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icddr,b has established three Health and Demographic Surveillance Systems (HDSS), namely Matlab HDSS, Chakaria HDSS and Urban Slum HDSS; each of them being dedicated to resolve public health crisis. The surveillance workers of these HDSSs visit the households every three months to record demographic events, such as, pregnancies, births, deaths, and migrations. The HDSSs help to understand how social, environmental, demographic, and programmatic factors interact over time and to produce health outcomes as well as to monitor the national and global health goals. In the current health paradigm, monitoring the SDGs, effects of climate change, migration, universal health coverage are global health concerns; the change in these patterns over time can be monitored through longitudinal data.
The Matlab-HDSS, located 75 Km Southeast of Dhaka was first set up in 1966. It covers 246,893 individuals from 60,400 households in 142 villages. This HDSS has the largest continuously operating population surveillance system amongst the low-income countries and is the longest running demographic surveillance site in the global South. It is widely used as an example of how demographic and health surveillance sites should be run, and has had great impact on national and international health policy.
The Matlab HDSS area is sub-divided into seven blocks, where icddr,b provides service in 4 blocks on family planning, immunization and limited curative services provided to under-five children and women of reproductive age; whereas the government service area provides the existing public health services in the three blocks.
The Chakaria-HDSS, 348 Km Southeast of Dhaka city, was initiated in 1999. It is comprised of coastal, plain and hilly areas and it is considered as a hotspot to monitor climate change and its impacts on health. The HDSS covers 86,667 individuals living in 16,000 households in 49 villages. The focus of the activities has been to facilitate local initiatives for the improvement of health of the villagers in general and of children, women, and the poor in particular. Although, Chakaria HDSS started with paper-based data collection, it was replaced by a web-based data collection and management system in 2014.
The urban slum HDSS, located in selected slums in Dhaka (North and South) and Gazipur City Corporations was initiated in 2015. This HDSS covers 120,000 individual living in 32,000 households located in the core and around the capital city. Extreme heat due to tin-tin structure of the informal settlements, overpopulation and congested setup makes the urban slum population experience the urban heat island phenomenon. This inhabitants of this HDSS are the most vulnerable population of Dhaka who needs special care.
In total, the three HDSSs covers 453,560 individuals from 106,400 households followed over the years, each of these sites being geographically, socio-economically and culturally diverse and ideal platform to monitor the national and global public health goals especially the targets of SDG and evaluating the public health interventions provided by government of Bangladesh and NGOs.
