems and monitor trends in the nation’s health.

Matlab’s observational data provide insight into changing patterns of disease, their links to social and environmental factors, and healthcare-seeking behaviour. Matlab also provides a platform on which interventions can be evaluated in a natural setting and on a significant scale. Findings from Matlab studies have helped to improve the health of the local population, but have also provided evidence to support wider implementation of interventions across Bangladesh.

The Matlab legacy

Research at Matlab has demonstrated the effectiveness of numerous interventions, generating evidence to shape policy and practice in Bangladesh and globally.

• Family planning: Pioneering work with female community health workers in the 1970s greatly increased contraceptive use and reduced fertility; these methods were widely adopted internationally.
• Immunisation: Work at Matlab showed that 63% of deaths in childhood were due to vaccine-preventable disease and could be prevented almost completely by effective immunisation campaigns.
• Child health and family planning: The annual number of childhood deaths has been reduced by around 75% in the last 25 years, due to the combined programmes in child health and family planning.
• Longevity: Life expectancy has increased from 50 years to around 65 years in the past 40 years thanks to interventions that have improved child survival and lowered fertility.