PhD (Medical Anthropology)
MA (Medical Anthropology)
Master of Social Science
Bachelor of Social Science
RESEARCH, TEACHING, or OTHER INTERESTS
Health (social science), Public Health, Environmental and Occupational Health, Anthropology
86
Scopus Publications
2328
Scholar Citations
27
Scholar h-index
46
Scholar i10-index
Scopus Publications
Evaluation of Bovine Lactoferrin for Prevention of Late-Onset Sepsis in Low-Birth-Weight Infants: A Double-Blind Randomized Controlled Trial Shabina Ariff, Sajid Bashir Soofi, Uswa Jiwani, Almas Aamir, Uzair Ansari, et al. Nutrients, 2025 Background: Sepsis remains a significant cause of morbidity and mortality in preterm and low birth weight (LBW) neonates, especially in low- and middle-income countries (LMICs). Lactoferrin, a glycoprotein present in breast milk with antimicrobial activity, is a low-cost, readily available, and promising intervention currently under investigation. The available literature presents conflicting results on the impact of lactoferrin on the risk of late-onset sepsis (LOS). This study evaluated the effectiveness of two doses of bovine lactoferrin (bLF) supplementation in preventing LOS and necrotizing enterocolitis (NEC) in preterm and LBW neonates in Pakistan. Methods: A three-arm, double-blind, placebo-controlled, randomized clinical trial in the neonatal intensive care unit of Aga Khan University was conducted from July 2019 to August 2020. Preterm (28 to 36 + 5 weeks gestational age) and low birth weight (≥1000 g to <2500 g) neonates who established enteral feeding by 72 h were eligible. The exclusion criteria included sepsis before randomization, maternal history of chorioamnionitis or group B streptococcus colonization, and congenital anomalies. Enrolled neonates were randomly assigned in a 1:1:1 ratio using a computer-generated random allocation sequence to receive placebo (D-glucose), 150 mg bLF, or 300 mg bLF mixed with breast milk once daily for 28 days. The study staff, parents, and outcome assessors were blinded to the allocation. The primary outcome was late-onset sepsis from the trial entry to 28 days. The secondary outcome was NEC from the trial entry to 28 days. Neonates were followed weekly for 28 ± 2 days, and episodes of LOS and NEC were recorded. Results: Of 305 neonates enrolled, 102, 102, and 101, respectively, were randomized to receive a placebo (arm A), 150 mg bLF (arm B), and 300 mg bLF (arm C), respectively. Outcome data of 291 participants (99 in arm A, 95 in arm B, and 97 in arm C) were available for inclusion in the intention-to-treat analysis. The frequency of culture-proven sepsis was 8/102 (7.8%) in arm A compared to 1/102 (0.98%) (p = 0.020) in arm B and 5/101 (4.9%) in arm C (p = 0.390). We did not find any difference in episodes of NEC between arms A (n = 3, 3%) and B (n = 0, 0%) (p = 0.087) or between arms A and C (n = 2, 2%) (p = 0.650). We reported compliance rates of 79 (79.79%) in arm A, 78 (82.1%) in arm B, and 82 (84.53%) in arm C for investigational products. Arm C recorded two deaths, but neither was attributed to the intervention. Conclusions: Bovine lactoferrin supplementation did not prevent late-onset sepsis in neonates of preterm and low birth weight in our trial. However, given the small sample size, further trials with larger sample sizes are required to investigate its efficacy in these at-risk groups.
M-SAKHI - Mobile health solutions to help community providers promote maternal and infant nutrition and health: a description of development of the Program Impact Pathway using Theory of Change Archana B Patel, Priyanka N Kuhite, Samreen Sadaf Khan, Amrita Puranik, Ashraful Alam, et al. Public Health Nutrition, 2024 Objective: Behaviour Change Communication (BCC) intervention programmes often lack documentation of successful processes. This manuscript aims to describe the development of Program Impact Pathway (PIP) using Theory of Change (ToC) approach for a mHealth BCC intervention titled ‘Mobile Solutions Aiding Knowledge for Health Improvement (M-SAKHI)’ aimed at reducing stunting in infants at 18 months of age. Design: The PIP was developed using ToC to design the intervention and plan its implementation. Literature review and data from previous pilots helped to identify health service gaps that needed to be addressed by the PIP of this intervention. Setting: M-SAKHI was implemented in 244 villages under governance of forty primary health centres of Nagpur and Bhandara districts of eastern Maharashtra in central India. Participants: The study investigators and the public health stakeholders participated in developing the PIP. M-SAKHI evaluation study recruited 2501 pregnant women who were followed up through delivery until their infants were 18 months old. Results: The PIP was developed, and it identified the following pathways for the final impact: (1) improving maternal and infant nutrition, (2) early recognition of maternal and infant danger signs, (3) improving access and utilisation to healthcare services, (4) improving hygiene, sanitation and immunisation practices, and (5) improving implementation and service delivery of community health workers through their training, monitoring and supervision in real time. Conclusion: This paper will illustrate the significance of development of PIP for M-SAKHI. It can aid other community-based programmes to design their PIP for nutrition-based BCC interventions.
Women's participation in household decisionmaking: Qualitative findings from the Shonjibon Trial in rural Bangladesh Elizabeth K. Kirkwood, Jasmin Khan, Mohammad Mehedi Hasan, Afrin Iqbal, Tazeen Tahsina, et al. Plos Global Public Health, 2024 A key element of women’s empowerment is the ability to participate in household decision-making. This study presents the qualitative results from the Shonjibon Cash and Counselling Trial baseline process evaluation with the aim of exploring the status of women’s decision-making at the trial’s outset and to facilitate the exploration of any changes in women’s empowerment over the course of the trial. Between January and March 2021, we conducted forty-one in-depth interviews with pregnant women in rural Bangladesh. The research team translated, transcribed, coded, and discussed the interviews. We used thematic analysis to examine women’s experience and perceptions on household decision-making. The key findings that emerged; women jointly participated in financial decision-making with their husbands; men made the final decision regarding seeking healthcare, and women solely made choices regarding infant and young child feeding. Our findings revealed that women felt that they needed to discuss their plans to go outside the house with their husbands, many perceived a lack of importance in the community towards women’s participation in decision-making. This study documents current contextual information on the status of women’s involvement in household decision-making and intrahousehold power dynamics at the start of the Shonjibon Cash and Counselling Trial.
Women's participation in decision-making: Analysis of Bangladesh Demographic and Health Survey data 2017–2018 Elizabeth K. Kirkwood, Shahreen Raihana, Neeloy Ashraful Alam, Michael J. Dibley Journal of International Development, 2024 Gender‐based inequities prevent women from partaking in decision‐making. This study is a secondary analysis of the 2017–2018 Bangladesh Demographic and Health Survey (BDHS) data. We examined women's participation in no‐decisions against a set of independent variables to determine the factors associated with not participating in any decisions. The adjusted multivariable logistic regression revealed that women, aged 15–19, with no children, living in larger households, not employed for cash, agreed with at least one reason for husband's beating their wives and were not exposed to print media, were significantly less likely to be involved in any household decisions. This study sheds light on ways to promote women's active participation in decisions and to identify programme‐modifiable indicators for future research.
Understanding Fijian health system challenges in the prevention of mother-to-child transmission of HIV services in the three tertiary hospitals in Fiji Amina Razzaq, Joanne Travaglia, Camille Raynes-Greenow, Neeloy Ashraful Alam AIDS Care Psychological and Socio Medical Aspects of AIDS HIV, 2024 Mother-to-child transmission is the most common route of human immunodeficiency virus transmission in children, which could be prevented with proper treatment and access to care. Health system challenges can impede the effectiveness of prevention of mother-to-child transmission (PMTCT) programmes. We aim to understand the health system challenges to the provision of PMTCT services for pregnant women in three tertiary hospitals in Fiji. Data were collected using in-depth interviews in the three tertiary hospitals and associated health clinics in Fiji between April-May 2013 and February-March 2014. Ethical approvals were obtained. A total of 58 healthcare providers were interviewed including doctors (n = 12), midwives (n = 19), nurses (n = 14), laboratory technicians (n = 5) and counsellors (n = 8). The data were analysed using thematic analysis. We found that the healthcare workers faced a wide range of health system challenges including institutional and human resource challenges. Staff shortage, limited PMTCT training and shortage of supplies were barriers to the quality of PMTCT services. Our findings would be useful in developing strategies to overcome barriers as it would be imperative in improving the quality of PMTCT service provision in Fiji and other similar settings.
Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation Bunga Astria Paramashanti, Michael J Dibley, Tanvir M Huda, Yayi Suryo Prabandari, Neeloy Ashraful Alam International Breastfeeding Journal, 2023 Background Global and Indonesian guidelines suggest that breastfeeding should continue for at least the first two years of life. While many studies have focused on six-month exclusive breastfeeding practices, little is known about why mothers do not sustain breastfeeding beyond this period. This qualitative study aimed to explore factors influencing breastfeeding continuation and formula feeding beyond six months, regardless of any additional food consumed, focusing on Indonesia’s rural and urban areas. Methods We collected the data through 46 in-depth interviews in Pati District and Surakarta City, Central Java, Indonesia. Participants were mothers, grandmothers, health care practitioners, and village kader (frontline female health workers). We used thematic analysis combining deductive and inductive techniques for analysing the data. Results Rural mothers practised breastfeeding and intended to breastfeed for a longer duration than urban mothers. Maternal attitude towards breastfeeding, breastfeeding knowledge, previous experiences, and other breastfeeding strategies (e.g., enhancing maternal dietary quality) positively influenced breastfeeding sustainability. In the urban setting, mothers encountered several breastfeeding barriers, such as perceived breast milk insufficiency and child hunger and satiety, child biting, and breastfeeding refusal, causing them to provide formula milk as a breast milk substitute or supplement. In addition, families, communities, health practitioners, and employment influenced maternal decisions in breastfeeding continuation and formula-feeding practices. Conclusions Optimal breastfeeding practices up to two years of age are determined by the individual and setting (i.e., community, healthcare, employment) factors. Providing breastfeeding education covering practical breastfeeding guidance will encourage mothers to breastfeed for longer. Such interventions should involve families, communities, health workers, and the work environment as a breastfeeding support system. Policymakers should develop, enforce, and monitor the implementation of breastfeeding policies to protect, promote, and support breastfeeding in households, communities, health systems, and work settings.
Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention Aliki Christou, Camille Raynes-Greenow, Adela Mubasher, Sayed Murtaza Sadat Hofiani, Mohammad Hafiz Rasooly, et al. Plos Global Public Health, 2023 Local perceptions and understanding of the causes of ill health and death can influence health-seeking behaviour and practices in pregnancy. We aimed to understand individual explanatory models for stillbirth in Afghanistan to inform future stillbirth prevention. This was an exploratory qualitative study of 42 semi-structured interviews with women and men whose child was stillborn, community elders, and healthcare providers in Kabul province, Afghanistan between October-November 2017. We used thematic data analysis framing the findings around Kleinman’s explanatory framework. Perceived causes of stillbirth were broadly classified into four categories–biomedical, spiritual and supernatural, extrinsic factors, and mental wellbeing. Most respondents attributed stillbirths to multiple categories, and many believed that stillbirths could be prevented. Prevention practices in pregnancy aligned with perceived causes and included engaging self-care, religious rituals, superstitious practices and imposing social restrictions. Symptoms preceding the stillbirth included both physical and non-physical symptoms or no symptoms at all. The impacts of stillbirth concerned psychological effects and grief, the physical effect on women’s health, and social implications for women and how their communities perceive them. Our findings show that local explanations for stillbirth vary and need to be taken into consideration when developing health education messages for stillbirth prevention. The overarching belief that stillbirth was preventable is encouraging and offers opportunities for health education. Such messages should emphasise the importance of care-seeking for problems and should be delivered at all levels in the community. Community engagement will be important to dispel misinformation around pregnancy loss and reduce social stigma.
The impact and implementation of an mHealth intervention to improve infant and young child feeding in Senegal: IIMAANJE protocol for a cluster randomized control trial Shauna M. Downs, Daouda Gueye, Medoune Sall, Bamba Ndoye, Ndèye Ndambao Sarr, et al. Frontiers in Public Health, 2023 Behavior change communication (BCC) strategies have the potential to improve infant feeding and nutrition outcomes among infants and young children in low- and middle-income countries. More recently, there has been a shift toward the adoption of mHealth interventions—the use of mobile phones to transmit health-related information or direct care—to promote recommended BCC strategies among the caregivers of infants and young children. In Senegal, most infants and young children are not fed according to recommended practices leading to a high prevalence of undernutrition and micronutrient deficiencies. The aims of this cluster randomized control trial, using an effectiveness-implementation (type 1) hybrid design, were to: (1) determine the impact of an mHealth IYCF intervention on IYCF practices and nutrition outcomes; and (2) examine the implementation, costs, and opportunities for scaling up the mHealth messaging intervention. The trial was conducted in three regions in Senegal (Thies, Fatick, Diourbel) with 488 mother, father and children (6–23 months) triads. The intervention included 8 scripted messages, that underwent cognitive testing prior to the intervention implementation, and 8 unscripted messages from positive deviants. One voice message and one text message were sent each week to members of our experimental group for a 16-week period. The impact of the intervention was assessed through a household survey, 24-h dietary recall, and hemoglobin measurements before and after the intervention implementation. The primary outcomes were minimal acceptable diet (MAD) and anemia. We also included a total of 54 participants in nine focus groups held with mothers and fathers and semi-structured interviews with Badienou Gox (i.e., community health workers) (n = 6) and national partners and program implementers (n = 6) to examine the intervention implementation process. The study was registered prior to data collection on Clinicaltrials.gov (Identifier: NCT05374837).
Impact of cooking with liquefied petroleum gas compared with traditional cooking practices on perinatal and early neonatal mortality: the Poriborton cluster randomised … C Raynes-Greenow, SM Billah, J Thornburg, S Islam, SM Rokonuzzaman, ... BMJ Global Health 11 (2), e020391 , 2026 2026 Citations: 1
Spillover Effects on Infant Caregiving and Domestic Work During the Poriborton Clean Cookstove Trial MK Hossain, NA Alam, EK Kirkwood, S Islam, SM Billah, MR Azad, ... medRxiv, 2025.12. 16.25342420 , 2025 2025
Understanding Complementary Feeding Practices and Their Influencing Factors in Rural and Urban Indonesia: A Qualitative Study BA Paramashanti, MJ Dibley, TM Huda, CR Titaley, NA Alam Ecology of Food and Nutrition 64 (6), 356-372 , 2025 2025
Sleep practices and association between supine sleep position and stillbirth in a rural sample of pregnant women in Bangladesh SR Harris, SM Billah, S Islam, SM Rokonuzzaman, NA Alam, R Azad, ... Women and Birth 38 (4), 101934 , 2025 2025
Multidisciplinary teamwork among healthcare workers in the provision of Prevention of Mother-to-child transmission services in the three tertiary hospitals in Fiji: A … A Razzaq, H Worth, NA Alam Nursing & Midwifery Research Journal 21 (3), 170-182 , 2025 2025
Evaluation of bovine lactoferrin for prevention of late-onset sepsis in low-birth-weight infants: a double-blind randomized controlled trial S Ariff, SB Soofi, U Jiwani, A Aamir, U Ansari, A Rizvi, M D’Almeida, ... Nutrients 17 (11), 1774 , 2025 2025 Citations: 1
Examine the key contributory factors in establishing effective multidisciplinary teamwork among healthcare workers while providing prevention of mother-to-child transmission of … A Razzaq, H Worth, NA Alam Tahir Khan, 155 , 2025 2025
Caregiver perceptions of complementary feeding in rural and urban Indonesia: A qualitative comparative study BA Paramashanti, MJ Dibley, TM Huda, E Nugraheny, S Suparmi, ... Midwifery 138, 104146 , 2024 2024 Citations: 4
Understanding Fijian health system challenges in the prevention of mother-to-child transmission of HIV services in the three tertiary hospitals in Fiji A Razzaq, J Travaglia, C Raynes-Greenow, NA Alam AIDS care 36 (7), 954-963 , 2024 2024 Citations: 2
The Impact of a Voice and Text Messaging Intervention on Hemoglobin and Anemia Status in Senegal: The IIMAANJE Cluster Randomized Controlled Trial J Sackey, S Downs, NA Alam, A Diouf, J Fanzo, D Gueye, S Mboup, ... Current Developments in Nutrition 8 , 2024 2024
Women’s participation in household decision-making: qualitative findings from the Shonjibon trial in rural Bangladesh EK Kirkwood, J Khan, MM Hasan, A Iqbal, T Tahsina, T Huda, ... PLOS Global Public Health 4 (6), e0002907 , 2024 2024 Citations: 7
‘Of’the community but not ‘of’the health system: Translating community health workers’ knowledge into credible advice in Aceh, Indonesia M Randell, M Li, CN Rachmi, H Jusril, S Abimbola, AY Tama, T Aswitama, ... Discover Health Systems 3 (1), 5 , 2024 2024 Citations: 12
Women's participation in decision‐making: Analysis of Bangladesh Demographic and Health Survey data 2017–2018 EK Kirkwood, S Raihana, NA Alam, MJ Dibley Journal of International Development 36 (1), 26-42 , 2024 2024 Citations: 21
The impact and implementation of an mHealth intervention to improve infant and young child feeding in Senegal: IIMAANJE protocol for a cluster randomized control trial SM Downs, D Gueye, M Sall, B Ndoye, NN Sarr, M Sarr, S Mboup, ... Frontiers in public health 11, 1258963 , 2023 2023 Citations: 7
Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation BA Paramashanti, MJ Dibley, TM Huda, YS Prabandari, NA Alam International breastfeeding journal 18 (1), 48 , 2023 2023 Citations: 41
M-SAKHI Mobile health solutions to help community providers promote maternal and infant nutrition and health using a community-based cluster randomized controlled trial in … MJ Dibley, AB Patel, PN Kuhite, NA Alam, A Puranik, S Khan, P Kelly, ... ANNALS OF NUTRITION AND METABOLISM 79, 327-327 , 2023 2023
Women's and family members' experience of participating in a practical demonstration based maternal nutrition education intervention: Qualitative evidence from rural Bangladesh. NA Alam, M Chowdhury, MJ Dibley, C Raynes-Greenow ANNALS OF NUTRITION AND METABOLISM 79, 355-356 , 2023 2023
Can a combined agriculture and nutrition behaviour change intervention improve women's empowerment in rural Bangladesh? A feasibility study E Kirkwood, M Dibley, W Khatun, G Ara, M Khanam, A Bokshi, M Li, ... ANNALS OF NUTRITION AND METABOLISM 79, 1139-1139 , 2023 2023
Explanatory models of stillbirth among bereaved parents in Afghanistan: Implications for stillbirth prevention A Christou, C Raynes-Greenow, A Mubasher, SMS Hofiani, MH Rasooly, ... PLOS Global Public Health 3 (6), e0001420 , 2023 2023 Citations: 4
Understanding the relationship between the public sector healthcare workers and NGO-based HIV counsellors while providing HIV counselling and testing services to pregnant women … A Razzaq, N Stephenson, C Raynes-Greenow, J Travaglia, NA Alam Midwifery 120, 103634 , 2023 2023 Citations: 4
MOST CITED SCHOLAR PUBLICATIONS
Local understandings of vulnerability and protection during the neonatal period in Sylhet District, Bangladesh: a qualitative study PJ Winch, MA Alam, A Akther, D Afroz, NA Ali, AA Ellis, AH Baqui, ... The lancet 366 (9484), 478-485 , 2005 2005 Citations: 236
Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study AC Moran, N Choudhury, NUZ Khan, ZA Karar, T Wahed, SF Rashid, ... BMC Pregnancy and Childbirth 9 (1), 54 , 2009 2009 Citations: 120
Beliefs and practices during pregnancy and childbirth in urban slums of Dhaka, Bangladesh N Choudhury, AC Moran, MA Alam, KZ Ahsan, SF Rashid, PK Streatfield BMC public health 12 (1), 791 , 2012 2012 Citations: 108
Assessing the intergenerational linkage between short maternal stature and under-five stunting and wasting in Bangladesh W Khatun, S Rasheed, A Alam, TM Huda, MJ Dibley Nutrients 11 (8), 1818 , 2019 2019 Citations: 107
Perceptions of antenatal iron-folic acid supplements in urban and rural Pakistan: a qualitative study YB Nisar, A Alam, B Aurangzeb, MJ Dibley BMC pregnancy and childbirth 14 (1), 344 , 2014 2014 Citations: 100
Newborn umbilical cord and skin care in Sylhet District, Bangladesh: implications for the promotion of umbilical cord cleansing with topical chlorhexidine MA Alam, NA Ali, N Sultana, LC Mullany, KC Teela, NUZ Khan, AH Baqui, ... Journal of perinatology 28 (2), S61-S68 , 2008 2008 Citations: 90
Early initiation of breastfeeding and severe illness in the early newborn period: An observational study in rural Bangladesh S Raihana, MJ Dibley, MM Rahman, T Tahsina, MAB Siddique, ... PLoS medicine 16 (8), e1002904 , 2019 2019 Citations: 86
A study of physician collaborations through social network and exponential random graph S Uddin, L Hossain, J Hamra, A Alam BMC health services research 13 (1), 234 , 2013 2013 Citations: 73
Causes of neonatal and maternal deaths in Dhaka slums: implications for service delivery F Khatun, S Rasheed, AC Moran, AM Alam, MS Shomik, M Sultana, ... BMC Public Health 12 (1), 84 , 2012 2012 Citations: 73
How can formative research inform the design of an iron-folic acid supplementation intervention starting in first trimester of pregnancy in Bangladesh? A Alam, S Rasheed, NUZ Khan, T Sharmin, TM Huda, SE Arifeen, ... BMC public health 15 (1), 374 , 2015 2015 Citations: 69
Developing community-based intervention strategies to save newborn lives: lessons learned from formative research in five countries Neonatal Mortality Formative Research Working Group Journal of perinatology: official journal of the California Perinatal … , 2008 2008 Citations: 69
Qualitative exploration of facilitating factors and barriers to use of antenatal care services by pregnant women in urban and rural settings in Pakistan YB Nisar, B Aurangzeb, MJ Dibley, A Alam BMC pregnancy and childbirth 16 (1), 42 , 2016 2016 Citations: 68
“The system here isn’t on patients’ side”- perspectives of women and men on the barriers to accessing and utilizing maternal healthcare services in South Sudan NS Mugo, MJ Dibley, EY Damundu, A Alam BMC health services research 18 (1), 10 , 2018 2018 Citations: 66
A formative study to inform mHealth based randomized controlled trial intervention to promote exclusive breastfeeding practices in Myanmar: incorporating qualitative study findings MP Hmone, MJ Dibley, M Li, A Alam BMC Medical Informatics and Decision Making 16 (1), 60 , 2016 2016 Citations: 57
Factors associated with intention to exclusive breastfeed in central women’s hospital, Yangon, Myanmar MP Hmone, M Li, K Agho, A Alam, MJ Dibley International breastfeeding journal 12 (1), 29 , 2017 2017 Citations: 56
M‐SAKHI—Mobile health solutions to help community providers promote maternal and infant nutrition and health using a community‐based cluster randomized controlled trial in … AB Patel, PN Kuhite, A Alam, Y Pusdekar, A Puranik, SS Khan, P Kelly, ... Maternal & Child Nutrition 15 (4), e12850 , 2019 2019 Citations: 53
Sociocultural factors perpetuating the practices of early marriage and childbirth in Sylhet District, Bangladesh EG Henry, NB Lehnertz, A Alam, NA Ali, EK Williams, SM Rahman, ... International health 7 (3), 212-217 , 2015 2015 Citations: 52
Barriers faced by the health workers to deliver maternal care services and their perceptions of the factors preventing their clients from receiving the services: a qualitative … NS Mugo, MJ Dibley, EY Damundu, A Alam Maternal and child health journal 22 (11), 1598-1606 , 2018 2018 Citations: 49
Risk of adverse pregnancy outcomes associated with short and long birth intervals in Bangladesh: evidence from six Bangladesh Demographic and Health Surveys, 1996–2014 MK Nisha, A Alam, MT Islam, T Huda, C Raynes-Greenow BMJ open 9 (2), e024392 , 2019 2019 Citations: 48
Exploring the intergenerational effects of undernutrition: association of maternal height with neonatal, infant and under-five mortality in Bangladesh W Khatun, A Alam, S Rasheed, TM Huda, MJ Dibley BMJ global health 3 (6) , 2018 2018 Citations: 47