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Ahmed A, Sayeed A, Tanwi TS, Saha N, Hanson M, Protyai DA, Hossain AT, Ahmed A, Rahman F, Akter E, Nusrat N, Badsha MS, Rahman A, Islam MK, Alam MS, Nahar Q, Arifeen SE, Rahman AE, Tahsina T. Trends and inequity in improved sanitation facility utilisation in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys. BMC Res Notes 2023; 16:303. [PMID: 37908017 PMCID: PMC10619219 DOI: 10.1186/s13104-023-06555-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023] Open
Abstract
Improved sanitation is indispensable to human health. However, lack of access to improved sanitation remains one of the most daunting public health challenges of the twenty-first century in Bangladesh. The aim of the study was to describe the trends in access to improved sanitation facilities following the inequity gap among households in different socioeconomic groups in Bangladesh. Data from the Bangladesh Demographic and Health Survey (BDHS) 2007, 2011, 2014, and 2017-18 were extracted for this study. Inequity in access to improved sanitation was calculated using rich-poor ratio and concentration index to determine the changes in inequity across the time period. In Bangladesh, the proportion of households with access to improved sanitation increased steadily from 25.4% to 45.4% between 2007 and 2014, but slightly decreased to 44.0% in 2017-18. Age, educational status, marital status of household head, household wealth index, household size, place of residence, division, and survey year were significantly associated with the utilisation of improved sanitation. There is a pro-rich situation, which means that utilisation of improved sanitation was more concentrated among the rich across all survey years (Concentration Index ranges: 0.40 to 0.27). The government and other relevant stakeholders should take initiatives considering inequity among different socioeconomic groups to ensure the use of improved sanitation facilities for all, hence achieving universal health coverage.
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Affiliation(s)
- Anisuddin Ahmed
- Department of Women's and Children's Health, Uppsala University, 75205, Uppsala, Sweden.
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
| | - Abu Sayeed
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Tania Sultana Tanwi
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Nondo Saha
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Molly Hanson
- Department of Women's and Children's Health, Uppsala University, 75205, Uppsala, Sweden
| | | | - Aniqa Tasnim Hossain
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ali Ahmed
- Western Sydney University, Penrith Campus, Sydney, Australia
| | - Fariya Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ema Akter
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Nowrin Nusrat
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Md Shawon Badsha
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Afruna Rahman
- Infectious Disease Division (IDD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | | | - Md Shah Alam
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Quamrun Nahar
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Tazeen Tahsina
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
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Kundu S, Chowdhury SSA, Hasan MT, Sharif AB. Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality. Int Breastfeed J 2023; 18:46. [PMID: 37641102 PMCID: PMC10463657 DOI: 10.1186/s13006-023-00584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breastfeeding. This study aimed to estimate the trends and magnitude of inequalities in early initiation of breastfeeding practice in Bangladesh from 2004 to 2017 applying both absolute and relative measures of inequality. METHODS We used data from the last five Bangladesh Demographic Health Survey (BDHS) from 2004 to 2017 to measure the inequalities in early initiation of breastfeeding practice using the WHO's Health Equity Assessment Toolkit (HEAT) software. Following summary measures were estimated to measure the inequalities: Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) where the equity dimensions were wealth status, education level, sex of child, place of residence, and subnational regions (divisions). For each measure, point estimates along with a 95% confidence interval (CI) were reported. RESULTS An uprising pattern in the prevalence of early initiation of breastfeeding was found, where early initiation of breastfeeding increased from 24.9% to 2004 to 59.0% in 2017. We found significant wealth-driven inequalities in early initiation of breastfeeding practice in every wave of survey favoring the poorest wealth quintile (in 2017, D -10.5; 95% CI -16.6 to -4.3). We also identified geographical disparities in early initiation of breastfeeding practice (in 2017, PAF 11.1; 95% CI 2.2 to 19.9) favoring the Rangpur (65.5%), and Sylhet (65.3%) divisions. Education-related disparities were observed in 2004 only, but not in later survey years, which was due to a much lower level of adherence among those with secondary or higher education. There were no significant disparities in early initiation of breastfeeding based on the urban vs. rural residence and sex of the child. CONCLUSIONS The highest attention should be placed in Bangladesh to attain the WHO's 100% recommendation of timely initiation of breastfeeding. This study emphasizes on addressing the existing socioeconomic and geographic inequalities. Awareness-raising outreach programs focusing the mothers from wealthier sub-groups and divisions with lower prevalence should be planned and implemented by the joint effort of the government and non-government organizations.
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Affiliation(s)
- Satyajit Kundu
- Global Health Institute, North South University, Dhaka, 1229, Bangladesh.
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
| | | | - Md Tamzid Hasan
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Azaz Bin Sharif
- Global Health Institute, North South University, Dhaka, 1229, Bangladesh
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
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Sen KK, Nilima S, Zahura FT, Bari W. Do education and living standard matter in breaking barriers to healthcare access among women in Bangladesh? BMC Public Health 2023; 23:1431. [PMID: 37495959 PMCID: PMC10373322 DOI: 10.1186/s12889-023-16346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Barriers to healthcare access for women have a substantial influence on maternal and child health. By removing barriers to accessing healthcare, several sustainable development goals can be achieved. The goal of this study, based on the dominance analysis, was to examine how living standards and spousal education play role in removing barriers to healthcare access for women in Bangladesh. METHODS The study used the nationally representative Bangladesh Demographic and Health Survey (BDHS), 2017-18 data. A binary logistic regression model was applied for analyzing different types of health access barriers in the study. Additionally, a dominance analysis was conducted to identify the most responsible factors for removing barriers. RESULTS In Bangladesh, 66% of women faced at least one barrier in accessing healthcare. The results obtained from logistic regression and dominance analysis revealed that women's standard of living and spousal education explained the highest variation of having at least one barrier in accessing healthcare. Specifically, a high standard of living explained 24% of the total explained variation (OR 0.56, 95% CI 0.52-0.62), while both spousal education accounted for 27% (OR 0.49, 95% CI 0.45-0.54) of the total explained variation. The regression results also showed that women with higher standards of living as well as educated women having educated partners had lower odds of facing barriers in getting permission (OR 0.87, 95% CI 0.76-1.00 and OR 0.66, 95% CI 0.58-0.75) to go for advice/treatment, obtaining money (OR 0.43, 95% CI 0.39-0.47 and OR 0.37, 95% CI 0.34-0.40), distance to a health facility (OR 0.60, 95% CI 0.55-0.66 and OR 0.70, 95% CI 0.65-0.76), and not wanting to go alone (OR 0.72, 95% CI 0.66-0.89 and OR 0.75, 95% CI 0.69-0.81) for getting medical advice/treatment. CONCLUSION The findings of the study suggest paying extra attention to the spousal education and living standard of women to strengthen and reform the existing strategies and develop beneficial interventions to enhance unhindered accessibility to healthcare facilities for women.
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Affiliation(s)
- Kanchan Kumar Sen
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Shahnaz Nilima
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Fatima-Tuz Zahura
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh
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Chowdhury SSA, Kundu S, Sharif AB. Socioeconomic and geographical inequalities in using skilled birth attendants during delivery in Bangladesh over two decades. BMC Pregnancy Childbirth 2023; 23:430. [PMID: 37296394 DOI: 10.1186/s12884-023-05754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Maternal and neonatal mortality is a major public health concern globally. Evidence supports that skilled birth attendants (SBA) can significantly reduce maternal and neonatal mortality. Despite the improvement in SBA use, Bangladesh lacks evidence of equality in SBA use across socioeconomic and geographic regions. Therefore, we aim to estimate the trends and magnitude of inequality in SBA use in Bangladesh over the last two decades. METHODS Data from the last 5 rounds of Bangladesh Demographic and Health Surveys (BDHS; 2017-18, 2014, 2011, 2007, and 2004) were used to measure the inequalities in the SBA use utilizing the WHO's Health Equity Assessment Toolkit (HEAT) software. Inequality was assessed by four summary measures, namely, Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) based on the four equity dimensions: wealth status, education level, place of residence, and subnational regions (divisions). Point estimates and a 95% confidence interval (CI) were reported for each measure. RESULTS An increasing trend in the overall prevalence of SBA use was observed (From 15.6% in 2004 to 52.9% in 2017). We found significant inequalities in SBA use in every wave of BDHS (from 2004 to 2017), with the result concentrating on the rich (in 2017, PAF: 57.1; 95% CI: 52.5-61.7), educated (in 2017, PAR: 9.9; 95% CI: 5.2-14.5), and people from urban areas (in 2017, PAF: 28.0; 95% CI: 26.4-29.5). We also identified geographic disparities in SBA use favoring Khulna and Dhaka divisions (in 2017, PAR: 10.2; 95% CI: 5.7-14.7). Our study also observed inequality in using SBA among Bangladeshi women decreased over time. CONCLUSION To increase SBA use and to decrease inequality in all four equity dimensions, disadvantaged sub-groups should be prioritized in policies and planning for program implementation.
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Affiliation(s)
| | - Satyajit Kundu
- Global Health Institute, North South University, Dhaka, 1229, Bangladesh.
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602, Bangladesh.
| | - Azaz Bin Sharif
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
- Global Health Institute, North South University, Dhaka, 1229, Bangladesh
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Abdulla F, Hossain MM, Rahman MM, Rahman MS, Rahman A. Risk factors of caesarean deliveries in urban-rural areas of Bangladesh. Front Reprod Health 2023; 5:1101400. [PMID: 36874261 PMCID: PMC9975760 DOI: 10.3389/frph.2023.1101400] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/09/2023] [Indexed: 02/18/2023] Open
Abstract
Background and aims The key interest of this research is to identify the causes of the ongoing increasing trends in caesarean section or C-section (CS) deliveries in both urban and rural areas of Bangladesh. Methods This study analyzed all Bangladesh Demographic and Health Survey (BDHS) datasets through Chi-square and z tests and the multivariable logistic regression model. Results CS deliveries were found to be more prevalent in urban than in rural areas of Bangladesh. Mothers above 19 years, above 16 years at first birth, overweight mothers, those with higher educational levels, those who received more than one antenatal care (ANC) visit, fathers having secondary/higher education degrees and employed as workers or in business, and mothers living in wealthy households in the cities of Dhaka, Khulna, Mymensingh, Rajshahi, and Rangpur divisions had a significantly higher likelihood of CS deliveries in urban areas. Contrastingly, mothers with ages between 20 and 39 years, above 20 years at first birth, normal weight/overweight mothers, those with primary to higher level of education, those in the business profession, fathers who also received primary to higher education, mothers who received more than one ANC visit, and those living in wealthy households in Dhaka, Khulna, Mymensingh, Rajshahi, and Rangpur divisions were more likely to have CS deliveries in rural areas. The 45-49 age group mothers had a five times higher likelihood of CS deliveries [odds ratio (OR): 5.39] in urban areas than in rural areas. Wealthy mothers were more likely to be CS-delivered in urban (OR: 4.84) than in rural areas (OR: 3.67). Conclusion The findings reveal a gradual upward alarming trend in CS deliveries with an unequal contribution of significant determinants in urban and rural areas of Bangladesh. Therefore, integrated community-level awareness programs are an urgent need in accordance with the findings on the risks of CS and the benefits of vaginal deliveries in this country.
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Affiliation(s)
- Faruq Abdulla
- Department of Applied Health and Nutrition, RTM Al-Kabir Technical University, Sylhet, Bangladesh
| | - Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Bangladesh.,School of Mathematics, Statistics & Physics, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Md Mahabubur Rahman
- Department of Statistics, Faculty of Sciences, Islamic University, Kushtia, Bangladesh
| | | | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, Australia
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Kundu S, Kundu S, Rahman MA, Kabir H, Al Banna MH, Basu S, Reza HM, Hossain A. Prevalence and determinants of contraceptive method use among Bangladeshi women of reproductive age: a multilevel multinomial analysis. BMC Public Health 2022; 22:2357. [PMID: 36526989 PMCID: PMC9756620 DOI: 10.1186/s12889-022-14857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Much scholarly debate has centered on Bangladesh's family planning program (FPP) in lowering the country's fertility rate. This study aimed to investigate the prevalence of using modern and traditional contraceptive methods and to determine the factors that explain the contraceptive methods use. METHODS The study used data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), which included 11,452 (weighted) women aged 15-49 years in the analysis. Multilevel multinomial logistic regression was used to identify the factors associated with the contraceptive method use. RESULTS The prevalence of using modern contraceptive methods was 72.16%, while 14.58% of women used traditional methods in Bangladesh. In comparison to women in the 15-24 years age group, older women (35-49 years) were more unwilling to use modern contraceptive methods (RRR: 0.28, 95% CI: 0.21-0.37). Women who had at least a living child were more likely to use both traditional and modern contraceptive methods (RRR: 4.37, 95% CI: 3.12-6.11). Similarly, given birth in the previous 5 years influenced women 2.41 times more to use modern method compared to those who had not given birth (RRR: 2.41, 95% CI: 1.65-3.52). Husbands'/partners' decision for using/not using contraception were positively associated with the use of both traditional (RRR: 4.49, 95% CI: 3.04-6.63) and modern methods (RRR: 3.01, 95% CI: 2.15-4.17) rather than using no method. This study suggests rural participants were 21% less likely to utilize modern methods than urban participants (RRR: 0.79, 95% CI: 0.67-0.94). CONCLUSION Bangladesh remains a focus for contraceptive use, as it is one of the most populous countries in South Asia. To lower the fertility rate, policymakers may design interventions to improve awareness especially targeting uneducated, and rural reproductive women in Bangladesh. The study also highlights the importance of male partners' decision-making regarding women's contraceptive use.
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Affiliation(s)
- Satyajit Kundu
- grid.443020.10000 0001 2295 3329Global Health Institute, North South University, Dhaka, 1229 Bangladesh ,grid.263826.b0000 0004 1761 0489School of Public Health, Southeast University, Nanjing, 210096 China ,grid.443081.a0000 0004 0489 3643Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Subarna Kundu
- grid.412118.f0000 0001 0441 1219Statistics Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Md. Ashfikur Rahman
- grid.412118.f0000 0001 0441 1219Development Studies Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Humayun Kabir
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Md. Hasan Al Banna
- grid.443081.a0000 0004 0489 3643Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Saurav Basu
- grid.415361.40000 0004 1761 0198Indian Institute of Public Health, New Delhi, 122002 India
| | - Hasan Mahmud Reza
- grid.443020.10000 0001 2295 3329Department of Pharmaceutical Sciences, North South University, Dhaka, 1229 Bangladesh
| | - Ahmed Hossain
- grid.412789.10000 0004 4686 5317College of Health Sciences, University of Sharjah, 27272 Sharjah, United Arab Emirates
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Hossain A, Suhel SA, Chowdhury SR, Islam S, Akther N, Dhor NR, Hossain MZ, Hossain MA, Rahman SA. Hypertension and undiagnosed hypertension among Bangladeshi adults: Identifying prevalence and associated factors using a nationwide survey. Front Public Health 2022; 10:1066449. [PMID: 36561867 PMCID: PMC9763893 DOI: 10.3389/fpubh.2022.1066449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background Although undiagnosed hypertension (HTN) is a serious concern worldwide, it is less of an importance in Bangladesh, where there is a dearth of research on the subject. So, we aimed to identify the prevalence and associated factors for diagnosed and undiagnosed HTN. Methods We analyzed the recent 2017-2018 Bangladesh Demographic and Health Survey data. We included 11,981 participants aged 18 years and above for the analysis. The prevalence rates of both diagnosed and undiagnosed hypertension were computed for all individuals and subgroups. The influence of socio-demographic, household, and community-related variables on HTN and undiagnosed HTN was investigated using multinomial regression analysis. Results The study finds 1,464 (12.2%) of the 11,981 respondents [6,815 females [56.9 %]; mean age 39.4 years] had diagnosed HTN, whereas 1 898 (15.8%) had undiagnosed HTN. The HTN and undiagnosed HTN were significantly prevalent in the elderly, type 2 diabetic (T2DM), and overweight and obese individuals. In terms of residential regions, people from coastal region had a significantly higher prevalence of both HTN (RRR: 1.37; 95% CI: 1.17-1.62) and undiagnosed HTN (RRR: 1.35; 95% CI: 1.17-1.56) compared to those from the central region of Bangladesh. Conclusions The high prevalence of undetected hypertension in Bangladesh suggests that screening procedures for the current chronic illness may be inadequate in routine clinical practice. All populations should have access to hypertension screening, but it is especially crucial for the elderly, those with diabetes, those who are overweight or obese, and those from coastal and northern regions of Bangladesh.
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Affiliation(s)
- Ahmed Hossain
- Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,Department of Public Health, North South University, Dhaka, Bangladesh
| | | | - Saifur Rahman Chowdhury
- Department of Public Health, North South University, Dhaka, Bangladesh,Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada,*Correspondence: Saifur Rahman Chowdhury
| | - Shofiqul Islam
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Nayma Akther
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Nipa Rani Dhor
- Department of Public Health, North South University, Dhaka, Bangladesh
| | | | | | - Syed Azizur Rahman
- Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Kundu S, Azene AG, Kundu S, Banna MHA, Mahbub T, Alshahrani NZ, Rahman MA. Prevalence of and factors associated with early initiation of breastfeeding in Bangladesh: a multilevel modelling. Int Health 2022:6682848. [PMID: 36049132 DOI: 10.1093/inthealth/ihac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/12/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early initiation breastfeeding (EIBF) is a sign of good health for both the mother and the newborn baby. The objective of this study was to estimate the prevalence of EIBF among mothers in Bangladesh and to identify its associated factors. METHODS The study used the most recent Bangladesh Demographic and Health Survey 2017-2018 data. A total of 4776 (weighted) respondents were included in the final analysis. The association between the outcome and the independent variables was determined using multilevel (mixed effects) logistic regression analysis. RESULTS The overall weighted prevalence of EIBF among Bangladeshi mothers was 61.19% (confidence interval [CI] 59.80 to 62.56). The study shows that non-poor wealth status (adjusted odds ratio [AOR] 0.81 [95% CI 0.68 to 0.95]), institutional delivery (AOR 0.77 [95% CI 0.61 to 0.96]) and caesarean delivery (AOR 0.31 [95% CI 0.26 to 0.38]) were associated with the lower odds of EIBF. Mother's secondary education (AOR 1.34 [95% CI 1.01 to 1.83]), at least four antenatal care visits (AOR 1.36 [95% CI 1.04 to 1.53]), normal birthweight (AOR 1.42 [95% CI 1.09 to 1.85]) and placed on mother's chest and bare skin after birth (AOR 1.33 [95% CI 1.11 to 1.60]) were associated with higher odds of EIBF. CONCLUSION In order to enhance EIBF in Bangladesh, health professionals should emphasise skin-to-skin contact after delivery.
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Affiliation(s)
- Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, Patuakhali 8602, Bangladesh.,School of Public Health, Southeast University, Nanjing 210009, China
| | - Abebaw Gedef Azene
- Department of Epidemiology and Biostatistics, School of Public health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Subarna Kundu
- Statistics Discipline, Khulna University, Khulna 9208, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh
| | - Tahira Mahbub
- Statistics Discipline, Khulna University, Khulna 9208, Bangladesh
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah 21589, Saudi Arabia
| | - Md Ashfikur Rahman
- Development Studies Discipline, Khulna University, Khulna 9208, Bangladesh
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Chowdhury MRK, Rahman MS, Billah B, Kabir R, Perera NKP, Kader M. The prevalence and socio-demographic risk factors of coexistence of stunting, wasting, and underweight among children under five years in Bangladesh: a cross-sectional study. BMC Nutr 2022; 8:84. [PMID: 35996184 PMCID: PMC9394024 DOI: 10.1186/s40795-022-00584-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 08/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Childhood stunting, wasting and underweight are significant public health challenges. There is a gap in knowledge of the coexistence of stunting, wasting, and underweight among children under five years (under-5) in Bangladesh. This study aims to (i) describe the prevalence of the coexistence of stunting, wasting, and underweight and ii) examine the risk factors for the coexistence of stunting, wasting, and underweight among children under-5 in Bangladesh. Methods This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18, respectively. The associations between the coexistence of stunting, wasting, and underweight and independent variables were assessed using the Chi-square test of independence. The effects of associated independent variables were examined using negative binomial regression. Results The prevalence of coexistence of stunting, wasting, and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children born with low birth weight ((adjusted incidence rate ratios, aIRR) 2.31, 95% CI 1.64, 3.24)); children of age group 36–47 months (aIRR 2.26, 95% CI 1.67, 3.08); children from socio-economically poorest families (aIRR 2.02, 95% CI 1.36, 2.98); children of mothers with no formal education (aIRR 1.98, 95% CI 1.25, 3.15); and children of underweight mothers (aIRR 1.73, 95% CI 1.44, 2.08) were the most important risk factors. Further, lower incidence among children with the coexistence of stunting, wasting, and underweight was observed in the 2017–18 survey (aIRR 0.59, 95% CI 0.49, 0.70) compared to children in the 2014 survey. Conclusions One out of thirty-five under-5 children was identified to have coexistence of stunting, wasting, and underweight in Bangladesh. The burden of coexistence of stunting, wasting, and underweight was disproportionate among children born with low birth weight, socio-economically poorest, a mother with no formal education, and underweight mothers, indicating the need for individual, household, and societal-level interventions to reduce the consequences of coexistence of stunting, wasting, and underweight. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00584-x.
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Affiliation(s)
- Mohammad Rocky Khan Chowdhury
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Russell Kabir
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, London, United Kingdom
| | - Nirmala K P Perera
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Manzur Kader
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Maria Aspmans gata 30A, 17164, Solna, Stockholm, Sweden.
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Haque ME, Mallick TS, Bari W. Does dropout from school matter in taking antenatal care visits among women in Bangladesh? An application of marginalized poisson-poisson mixture model. BMC Pregnancy Childbirth 2022; 22:476. [PMID: 35698030 DOI: 10.1186/s12884-022-04794-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background There exists a lack of research in explaining the link between dropout from school and antenatal care (ANC) visits of women during pregnancy in Bangladesh. The aim of this study is to investigate how the drop out from school influences the ANC visits after controlling the relevant covariates using an appropriate count regression model. Methods The association between the explanatory variables and the outcome of interest, ANC visits, have been performed using one-way analysis of variance/independent sample t-test. To examine the adjusted effects of covariates on the marginal mean of count data, Marginalized Poison-Poisson mixture regression model has been fitted. Results The estimated incidence rate of antenatal care visits was 10.6% lower for the mothers who were not continued their education after marriage but had at least 10 years of schooling (p-value <0.01) and 20.2% lower for the drop-outed mothers (p-value <0.01) than the mothers who got continued their education after marriage. Conclusions To ensure the WHO recommended 8+ ANC visits for the pregnant women of Bangladesh, it is essential to promote maternal education so that at least ten years of schooling should be completed by a woman and dropout from school after marriage should be prevented.
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Shabuz ZR, Haque ME, Islam MK, Bari W. Link between unmet need and economic status in Bangladesh: gap in urban and rural areas. BMC Womens Health 2022; 22:176. [PMID: 35568941 PMCID: PMC9107634 DOI: 10.1186/s12905-022-01752-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Unmet need for family planning (FP) is a core concept in designing FP programmes and reduction of unmet need for FP can improve reproductive and maternal health services. Bangladesh is still away from achieving the target regarding unmet need for FP. This study aimed to explore the composite effect of economic status and place of residence on unmet need for FP among currently married women of reproductive age in Bangladesh after controlling the effect of other selected covariates. Methods The study used the data extracted from the Bangladesh Demographic and Health Survey (BDHS) 2017–2018, which is a nationally representative survey implemented using a stratified two-stage cluster sample design. A total of 13,031 currently married women of reproductive age were included in the final analysis. Binary logistic regression model has been employed to identify the factors influencing the unmet need for FP. Model-I investigated the effect of composite variable place-wealth on unmet need for FP and Model-II examined the effect of place-wealth on unmet need for FP after adjusting for the effect of other selected covariates. The Odds Ratios with p-values were reported to identify significant covariates. Results The rate of unmet need for FP was 15.48%. The composite factor of economic status and place of residence had significant influence on unmet need for FP in both models. Generally, rural women were significantly more likely to have unmet need for FP than their urban counterparts. In particular, women from rural areas and belong to rich families had the highest likelihoods of unmet need for FP. The other selected covariates also had significant influence on unmet need for FP. Conclusion This study shows that rural women had higher odds of unmet need for FP than urban women. The healthcare providers and stakeholders should take necessary actions to motivate women to use contraceptive specially the women who are residing in the rural areas.
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Affiliation(s)
| | - M Ershadul Haque
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Md Kawsarul Islam
- Department of Mathematics and Statistics, Bangladesh University of Textiles, Dhaka, Bangladesh
| | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
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12
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Islam M, Ahmed MS, Mistry SK. Factors associated with women's approval on intimate partner violence in Bangladesh: A cross-sectional analysis of latest demographic and health survey 2017-18. Heliyon 2021; 7:e08582. [PMID: 34950793 DOI: 10.1016/j.heliyon.2021.e08582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/01/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Background In Bangladesh, intimate partner violence (IPV) is high among women faced by their husband. Regrettably, IPV is often justified by the women themselves, resulting in poor social and health outcomes among them. In this paper, we explored the factors that influence the approval of IPV among the women by their husband in Bangladesh. Method The present used the data from the most recent Bangladesh Demographic and Health Survey (BDHS) 2017–18. The BDHS 2017–18 followed a two-stage stratified random sampling techniques and the present analysis was carried out among a weighted sample of 20,127 women. Multivariate logistic regression was used to identify the demographic and socio-economic factors associated with the approval of IPV among the women. Results Overall, one in five women (20.5%) approved at least one form of violence by their husband. In adjusted analysis, women who completed secondary education were 57% less likely [AOR = 0.43, 95% CI: 0.34–0.54] to approve IPV compared to those who had no formal education. Similarly, women who belonged to Hinduism and other religious group were 42% less likely [AOR = 0.58, 95% CI: 0.45–0.74] to approve IPV compared to those who practiced Islam. Moreover, women who were exposed to television, participated in the decision on household purchase and moving outside home had 14%, 19%, and 21% less chance for approving IPV by the husband for at least one reason (p < 0.05). Conclusion This study highlighted that many women in Bangladesh approve violence by their husband which could be a major obstacle to the reduction of violence from society. Behavior change intervention should be implemented, particularly targeting the less-educated Muslim women to increase the awareness on IPV in Bangladesh.
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Sakib MS, Ripon Rouf ASM, Tanny TF. Determinants of Early Initiation of Breastfeeding Practices of Newborns in Bangladesh: Evidence From Bangladesh Demographic and Health Survey. Nutr Metab Insights 2021; 14:11786388211054677. [PMID: 34720590 PMCID: PMC8554558 DOI: 10.1177/11786388211054677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/03/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose Early initiation of breastfeeding is essential for newborns after birth to reduce mortality and morbidity. Early initiation of breastfeeding awareness/activities may be a vital role in Bangladesh to minimize the infant deaths. The aim of this study is to identify factors associated with the early initiation of breastfeeding practices. Methods In this study, Bangladesh Demographic and Health Survey (BDHS) 2017 to 2018 data was used that will be the first analysis for early initiation of breastfeeding practices in this data set in Bangladesh. Considering the importance of early breastfeeding practices, the dependent variable was divided into 3 categories (immediately: breastfeeding for less than 20 minutes, within an hour, and after 1 hour) to find a significant association with early breastfeeding practices in Bangladesh. Bivariate analysis is used to examine the differentials to early initiation of breastfeeding according to the selected number of background variables. Multinomial logistic regression is used to determine predictive independent factors associated with the dependent variable. Results Using BDHS 2017 to 2018 data on 4950 observations, this study revealed that 24.6% of mothers breastfed their babies immediately after birth and 36.2% of mothers breastfed their babies within an hour. The rate of mothers who breastfeed their babies immediately after birth is lowest at the age of 20 to 25, mothers with a higher level of education, richer class, Khulna division, the first child born, Islam, and private/NGO. With a multivariate analysis of breastfeeding within an hour compared to immediate breastfeeding: richest (OR = 0.71), Barisal division (OR = 0.72), and Buddhism ( O R = 0 . 52 ) are less likely to breastfeed newborns compared to the reference category. On the other hand, primary, secondary, and higher educated mothers are more likely to breastfeed newborns compared to no educated mothers. Besides, breastfeeding newborns after 1 hour compared to immediate after birth: mothers aged 20 to 25 (OR = 1.40), richer (OR = 1.46), higher secondary (OR = 2.06), Khulna division (OR = 1.81), and private/NGO (OR = 2.51) are more likely breastfeed newborn. Conclusion Mother's education, wealth index, region, birth order, religion, and place of delivery have a significant impact on the early initiation of breastfeeding practices, but the rate of immediate breastfeeding is relatively lower than others. Ultimately, this information will help planners and other professionals plan strategies and interventions to provide good quality health services.
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Hossain MM, Sobhan MA, Rahman A, Flora SS, Irin ZS. Trends and determinants of vaccination among children aged 06-59 months in Bangladesh: country representative survey from 1993 to 2014. BMC Public Health 2021; 21:1578. [PMID: 34419002 PMCID: PMC8379560 DOI: 10.1186/s12889-021-11576-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/29/2021] [Indexed: 12/01/2022] Open
Abstract
Background Vaccination has important consequences for childhood development, mortality, and inequalities in health and well-being. This research explores the trend of vaccinations coverage from 1993 to 2014 and determines the significant factors for vaccinations coverage in Bangladesh, considering geospatial, socioeconomic, and demographic characteristics. Methods This study uses a secondary dataset extracted from the Bangladesh Demographic and Health Survey (BDHS) from 1992 to 93 to 2014. The association between selected independent variables and vaccination coverage of children was examined through the Chi-square test. In addition, unadjusted and adjusted logistic regression approaches were applied to determine the effects of covariates on vaccination status by using the BDHS-2014 dataset. Results The results reveal that the trend of the vaccination coverage rate has gradually been increased over the study period. The coverage rate of BCG is observed maximum while the lowest for Measles vaccination among all types of vaccinations. The findings revealed that the significantly lower coverage of all vaccination had been observed in the Sylhet region. Children of higher educated mothers (OR 10.21; CI: 4.10–25.37) and father (OR 8.71; CI: 4.03–18.80), born at health facilities (OR 4.53; CI: 2.4–8.55) and whose mother has media exposure (OR 3.20; CI: 2.22–4.60) have more chance of receiving BCG vaccine. For DPT vaccination coverage, there is a significant difference from children whose mothers have primary (OR 1.7; CI: 1.35–2.15), secondary (OR 3.5; CI: 2.75–4.45), and higher (OR 9.6; CI: 5.28–17.42) educational qualification compared to children of illiterate mothers. Findings demonstrated that children born in wealthier households have a higher likelihood of being immunized against DPT, Polio, and Measles vaccination than children born in the poorest households. Conclusions The findings reveal that to enhance and make sustainable the overall country’s vaccination coverage, we should pay more attention to the mother’s education, socioeconomic condition, children’s age, birth order number, having media exposure, place of residence, and religion. The authors think that this finding would be helpful to accelerate the achievement target of Sustainable Development Goals (SDGs) for children’s health in Bangladesh. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11576-0.
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Affiliation(s)
- Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh. .,School of Mathematics, Statistics & Physics, Newcastle University, Newcastle upon Tyne, UK.
| | - Md Abdus Sobhan
- Chief Economist's Unit, Bangladesh Bank, Head Office, Dhaka, 1000, Bangladesh
| | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, 2678, Australia.
| | | | - Zahida Sultana Irin
- Department of Medicine, University of British Columbia, Vancouver, V5Z 1M9, British Columbia, Canada
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Kiser H, Hossain MA. Estimation of number of ever born children using zero truncated count model: evidence from Bangladesh Demographic and Health Survey. Health Inf Sci Syst 2018; 7:3. [PMID: 30588293 DOI: 10.1007/s13755-018-0064-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 11/24/2018] [Indexed: 11/27/2022] Open
Abstract
Fertility is an important demographic indicator for any country and there has always been a concern for number of ever born children to know the transition of fertility pattern intensively. Child ever born is the count response variable ranges from 1 to 15 and was originally collected by the Bangladesh Demographic and Health Survey (BDHS) considering the reproductive women who had given at least one birth. This study proposes zero truncated Poisson and zero truncated negative binomial regression models in order to find the best fitted model to estimate number of ever born children using BDHS 2014 dataset. Findings reveal that, the number of children increases with the increment of respondent's age but number of children declines if education status of respondents as well as their husbands' increases. Similarly, religion, wealth index and wanted last child have significantly influenced the number of child ever born. Surprisingly, the number of children ever born to a mother from rural area does not differ significantly from that of urban area in Bangladesh, though there exists a little fluctuation in the number of children ever born to a mother living in seven administrative divisions. Intension of contraceptive use has no influence on number of ever born children to a mother.
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Affiliation(s)
- Humayun Kiser
- Department of Statistics, Comilla University, Cumilla, 3506 Bangladesh
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Chowdhury MAB, Adnan MM, Hassan MZ. Trends, prevalence and risk factors of overweight and obesity among women of reproductive age in Bangladesh: a pooled analysis of five national cross-sectional surveys. BMJ Open 2018; 8:e018468. [PMID: 30030307 PMCID: PMC6059314 DOI: 10.1136/bmjopen-2017-018468] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014. DESIGN We analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys. SETTING Bangladesh. PARTICIPANTS Women aged 15-49 years. PRIMARY OUTCOME Overweight/obesity. RESULTS A total of 58 192 women were included in the analysis. The prevalence of overweight and obesity among women of reproductive age increased significantly from 7.53% (95% CI 6.83 to 8.29) and 1.82% (95% CI 1.48 to 2.24) in 1999 to 28.37% (95% CI 27.49 to 29.28) and 10.77% (95% CI 10.22 to 11.35) in 2014, respectively. Age, education, wealth index, watching television and contraceptive use were associated with overweight and obesity in both urban and rural areas. CONCLUSIONS Overweight and obesity prevalence increased significantly among Bangladeshi women of reproductive age between 1999 and 2014. Development of effective low-cost strategies to address the increasing burden of obesity should be a high priority.
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Affiliation(s)
| | - Md Mohiuddin Adnan
- Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Md Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Islam AZ. Factors affecting modern contraceptive use among fecund young women in Bangladesh: does couples' joint participation in household decision making matter? Reprod Health 2018; 15:112. [PMID: 29929526 PMCID: PMC6013886 DOI: 10.1186/s12978-018-0558-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 06/15/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The purpose of the study was to explore the association between couples' joint participation in household decision making and modern contraceptive use (MCU) among fecund (physically able to bear child) young women in Bangladesh. METHODS This study utilized a cross-sectional data (n = 3507) extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. Differences in the utilization of modern contraceptives (MC) by socio-demographic characteristics were assessed by χ2 analyses. Binary logistic regression was used to identify the associated factors of usingMC, and the odds ratio with a 95% CI was computed to assess the strength of association. Multicollinearity was also checked by examining the standard errors in the fitted model. RESULTS Desire for a child after two years go by and no child at all contributed the most to increasing MCU followed by receiving family planning (FP) methods from FP workers. Couples' joint decision making power on women's health care, child's health care and visiting family members or relatives emerged as the third most influential factor that might be associated with MCU. CONCLUSIONS Since spousal joint decision making increases the likelihood of using MC, government should include strategic interventions in FP programs to elevate women's status through creating educational and employment opportunities and encouraging more visible involvement in household decision making.
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Affiliation(s)
- Ahmed Zohirul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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Chowdhury M, Dibley MJ, Alam A, Huda TM, Raynes-Greenow C. Household Food Security and Birth Size of Infants: Analysis of the Bangladesh Demographic and Health Survey 2011. Curr Dev Nutr 2018; 2:nzy003. [PMID: 30019026 PMCID: PMC6041808 DOI: 10.1093/cdn/nzy003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/06/2017] [Accepted: 12/31/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND More than one-third of the population in Bangladesh is affected by household food insecurity in a setting where child survival and well-being are under threat. The relation between household food security and birth size of infants is an important area to explore given its explicit effect on mortality and morbidity. OBJECTIVE Our study aims to estimate the association between household food security and birth size of infants. METHODS For the analysis we used a nationally representative cross-sectional survey of 8753 households with a live birth between 2006 and 2011, collected under the Bangladesh Demographic and Health Survey (BDHS) 2011. We investigated the association of small birth size with the following potential explanatory variables: sex of the child; birth interval; mother's age at birth, height, body mass index (BMI), anemia status, parity, previous pregnancy loss, antenatal care visits, exposure to television, and participation in health care decisions; cooking fuel; parents' education level; region; place of residence; and wealth index using Pearson's chi-square test. We then constructed a multivariable logistic regression model of birth size on food security after controlling for all potential confounders as well as the cluster sampling design. The odds ratio (OR) was reported for each of the covariates; a P value <0.05 was interpreted as statistically significant. RESULTS A total of 1485 (17.3%) children were reported as small at the time of birth and more than one-third of households (35.7%) experienced some degree of food insecurity. Mothers from food-insecure households had 38% higher odds of having small-size infants compared to food-secure households (adjusted OR: 1.38; 95% CI: 1.19, 1.59; P < 0.001). CONCLUSION Household food security is one of the key factors associated with small birth size. Interventions to increase birth size should target women belonging to food-insecure households.
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Affiliation(s)
| | - Michael J Dibley
- School of Public Health, The University of Sydney, Camperdown NSW 2006, Australia
| | - Ashraful Alam
- School of Public Health, The University of Sydney, Camperdown NSW 2006, Australia
| | - Tanvir M Huda
- School of Public Health, The University of Sydney, Camperdown NSW 2006, Australia
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Kiser H, Nasrin T. Factors influencing prospective mother with prenatal qualified doctor care among the reproductive women in Bangladesh. Health Inf Sci Syst 2018; 6:3. [PMID: 29472984 DOI: 10.1007/s13755-018-0041-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 02/01/2018] [Indexed: 11/30/2022] Open
Abstract
Maternal and child mortality are the key indicators of health and development of the country. Maternal and child health are interconnected to prenatal care. Consulting a doctor at the prenatal stage will not only ensure mother's and her unborn babies' safety, but also has a great influence to reduce the maternal and infant mortality. In this paper, an attempt has been made to analyze the status of prenatal care provided by the qualified doctor among pregnant mothers in Bangladesh. Data and required information of 8793 reproductive women were collected from the Bangladesh Demographic and Health Survey (BDHS) 2014. Logistic regression model has been used to identify the most significant determinants of the prenatal doctor visits. In this research, it is found that prenatal cares by a qualified doctor during pregnancy depend on several social and demographic characteristics of a woman. It is observed that women staying both urban and rural areas have similar behaviour of caring regarding their pregnancy related complications. Beside this Respondent's age, education, her husband's education and the number of ever born children have significant contribution on prenatal doctor visit. On the other hand, division, religion, husband's desire for children has no effect on it. Overall the model is able to predict 71.65% women into their appropriate group based on these factors.
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Affiliation(s)
- Humayun Kiser
- Department of Statistics, Comilla University, Comilla, 3506 Bangladesh
| | - Tasmina Nasrin
- Department of Statistics, Comilla University, Comilla, 3506 Bangladesh
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Chowdhury AH, Hanifi SMA, Mia MN, Bhuiya A. Socioeconomic inequalities in under-five mortality in rural Bangladesh: evidence from seven national surveys spreading over 20 years. Int J Equity Health 2017; 16:197. [PMID: 29132365 PMCID: PMC5684741 DOI: 10.1186/s12939-017-0693-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 11/01/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Socioeconomic inequality in health and mortality remains a disturbing reality across nations including Bangladesh. Inequality drew renewed attention globally. Bangladesh though made impressive progress in health, it makes an interesting case for learning. This paper examined the trends and changing pattern of socioeconomic inequalities in under-five mortality in rural Bangladesh. It also examined whether mother's education had any effect in reducing socioeconomic inequalities. METHODS Data from rural samples of seven Bangladesh Demographic Health Surveys, carried out so far, were used. Children born alive during 5 years preceding the surveys were included in the analysis. Univariate, bivariate and multivariate analyses were carried out. RESULTS Under-five mortality rate steadily declined over the years from 128/1000 in 1994 to 48 in 2014. Females had 8% lower mortality rates than males. Children of mothers with no schooling had 1.88 times higher mortality than those whose mother had six or more years of schooling. Similarly, children from low asset category households had on an average 1.17 times higher mortality rate than those from high asset category households. Inequality by mother's education disappeared in the recent years, and inequality by household socioeconomic condition persisted all through. The pattern of inequality by sex, mother's education, and household socioeconomic status was not changed statistically significantly over the years, and mothers' education did not reduce socioeconomic inequalities. DISCUSSION The reduction in mortality was consistent with changes in the proximate determinants of child survival in the country. Proximate determinants included maternal factors, environmental contamination, nutrient deficiency, personal illness control, and injury. Health and population programmes have been effective in increasing immunization coverage, use of ORS for managing diarrhoeal diseases, and increasing contraceptive use. Development activities on the other hand raised the literacy, especially among females, demand for modern health services, and reduction of poverty. However, socioeconomic inequality still exists in both under-five mortality and proximate determinants of child survival. CONCLUSIONS The socioeconomic inequality in under-five mortality is showing resistance against further reduction. An assessment of the adequacy of the existing programmes taking the proximate determinants of child survival into consideration will be useful for further improvement.
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Affiliation(s)
- Asiful Haidar Chowdhury
- Health Systems and Population Studies Division, Level 7, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Syed Manzoor Ahmed Hanifi
- Health Systems and Population Studies Division, Level 7, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Mohammad Nahid Mia
- Health Systems and Population Studies Division, Level 7, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Abbas Bhuiya
- Partners in Population and Development, Plot 17/B&C, Block F, Sher-E-Bangla Nagar, Administrative Zone, Agargaon, Dhaka, 1207 Bangladesh
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Roy S, Hossain SMI. Fertility differential of women in Bangladesh demographic and health survey 2014. Fertil Res Pract 2017; 3:16. [PMID: 29046818 PMCID: PMC5640927 DOI: 10.1186/s40738-017-0043-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 10/08/2017] [Indexed: 11/25/2022]
Abstract
Background The aim of this study was to examine the fertility differential of women age 15 to 49 using data from Bangladesh Demographic and Health Survey 2014- a survey of women who were born from 1963 to 1999. Methods The secondary data analysis was carried out using the BDHS 2014 in order to discuss differences in childbearing practices in Bangladesh. Descriptive statistics were used to analyze the data including education level, geographic location, and religion. A trend test used to assess the inferences. Results On average, women had 2.3 children in the BDHS 2014; more than 90% of them gave birth to at least one child by age 49 and the average age of first birth was 18 years. Fertility of women strongly differed by education (p < 0.001). The percentage of women with secondary education who had no child was 50.3% and never attended school 8.4%;those with secondary education were six times as likely as those who never attended school to have no child and this pattern was stronger among urban compared with rural women. Conclusions Fertility differential becomes robust as education increases. Women’s fertility is also related to religion and residence, but these factors were not strongly related as those educational attainments.
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Islam AZ, Rahman M, Mostofa MG. Association between contraceptive use and socio-demographic factors of young fecund women in Bangladesh. Sex Reprod Healthc 2017; 13:1-7. [PMID: 28844349 DOI: 10.1016/j.srhc.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/31/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to explore the association between socio-demographic factors and contraceptive use among fecund women under 25years old. METHODS This study utilized a cross-sectional data (n=3744) extracted from the Bangladesh Demographic and Health Survey 2011. Differences in the use of contraceptives by socio-demographic characteristics were assessed by χ2 analyses. Binary logistic regression was used to identify the determinants of contraceptive use among young women. RESULTS This study observed that 71% fecund women aged below 25years used contraceptives. Getting family planning (FP) methods from FP workers increases the likelihood of using contraceptives among young women because outreach activities by FP workers and accessibility of FP related information pave the way of using contraceptives. Husband-wife joint participation in decision making on health care increases the likelihood of using contraceptives. Participation of women in decision making on health care could be achieved by promoting higher education and gainful employment for women. CONCLUSIONS Reproductive and sex education should be introduced in schools to prepare the young for healthy and responsible living. Moreover, policy makers should focus on developing negotiation skills in young women by creating educational and employment opportunities since husband-wife joint participation in decision making increases contraceptive use.
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Affiliation(s)
- Ahmed Zohirul Islam
- Department of Population Science and Human Resource Development, Faculty of Science, University of Rajshahi, Rajshahi 6205, Bangladesh; Educational Sciences, Faulty of Education, Middle East Technical University, Turkey.
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, Faculty of Science, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md Golam Mostofa
- Department of Population Science and Human Resource Development, Faculty of Science, University of Rajshahi, Rajshahi 6205, Bangladesh
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Islam AZ, Mondal MNI, Khatun ML, Rahman MM, Islam MR, Mostofa MG, Hoque MN. Prevalence and Determinants of Contraceptive use among Employed and Unemployed Women in Bangladesh. Int J MCH AIDS 2016; 5:92-102. [PMID: 28058196 PMCID: PMC5187648 DOI: 10.21106/ijma.83] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Contraceptive use plays a significant role in controlling fertility, particularly in reaching the replacement level of fertility. The association between women's employment status and contraceptive use is poorly studied and understood in Bangladesh. The aim of this study was to determine the factors that influence contraceptive use among employed and unemployed women in Bangladesh. METHODS Data and necessary information of 16,616 married women were extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. The cross sectional data has been used for univariate analysis, to carry out the description of the variables; bivariate analysis, to find the associations among the variables; and binary logistic regression analysis, to evaluate the effects of selected sociodemographic factors on contraceptive use. RESULTS The results revealed that the contraceptive use was found higher among employed women (67%) than that of unemployed women. Women's age, education, region, number of living children, and child preference were found to be significantly associated with current use of contraception among employed women. On the other hand, women's age, education, husband's education, region, residence, religion, number of living children, ever heard about family planning, and child preference were identified as the significant predictors of contraceptive use among unemployed women. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS A gap in using contraceptives among employed and unemployed women is identified. By creating employment opportunities for women to be enhanced the contraceptive use. Moreover, the sociodemographic factors need to be taken into consideration in formulating policies and implementing programs to increase the contraceptive prevalence rate among women.
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Affiliation(s)
- Ahmed Zohirul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205; Bangladesh
| | - Md. Nazrul Islam Mondal
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205; Bangladesh
| | - Mt. Laily Khatun
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205; Bangladesh
| | - Md. Mosiur Rahman
- International Health and Medicine, Division of Public Health, Graduate School of Medicine, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8519, Japan
| | - Md. Rafiqul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205; Bangladesh
| | - Md. Golam Mostofa
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205; Bangladesh
| | - Md. Nazrul Hoque
- Hobby Center for Public Policy, University of Houston, Houston, TX 77204-5021, USA
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Mahumud RA, Hossain MG, Sarker AR, Islam MN, Hossain MR, Saw A, Khan JA. Prevalence and associated factors of contraceptive discontinuation and switching among Bangladeshi married women of reproductive age. Open Access J Contracept 2015; 6:13-19. [PMID: 29386920 PMCID: PMC5683137 DOI: 10.2147/oajc.s76070] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction Contraceptive discontinuation is a worldwide incident that may be connected with low incentive to avoid pregnancy. Contraceptive discontinuation highly contributes to unplanned pregnancy and unwanted births. Objectives The objective of this study was to observe the prevalence of discontinuation and switching of contraceptive methods among Bangladeshi married women. In addition, the sociodemographic factors associated with contraceptive discontinuation and switching were assessed. Methods Secondary cross-sectional data was used in this study. A total of 16,273 married Bangladeshi women of reproductive age (15–49 years) were considered in the present study, from the Bangladesh Demographic and Health Survey, 2011. Logistic regression models were used to determine the relationships between key sociodemographic factors and user status. Results The prevalence of discontinuation and switching of contraceptive method among women were 38.4% and 15.4%, respectively. The logistic regression model demonstrated that women in early reproductive years (25–29 years and 30–34 years) significantly more often (odds ratio [OR] =0.84 and 0.71, respectively) discontinued use of contraceptives. Significantly higher rates of discontinuation were pronounced among women who used the pill (OR =0.72) and injectable contraception users (OR =0.60), had small family size (OR =0.49), lived in a rural community (OR =1.65), and who were less educated (OR =1.55). Conclusion Contraceptive discontinuation may reflect an association among less education, currently married, and smaller family size. Awareness of contraceptive methods can decrease the burden of unplanned pregnancies and thus progresses the family planning program.
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Affiliation(s)
- Rashidul Alam Mahumud
- Health Economics and Financing Research Group, Center for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Abdur Razzaque Sarker
- Health Economics and Financing Research Group, Center for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Nurul Islam
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Ripter Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Aik Saw
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jahangir Am Khan
- Health Economics and Financing Research Group, Center for Equity and Health Systems, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Adjunct Faculty, Health Economics Unit, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Hossain MA, Sumi NS, Haque ME, Bari W. Consequences of intimate partner violence against women on under-five child mortality in Bangladesh. J Interpers Violence 2014; 29:1402-1417. [PMID: 24288192 DOI: 10.1177/0886260513507140] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
It is well established that intimate partner violence (IPV) against women adversely affects maternal morbidity and mortality. But a limited number of studies were found in the literature regarding the association between IPV and under-five child mortality. In this article, using Bangladesh Demographic and Health Survey (BDHS) 2007 data, we examined the effect of IPV on under-five child mortality. A product-limit approach was used for bivariate survival analysis, and Cox proportional hazard multiple regression models were used to investigate the effect of IPV controlling potential confounders. In bivariate analysis, the variables exposure to IPV, mother's age at birth, mother's education, residence type, division, number of children, wealth index, occupation, access to media, and decision autonomy were found to be potential risk factors for child mortality. Results indicated that women exposed to IPV were more likely to experience under-five child mortality compared with women not exposed. The unadjusted hazard ratio for IPV was 1.21 (95% confidence interval [CI] = [1.09, 1.35]) with p value < .01, whereas it was 1.16 (95% CI = [1.04, 1.29]) with p value < .01 and 1.13 (95% CI = [1.01, 1.26]) with p value < .05 in two adjusted models. These results implied that IPV against women is a problem not only for women but also for their children's survival.
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