Addressing economic and health challenges of COVID-19 in Bangladesh: Preparation and response

Assessment of COVID-19 management and its consequences on healthcare professionals: a cross-sectional study from Bangladesh

OBJECTIVE

This explorative study aims to identify the gaps in COVID-19 management and their consequences on physicians in terms of contracting infection and psychological well-being during the early phase of the pandemic.

DESIGN, SETTINGS AND PARTICIPANTS

We conducted a nationwide cross-sectional online study to collect information from 420 intern doctors who were at their internship in government medical colleges from February to August 2020.

METHODS

We performed univariate and bivariate analyses to assess COVID-19 management. We investigated the consequences of COVID-19 management on infection risk, experiencing stress, developing anxiety, depression and sleep disturbance using five sets of multivariable logistic regression analyses.

RESULTS

Findings indicate a delay in first-case detection and identify people's tendency to hide COVID-19 symptoms as one of the possible causes of that delay. About 56% of the intern doctors experienced that patients were trying to hide COVID-19 symptoms in the earlier phase of the pandemic. More than half of the respondents did not get any training on COVID-19 from their working institutions. About 30% and 20% of the respondents did not use personal protective equipment (PPE) and masks while treating patients. Respondents who treated patients without PPE, masks, face shields and gloves were almost two times as likely to be infected by COVID-19. The odds of experiencing COVID-19-related stress was almost twofold among respondents who treated patients without wearing PPE and masks. Experiencing COVID-19-related stress was further associated with an increased risk of developing anxiety and depression that led to sleep disturbance.

CONCLUSION

Ensuring the maximum utilization of limited resources during any public health crisis such as COVID-19 needs developing coping mechanisms by projecting future demand. Ensuring proper training and safety measures can reduce physical and psychological hazards among physicians.

Experiences of aftermath of COVID-19 in relation to social, financial and health related aspects among previously hospitalized patients: a qualitative exploration

Background

There is increasing evidence of long-term consequences of COVID-19. The world has seen multidimensional impact of the pandemic and Bangladesh is no exception to that. Policymakers in Bangladesh laid out strategies to curb the initial spread of COVID-19. However, long-term consequences of COVID-19 received little or no attention in the country. Evidence suggests that people presumed to be recovered face multidimensional post-covid consequences. This study aimed to describe the aftermath of COVID-19 in relation to social, financial and health related aspects among previously hospitalized patients.

Methods

This descriptive qualitative study includes participants (n = 14) who were previously hospitalized for COVID-19 and returned home after recovery. The participants were part of a mixed method study from which they were purposively selected. Semi-structured in-depth interviews were conducted over telephone. Inductive content analysis was used to analyze the data.

Results

Twelve sub-categories emerged from the data analysis which converged into five main categories. The main categories included perspective on physical health, financial struggle, life adjustment, interplay between different domains, and spontaneous support.

Conclusion

The lived experiences of COVID-19 recovered patients highlighted multidimensional impact on their daily lives. Physical and psychological wellbeing found to be related to the effort of restoring financial status. People's perception about life altered due to pandemic, for few the pandemic was an opportunity to grow while others found it difficult to accept the hardship. Such multidimensional post COVID-19 impact on people's lives and wellbeing holds considerable implication for response and mitigation plan for future related pandemics.

A review on the gendered impact of COVID-19 pandemic towards achieving sustainable development goals in Bangladesh: Ecofeminist perspectives on the response to COVID-19 pandemic

In this article, we have reviewed how the women of Bangladesh are negatively exposed to the COVID-19 pandemic in terms of quality education, employment loss, labour market contribution, domestic violence, and health and wellness, thus putting their lives at more significant risk. We have employed the Drivers-Pressures-States-Impact-Response (DPSIR) framework to analyze the gendered effects of COVID-19 on some specific Sustainable Development Goals (SDGs) in Bangladesh. We have purposively selected five SDGs, SDG 1 (no poverty), SDG 3 (good health and well-being), SDG 4 (quality education), SDG 5 (gender equality), and SDG 8 (decent work & economic growth), those have direct effects on women's livelihood and well-being. Our DPSIR framework analysis has shown that gendered vulnerabilities have been exacerbated due to the COVID-19 situation with multiple pre-existing socio-cultural norms and various state policies like patriarchal values, stay-home policies etc. As SDG 1 focuses on poverty reduction, and SDG 8 focuses on decent work and economic growth, unemployment, losing job opportunities and economic downturn due to the pandemic have slowed down national growth as well as increased poverty in the country. With excessive pressure on the health sector to deal with COVID-19, women’s essential maternal, sexual and reproductive health (SRH) services were neglected and health disparities were also observed. Thus, many women and adolescent girls could not access SRH services when needed that led to a myriad of consequences for SDG 3 achievements. The prolonged shutdown of educational institutes resulted in mass school dropouts, mental health problems, and higher risks of child labour and child marriage among girl children which has significant negative impacts on the achievement of SDG 4. Due to COVID-19-related preventive measures, such as social distancing, and lockdown, women have been involved to do more care and household job following traditional gender roles, experienced work from home, and a ‘shadow pandemic’ domestic violence amidst the COVID-19. Consequently, the overall gender gap has increased (SDG 5). We have argued that the existing neoliberal market economy has failed to save the global society from a pandemic, therefore, it is important to rethink its development targets and indicators. Moreover, a paradigm shift is recommended by deconstructing present economic systems to build a resilient society based on the caring relationships among nature, humans, and society embracing an ecofeminist perspective.

A Statistical Synopsis of COVID-19 Components and Descriptive Analysis of Their Socio-Economic and Healthcare Aspects in Bangladesh Perspective

The aim of the work is to analyze the socio-economic and healthcare aspects that arise in the contemporary COVID-19 situation from Bangladesh perspective. We elaborately discuss the successive COVID-19 occurrences in Bangladesh with consequential information. The components associated with the COVID-19 commencement and treatment policy with corresponding features and their consequences are patently delineated. The effect of troublesome issues related to the treatment is detailed with supporting real-time data. We elucidate the applications of modern technologies advancement in epidemiological aspects and their existent compatibility in Bangladesh. We statistically analyze the real-time data through figurative and tabular approaches. Some relevant measures of central tendency and dispersion are utilized to explore the data structure and its observable specifications. For a clear manifestation, Z- scores of the COVID-19 components are analyzed through the Box-Whisker plot. We have discovered that the gathered data exhibit features that are unsatisfactory for the normal distribution, are highly positively skewed, and are predominated by the earliest occurrences. Infections and deaths were initially lower than the global average, but they drastically rose in the first quarter of 2021 and persisted for the remainder of the year. Substantial preventive results were produced by the region-wisetime-worthy moves. In the fourth quarter of 2021, the infections and deaths noticeably decreased, and the number of recoveries was highly significant. In the middle of 2022, a lethal rise in infections was observed in Bangladesh and that was quickly stabilized, and the pandemic ingredients were under control. According to our assessment, some concluding remarks are made at the end of this work.

Understanding the impact of COVID-19 on the informal sector workers in Bangladesh

The COVID-19 pandemic put dents on every sector of the affected countries, and the informal sector was no exception. This study is based on the quantitative analyses of the primary data of 1,867 informal workers of Bangladesh to shed light on the impact of the pandemic-induced economic crisis on this working class. The survey was conducted between 8 July and 13 August 2020 across the eight administrative divisions of the country. Analysis points out that about ninety percent of these workers faced an income and food expenditure drop during the lockdown. The effect was higher in males, particularly among the urban-centric and educated males engaged in services and sales. The findings suggest that policy support is needed for the informal workers to face such a crisis.

Public Confidence in COVID-19 Prevention and Response in Bangladesh

Community confidence in institutional approaches to emergency management directs how they cooperate and comply with public policy responses. In the context of emerging COVID-19 pandemic risk management, this study aims to assess public confidence in the Government of Bangladesh (GoB) and private sector entities for the activities undertaken during preparedness, prevention, and response phases. A survey was conducted with 307 respondents who willingly took part in the study. Cronbach's alpha was calculated to assess the internal reliability and the Mann-Whitney U test was conducted to estimate the mean score difference between the observations. A confirmatory factor analysis (CFA) was applied in the study. The findings suggest that the participants were highly positive about the GoB efforts to organize and provide PPE for doctors in time as a safeguard against COVID-19 and coordination and informed decision making in relation to facing COVID-19. Overall, the participants showed a lower-level confidence in the preparedness and response measures taken by authorities in Bangladesh. The results explored how the GoB failed to reach the public satisfaction level regarding provision of food and financial support to low income and middle income people. A lack of collaboration and coordination among different inter-GoB and private sectors makes mitigation and recovery process difficult. This research provides a set of policy recommendations for future public health emergency management based on the participants' concerns and suggestions, and a review of consequences of policy responses in the early stage.

Silent cries behind closed doors: An online empirical assessment of fear of COVID-19, situational depression, and quality of life among Pakistani citizens

The present study aimed to investigate the effects of fear of COVID-19 and situational depression on the quality of life (QOL) of Pakistani citizens. An online cross-sectional survey was conducted on Pakistani citizens via the snowball sampling technique. A total of 377 respondents (256 males and 121 females) participated in this study from August to October 2020. Adapted scales were validated using confirmatory factor analysis, and partial least squares structural equation modelling (PLS-SEM) was applied to the data to test the hypothesised model. The study's findings showed a negative relationship between fear of COVID-19 and QOL. Likewise, a reciprocal relationship was found between situational depression and quality of life. The results indicate that fear of COVID-19 and situational depression during the pandemic have affected the lives of Pakistani citizens. The findings are particularly relevant for improving the QOL by limiting the information received from media and social networks. There is a need to control these mediums and promote community-based interventions to provide accurate knowledge regarding COVID-19. Fear of COVID-19 and situational depression may be reduced in this way. Based on the current findings, psychotherapy and counselling programmes must be planned to minimise the adverse effects of fear of COVID-19 and depression on the QOL of citizens due to the ongoing progression of the pandemic.

Capacity development and safety measures for health care workers exposed to COVID-19 in Bangladesh

Background

The safety of health care workers (HCWs) in Bangladesh and the factors associated with getting COVID-19 have been infrequently studied. The aim of this study was to address this gap by assessing the capacity development and safety measures of HCWs in Bangladesh who have been exposed to COVID-19 and by identifying the factors associated with respondents’ self-reported participation in capacity development trainings and their safety practices.

Methods

This cross-sectional study was based on an online survey of 811 HCWs working at 39 dedicated COVID-19 hospitals in Bangladesh. A pretested structured questionnaire consisting of questions related to respondents’ characteristics, capacity development trainings and safety measures was administered. Binary logistic regressions were run to assess the association between explanatory and dependent variables.

Results

Among the respondents, 58.1% had been engaged for at least 2 months in COVID-19 care, with 56.5% of them attending capacity development training on the use of personal protective equipment (PPE), 44.1% attending training on hand hygiene, and 35% attending training on respiratory hygiene and cough etiquette. Only 18.1% reported having read COVID-19-related guidelines. Approximately 50% of the respondents claimed that there was an inadequate supply of PPE for hospitals and HCWs. Almost 60% of the respondents feared a high possibility of becoming COVID-19-positive. Compared to physicians, support staff [odds ratio (OR) 4.37, 95% confidence interval (CI) 2.25–8.51] and medical technologists (OR 8.77, 95% CI 3.14–24.47) were more exhausted from working in COVID-19 care. Respondents with longer duty rosters were more exhausted, and those who were still receiving infection prevention and control (IPC) trainings were less exhausted (OR 0.54, 95% CI 0.34–0.86). Those who read COVID-19 guidelines perceived a lower risk of being infected by COVID-19 (OR 0.44, 95% CI 0.29–0.67). Compared to the respondents who strongly agreed that hospitals had a sufficient supply of PPE, others who disagreed (OR 2.68, 95% CI 1.31–5.51) and strongly disagreed (OR 5.05, 95% CI 2.15–11.89) had a higher apprehension of infection by COVID-19.

Conclusion

The findings indicated a need for necessary support, including continuous training, a reasonable duty roster, timely diagnosis of patients, and an adequate supply of quality PPE.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07071-2.

Knowledge, attitudes and practices towards COVID-19 guidelines among students in Bangladesh

This paper explores the level of knowledge, attitudes and practices towards COVID-19 guidelines among the students in Bangladesh. In achieving this objective, this paper used primary data collected from 1822 students wherein three different Likert scales and a one-way ANOVA test were used to assess knowledge, attitudes, and practices (KAP) scores as well as mean differences with respect to different variables. This research reveals that the majority of students had a higher level of knowledge and a positive attitudes towards the COVID-19 guidelines. Contrarily, only 0.22 percent of students showed a strong compliance towards COVID-19 guidelines while the majority of students (60.54 percent) had rather poor adherence which is an alarming finding. Hence, reopening the educational institutions in Bangladesh amid this second wave of the pandemic is not advisable yet. Nevertheless, reinforcing the preventive measures through campaigns or online discussion is crucial to persuade people to follow the preventive guidelines. In addition to this, urgent vaccination of all students and teachers is highly recommended to contain this global disease in an attempt to reopen the on-campus education system as soon as possible.