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Background

The core of the project is a demographical surveillance system (DSS) which registers more than 90,000 people in 6 suburbs of the capital Bissau. More than 150 local assistants make regular visits to all houses in the area, collecting information on health, diseases, immunisations, breast-feeding, etc. The primary focus is on women and children. Furthermore, all admissions to the country’s sole paediatric ward in the capital are recorded.

The thorough registration process provides the Bandim Health Project with a unique opportunity to study the population effects of new health interventions such as the introduction of new vaccines, vitamin A supplementation or the distribution of bednets to prevent malaria. Research from the project has led to several important discoveries. One of the most important findings was that a new measles vaccine used in low-income countries was associated with a two-fold increase in mortality among girls. This discovery led to the withdrawal of the vaccine. Had it not been withdrawn, it could have cost at least ½ million additional female deaths per year in Africa alone. As illustrated by this example, it has been the experience that the most important health interventions, including vaccines and vitamin A supplementation, have non-specific and sex-differential effects.

 
The Bandim Health Project is led by Peter Aaby. Peter Aaby holds a research professorship grant from the Novo Nordisk Foundation. Bandim Health Project is a co-founder of the Graduate School in International Health at Copenhagen University. Since the project’s foundation in 1978, more than 500 scientific articles have been published, and 33 PhD or doctoral degrees and 13 Master of International Health degrees have been obtained by researchers employed by the project.

The Bandim Health Project receives grants from Danida, Novo Nordisk Foundation, Danish National Research Foundation, Forskningsrådet for Sundhed og Sygdom, The Lundbeck Foundation, EU, March of Dimes and many others.

The Bandim DSS is located in a suburban area of the capital Bissau in Guinea-Bissau, West Africa, a former Portuguese colony, which was liberated in 1974, after a violent war. The study area comprises six suburbs of the capital and a mobile rural unit following a national cohort of women of fertile age and their children from 100 villages. After independence in 1974 an extremely high under-five mortality rate (around 500/1000 person-years observed) prompted the Ministry of Health to approach the Swedish Agency for Research Cooperation with Developing Countries to organize a study to define nutritional priorities in preventive health care. The nutrition and child-health study was initiated in 1978, and a census was carried out, with a subsequent anthropometric survey and organization of antenatal care for all women found pregnant during the census. All new pregnancies were registered, together with births, deaths, and migrations. This became the basis for the ongoing registration of the population in the Bandim suburb.

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