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Das H, Jannat Z, Fatema K, Momo JET, Ali MW, Alam N, Chowdhury MEEK, Morgan C, Oliveras E, Correa GC, Reynolds HW, Uddin MJ, Wahed T. Prevalence of and factors associated with zero-dose and under-immunized children in selected areas of Bangladesh: Findings from Lot Quality Assurance Sampling Survey. Vaccine 2024; 42:3247-3256. [PMID: 38627143 DOI: 10.1016/j.vaccine.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/17/2024] [Accepted: 04/04/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND In the era of Gavi's 5.0 vision of "leaving no one behind with immunization", childhood routine vaccination in missed communities is considered as a priority concern. Despite having a success story at the national level, low uptake of immunization is still persistent in selected pocket areas of Bangladesh. However, prevalence and the associated factors of zero-dose (ZD) and under-immunization (UI) are still unknown at those geo-pockets of Bangladesh. Thus, the study aims to report and identify the factors associated with ZD and UI in selected geographical locations. METHODS This study used data from a Lot Quality Assurance Sampling (LQAS) survey where 504 households from 18 clusters of four hard to reach (HTR) and one urban slum were included. Caregivers of children aged 4.5 to 23 months were interviewed. Three outcome variables- ZD, UI and ZD/UI were considered and several related attributes were considered as independent variables. Data were analyzed through bivariate analysis, binary logistic regression and dominance analysis. RESULTS Overall, 32% of the children were either ZD (8%) or UI (26%) in the selected areas. The adjusted odds of ZD/UI for urban slum and haor (wetlands) areas were 5.62 and 3.61 respectively considering coastal areas as reference. However, distance of nearest EPI center, availability of EPI card, age of caregivers, education and occupation of mother and number of earning members in household were influential factors for ZD/UI. According to dominance analysis, availability of EPI card can explain the most of the variation of ZD/UI in this study. CONCLUSION The study findings highlight the high prevalence ZD/UI in certain geo-pockets of the country. It provided a powerful insight of current situation and associated factors in regards to ZD/UI in the country which will help policy-makers and programme managers in designing programmes to reduce missed communities in Bangladesh.
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Affiliation(s)
- Hemel Das
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | - Zerin Jannat
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | - Kaniz Fatema
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | - Jannat-E-Tajreen Momo
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | - Md Wazed Ali
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | - Nurul Alam
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | | | - Christopher Morgan
- Jhpiego, the Johns Hopkins University affiliate, 1615 Thames Street, Baltimore, MD 2231, USA
| | - Elizabeth Oliveras
- Jhpiego, the Johns Hopkins University affiliate, 1615 Thames Street, Baltimore, MD 2231, USA
| | - Gustavo Caetano Correa
- Evaluation and Learning Measurement, Evaluation & Learning (MEL), Gavi The Vaccine Alliance, Geneva, Switzerland
| | - Heidi W Reynolds
- Evaluation and Learning Measurement, Evaluation & Learning (MEL), Gavi The Vaccine Alliance, Geneva, Switzerland
| | - Md Jasim Uddin
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh
| | - Tasnuva Wahed
- Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh.
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Gonzales Martinez R, Wells J, Anand P, Pelto G, Dhansay MA, Haisma H. Community Participation and Multidimensional Child Growth: Evidence from the Vietnam Young Lives Study. Curr Dev Nutr 2022; 6:nzac022. [PMID: 35415386 PMCID: PMC8989278 DOI: 10.1093/cdn/nzac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background Community participation has the potential to improve the effects of interventions and reduce inequalities in child growth. Multidimensional indicators capture such effects and inequalities. Objectives The objective of this study was to measure the association between multidimensional child growth and community participation in 2 nutrition-sensitive interventions. Methods A Multidimensional Index of Child Growth was calculated with the 5-y-old cohort of the Vietnam Young Lives Survey. Young Lives is a unique dataset that has information on community participation in the design and implementation stages of 2 interventions: a health and a water, sanitation, and hygiene (WASH) intervention. Community participation during the interventions was recorded retrospectively with interviews at the household level. Ordinary least-squares and quantile regressions were estimated using data on 240 children. A Multidimensional Index of Child Advantage, sex, and location (urban/rural) were included as control covariates. Results A positive association (post hoc statistical power = 0.859) was estimated for community participation during the design stage of the WASH intervention, particularly for the most deprived children (P < 0.05). Negative effects were estimated for the health intervention during the design stage (P < 0.05) and no significant effects were found for community participation during the implementation stage of the interventions. Instead of the physical dimension, the significant associations in the design stage were related to the nonphysical dimension of child growth. Inequalities in multidimensional growth were found for children living in rural areas, but not for girls. Conclusions The association between community participation and multidimensional child growth is indicative of the importance of community participation during the design phase of interventions, in particular for the nonphysical dimensions of child growth related to social and psychological factors. The benefits of participation were greater for urban children compared with rural children, which deserves further attention.
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Affiliation(s)
- Rolando Gonzales Martinez
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
| | - Jonathan Wells
- Institute of Child Health Great Ormond Street, University College London, London, United Kingdom
| | - Paul Anand
- Faculty of Art and Social Sciences, Open University, London, United Kingdom
| | - Gretel Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Muhammad Ali Dhansay
- South African Medical Research Council and Stellenbosch University, Cape Town, South Africa
| | - Hinke Haisma
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
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Till M, Abu-Omar K, Ferschl S, Reimers AK, Gelius P. Measuring capabilities in health and physical activity promotion: a systematic review. BMC Public Health 2021; 21:353. [PMID: 33588799 PMCID: PMC7885491 DOI: 10.1186/s12889-020-10151-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The capability approach by Amartya Sen and Martha Nussbaum has gained increasing attention in the field of public health. As it combines individual, social and structural factors and shifts the focus of attention from the actual behavior towards available options for health behaviors that people can actually choose from, it may help advance our understanding of complex health issues. OBJECTIVES The aim of this article is to identify and describe tools available to measure capabilities within the context of health, with a specific focus on capabilities for health-enhancing physical activity. METHOD We conducted a systematic literature review using 11 databases covering scientific journal articles published in English or German between the years 2000 and 2020 with a focus on capabilities for health or physical activity. RESULTS We found a total of 51 articles meeting our inclusion criteria. Four articles measured capabilities using qualitative methods, one combined qualitative and quantitative methods, while the rest used quantitative methods. We identified a total 11 different capability questionnaires, all showing moderate to good validity/reliability. Only one questionnaire and one interview-based tool specifically dealt with capabilities for health enhancing physical activity. CONCLUSION Although we were able to identify measurement tools for capabilities in health, this review has shown that there is no generic tool available for the measurement across all population- and age-groups, and tools focusing on physical activity are scarce. However, our results can be used as guide for future projects that aim at measuring capabilities.
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Affiliation(s)
- M Till
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - K Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - S Ferschl
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - A K Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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" When I Breastfeed, It Feels as if my Soul Leaves the Body": Maternal Capabilities for Healthy Child Growth in Rural Southeastern Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176215. [PMID: 32867111 PMCID: PMC7504657 DOI: 10.3390/ijerph17176215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/21/2022]
Abstract
The burden of childhood stunting in Tanzania is persistently high, even in high food-producing regions. This calls for a paradigm shift in Child Growth Monitoring (CGM) to a multi-dimensional approach that also includes the contextual information of an individual child and her/his caregivers. To contribute to the further development of CGM to reflect local contexts, we engaged the Capability Framework for Child Growth (CFCG) to identify maternal capabilities for ensuring healthy child growth. Ethnographic fieldwork was conducted in Southeastern Tanzania using in-depth interviews, key informant interviews, participant observation, and focus group discussions with caregivers for under-fives. Three maternal capabilities for healthy child growth emerged: (1) being able to feed children, (2) being able to control and make decisions on farm products and income, and (3) being able to ensure access to medical care. Mothers’ capability to feed children was challenged by being overburdened by farm and domestic work, and gendered patterns in childcare. Patriarchal cultural norms restricted women’s control of farm products and decision-making on household purchases. The CFCG could give direction to the paradigm shift needed for child growth monitoring, as it goes beyond biometric measures, and considers mothers’ real opportunities for achieving healthy child growth.
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Chakraborty B, Darak S, Haisma H. Maternal and Child Survival in Haor Region in Bangladesh. An Analysis of Fathers' Capabilities to Save the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5781. [PMID: 32785170 PMCID: PMC7460361 DOI: 10.3390/ijerph17165781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
Maternal and child survival is a major public health problem in haor areas in Bangladesh. Fathers feel responsible as expressed by their capability "to save the future". Using the Capability Framework for Child Growth, we aimed to identify what contextual factors underlie a father's real opportunities to secure a safe delivery, including social norms and beliefs. Parents from households having children less than two years old were asked to participate in two rounds of qualitative research. In total, 25 focus group discussions and eight in-depth interviews were conducted. Late admission to health facilities emerged as the overarching disabling factor for fathers' capability to save the lives of mothers and children. Poor communication about the mother's health condition between spouses and fear for caesarean birth were underlying this late admission. In addition, inadequate advice by local doctors, underdeveloped infrastructure, and seasonal extremities contributed to late admission to health care facilities. The participants indicated that mother's autonomy in haor to seek health care is a constraint. This capability analysis points towards relevant interventions. In addition to the need for an improved health infrastructure, programs to improve maternal and child survival in haor could focus on the gendered household responsibilities and poor communication between spouses.
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Affiliation(s)
- Barnali Chakraborty
- BRAC James P Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747AD Groningen, The Netherlands;
| | | | - Hinke Haisma
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747AD Groningen, The Netherlands;
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