BMMS 2010 data request form
Government of the People’s Republic of Bangladesh
Ministry of Health and Family Welfare
National Institute of Population Research and Training (NIPORT)
13/1 Sheikh Shaheb Bazar, Azimpur, Dhaka-1205
Data Request Form and Data Sharing Agreement for the 2010
Bangladesh Maternal Mortality and Health Care Survey (BMMS)
The primary objective of BMMS 2010, sponsored by the Government of Bangladesh was to assess progress
toward Millennium Development Goal 5. Specifically the survey aimed to estimate the change in maternal
mortality since BMMS 2001 and to collect additional data on causes of maternal death, use of maternal
health services and related determinants. The survey involved a nationally representative sample of
175,000 households. The survey was conducted by the National Institute of Population Research and
Training (NIPORT), Ministry of Health and Family Welfare, the Government of the People’s Republic of
Bangladesh. Technical assistance was provided by the International Centre for Diarrhoeal Disease
Research, Bangladesh (ICDDR,B), the United States Agency for International Development
(USAID)/Bangladesh, and MEASURE Evaluation. Collectively these organizations involved with the BMMS
are referred as “BMMS survey team.” Fieldwork was conducted by Mitra and Associates and by the
Associates for Community and Population Research (ACPR) through a subcontract with NIPORT. The survey
was funded by the Government of Bangladesh, USAID, the Australian Agency for International Development
(AusAID), and the United Nations Population Fund (UNFPA).
This document specifies the details and the terms and conditions of accessing the public use data, which
will be shared only after unique individual identifiers for individuals and health facilities have been
removed. This form is to be filled out by any individual requesting to access and use the data. All requests
for access to the data will be reviewed by and subject to the approval of NIPORT. The requirements set
forth in this document apply to the person requesting this data, herein referred to as the “Requestor,” and
any other people making up his/her research team. Requestor agrees to comply with applicable
international and local privacy and security laws in his/her use of the data. Requestor shall ensure that any
agents (e.g., research team members) to whom he/she provides access to the data agree to the same
restrictions and conditions set forth in this document. Requestor agrees to use appropriate safeguards to
protect the data from misuse and shall promptly notify NIPORT of any unauthorized or impermissible use or
disclosure of the data not provided for in this document of which he/she becomes aware.
Data Release Requirements
Please note that NIPORT requires that the Requestor agree to the following in regard to the use of BMMS
2010 data:



The data may only be used for program development, policy formulation, and research analysis
purposes, and, with respect to research analysis purposes, not for any purpose not approved, as
applicable, by Requestor’s local institution IRB outlined in the statement of purpose section of this
form. Under no circumstances may the data be used for any commercial purpose.
The Requestor shall present all data and results in such a way as to prevent deductive disclosure of
individuals or health facilities and shall not take any action to identify individuals or facilities
participating in the study.
The Requestor shall not share data with others outside his/her research team. The Requestor shall
not use and shall not allow his/her study team to access or use the data for any reason beyond the
scope of the purpose(s) outlined in the data request form. In particular, the data are strictly for the
Page 1 of 3
BMMS 2010 data request form




use of Requestor and his/her research team that are identified by name in this written request,
consistent with the purpose(s) outlined in this document and access to data sets and data printouts
by the Requestor’s study team shall be limited accordingly.
Requestor must submit an amended data request form and receive approval from NIPORT before
(i) expanding use of the data to a purpose not identified in this document; and/or (ii) expanding
access to persons not specifically identified by name in this document.
Requestor agrees that he/she will use these data only for analysis purposes and not take any
actions to identify or contact individuals, communities, or specific service providers. Individuals,
health facilities and/or health care providers shall not be identified in publications, reports, or
presentations, either directly or indirectly.
This application is for a SINGLE USE of the data for the purpose proposed in the data request form.
Upon the completion of the proposed scope of work the data are to be securely erased.
Any publications, presentations or reports resulting from Requestor’s analysis of the data will be
communicated to NIPORT (please see the contact information below).
BMMS 2010 survey team should be acknowledged in all reports based on these data using the
following text:
Data for this research was provided by the National Institute of Population Research and Training
(NIPORT), in collaboration with the International Centre for Diarrhoeal Disease Research,
Bangladesh (ICDDR,B), USAID Bangladesh, and MEASURE Evaluation, UNC-CH. The survey was
funded by the Government of the People’s Republic of Bangladesh, USAID Bangladesh, AusAID, and
UNFPA. Views expressed do not necessarily reflect those of the Government of the People’s Republic
of Bangladesh or other funding or technical assistance agencies.

The Requestor should be aware these data are being released ‘as is’ and NIPORT may or may not be
able to assist with data inquiries.
Failure to comply with these terms and conditions will result in future exclusion from access to other data
resources available through NIPORT and other agencies of BMMS survey team, and may result in action by
NIPORT against Requestor to the extent that Requestor’s breach of these terms and conditions results in
damages or losses to NIPORT.
These terms and conditions shall remain in effect as long as Requestor retains the data.
A file will be maintained at NIPORT for all correspondence documenting signed agreements of each
Requestor and a copy of the final product(s) resulting from Requestor’s use of the data.
Should you have questions about BMMS 2010 and the terms and conditions of the data request form
please contact:
Director (Research), NIPORT
13/1 Sheikh Shaheb Bazar
Azimpur, Dhaka-1205, Bangladesh
Phone: 8625251
Email: [email protected]
Page 2 of 3
BMMS 2010 data request form
Please provide the following information:
Contact Information. The following contact information of the Principal Investigator of your study is required.
Name:
Organization:
Address:
Telephone:
E-mail:
Cell:
FAX:
Date:
Statement of Purpose. Please describe the proposed use of the data. If there is an existing proposal or
study protocol, please submit it with this form and provide a brief summary below.
Please list persons who will have access to these data and their role in your organization:
Name
Role
In the event that additional people will have access to this dataset, the Requestor should provide NIPORT
with an amended data request form containing an updated list.
Certification by Requestor: By submitting this data request form, I certify that the information provided
above is true, and I agree to the data use requirements mentioned above.
Signature of requestor:
Date:
Certification by Requesting Institution: By submitting this data request form, I certify that the information
provided above is true and on behalf of the institution, I agree to the data use requirements mentioned
above.
Signature for requesting institution:
Date:
Name:
Designation:
Page 3 of 3