Sexual Health

Setting stakeholder-led research priorities for advancing Sexual and Reproductive Health and Rights in Bangladesh using CHNRI method: an icddr,b initiative.

TL;DR

A stakeholder-led CHNRI prioritisation exercise identified 197 unique sexual and reproductive health and rights research questions in Bangladesh, with the top 20 priorities spanning adolescent health, fertility, gynaecological issues, maternal and neonatal health, and SRH of key populations.

Key Findings

Seventy-six experts submitted 454 research questions that were condensed into 197 unique research questions across five SRHR themes in Bangladesh.

  • Five themes were selected: adolescent health (AH), fertility, gynaecological issues (GI), maternal and neonatal health (MNH), and SRH of key populations (SRHKP).
  • The 454 submitted research questions were reduced to 197 unique RQs after consolidation.
  • All 76 experts scored the 197 RQs based on five pre-selected criteria.
  • The Child Health and Nutrition Research Initiative (CHNRI) method was adopted for the prioritisation exercise.

Weighted research priority scores for the 197 research questions ranged from 0.944 to 0.623, with a median of 0.848.

  • Both weighted and unweighted research priority scores (RPS) and average expert agreement (AEA) were calculated.
  • The weighted RPS range spanned from 0.944 (highest) to 0.623 (lowest).
  • The median weighted RPS was 0.848.
  • There was significant overlap between the top 20 RQs ranked by RPS and those ranked by AEA.

Among the top 20 ranked research questions, six belonged to adolescent health, six to maternal and neonatal health, five to SRH of key populations, two to gynaecological issues, and one to fertility.

  • Adolescent health top-ranked RQs included adolescent pregnancy, sexual health education, and mental health.
  • MNH research priorities focused on Newborn Stabilizing Units at sub-district hospitals, PPH bundle approaches, and counselling on danger signs to prevent adverse birth outcomes.
  • SRHKP top-ranked RQs addressed stigma and discrimination towards key populations and their impact on SRH behaviours.
  • GI priorities emphasised early detection of gynaecological cancers, including HPV testing for cervical cancer screening.
  • Fertility top-ranked RQs included promoting proper birth spacing among newlywed and underaged married women.

Top-ranked adolescent health research questions focused on adolescent pregnancy, sexual health education, and mental health.

  • Six of the top 20 overall research questions came from the adolescent health theme.
  • These priorities reflect the need for intervention research to address barriers and assess effectiveness of evidence-based interventions.
  • Mental health was identified as a priority research area within adolescent SRHR in Bangladesh.

Top-ranked gynaecological issues research priorities emphasised early detection of gynaecological cancers, including HPV testing for cervical cancer screening.

  • Two of the top 20 overall research questions came from the gynaecological issues theme.
  • HPV testing for cervical cancer screening was specifically identified as a priority research area.
  • Early detection of gynaecological cancers broadly was highlighted as a research gap.

Stigma and discrimination towards key populations and their impact on SRH behaviours were the top-ranked research questions in the SRH of key populations theme.

  • Five of the top 20 overall research questions came from the SRHKP theme.
  • The prioritisation highlights the need to address structural barriers affecting key populations' sexual and reproductive health in Bangladesh.
  • Key populations' SRH was treated as a distinct theme within the broader SRHR prioritisation framework.

The study emphasises the need for intervention research to address barriers, assess effectiveness, and enhance uptake of evidence-based and innovative interventions for SRHR in Bangladesh.

  • The CHNRI method was used as a stakeholder-led approach to ensure research priorities reflect local needs.
  • The prioritisation exercise was an icddr,b initiative involving 76 experts.
  • The findings are intended to guide future SRHR-related research investment and programming in Bangladesh.

What This Means

This research describes a structured process to identify the most important sexual and reproductive health research questions for Bangladesh. Using a method called CHNRI (Child Health and Nutrition Research Initiative), 76 experts from various fields submitted and then scored nearly 200 unique research questions across five topic areas: adolescent health, fertility, women's reproductive cancers and conditions, maternal and newborn health, and the sexual health of marginalized groups. The experts rated each question on criteria like feasibility and potential impact, producing ranked lists of the most critical research priorities. The top 20 research priorities spanned all five topic areas, with adolescent health and maternal/newborn health each contributing six questions. Key priorities included understanding and preventing adolescent pregnancy, improving sexual health education and mental health among teenagers, detecting cervical and other gynaecological cancers earlier (including through HPV testing), improving care for newborns at district hospitals, reducing postpartum hemorrhage, and addressing the stigma faced by marginalized groups that prevents them from seeking sexual and reproductive health care. Notably, experts showed strong agreement on which questions ranked highest, suggesting a shared understanding of research gaps in Bangladesh. This research suggests that future investment in Bangladesh's sexual and reproductive health should focus especially on intervention studies — research that tests practical solutions to known problems rather than simply documenting those problems. By involving a broad group of stakeholders in setting these priorities, the findings are intended to make research funding and programming more relevant to the real needs of Bangladesh's population, potentially improving health outcomes for adolescents, women, newborns, and marginalized communities.

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Citation

Sayeed A, Saha N, Ameen S, Akter E, Hossain L, Hasan M, et al.. (2025). Setting stakeholder-led research priorities for advancing Sexual and Reproductive Health and Rights in Bangladesh using CHNRI method: an icddr,b initiative.. Journal of global health. https://doi.org/10.7189/jogh.15.04186