Bangladesh Health Research Articles

Examining the decline in modern contraception usage among married women in Bangladesh: Applying Blinder-Oaxaca decomposition analysis.

Controlling population expansion and reducing unintended pregnancies through the use of modern contraceptives is a cost-effective strategy. In recent years, the rate of modern contraceptive use in Bangladesh has been declining. So, this study aimed to investigate the associated factors of the deterioration in modern contraceptive usage. This study used data from two successive Bangladesh Demographic and Health Surveys (2014 and 2017-18) and applied the Blinder-Oaxaca decomposition analysis to understand the drivers. A popular binary logistic regression model is fitted to determine the factors that influence the use of modern contraceptive methods over the years. This study revealed that highly educated women were more likely to use modern contraception methods, and their use increased by 3 percent over the years. Factors such as women's working status, husband's education, number of living children, and fertility preference were found significantly associated with decreased usage of modern contraception methods over years. The result of the Blinder-Oaxaca (BO) decomposition analysis found a significant decrease between 2014 and 2018. Respondent's age, working status, husband's age, opinion on decision making, region, and media exposure were the most significant contributors to explaining the shift between 2014 and 2018. The two factors that contributed most to narrowing the difference between the two surveys were women's decision on own health (26%), and employment status (35%). The factors that influence modern contraceptive prevalence are important to know for policy implication purposes in Bangladesh. The findings indicate the need for further improvement of factors for balancing the usage of modern contraception methods.

Introducing a standardised register for strengthening the inpatient management of newborns and sick children: Implementation research in selected health facilities of Bangladesh.

It is imperative to maintain accurate documentation of clinical interventions aimed at enhancing the quality of care for newborns and sick children. The National Newborn Health and IMCI programme of Bangladesh led the development of a standardised register for managing newborns and sick children under five years of age during inpatient care through stakeholder engagement. We aimed to assess the implementation outcomes of the standardised register in the inpatient department. We conducted implementation research in two district hospitals and two sub-district hospitals of Kushtia and Dinajpur districts from November 2022 to January 2023 to assess the implementation outcomes of the standardised register. We assessed the following World Health Organization implementation outcome variables: usability, acceptability, adoption (actual use), fidelity (completeness and accuracy), and utility (quality of care) of the register against preset benchmarks. We collected data through structured interviews with health care providers; participant enrolment; and data extraction from inpatient registers and case record forms. The average usability and acceptability scores among health care providers were 73 (standard deviation (SD) = 14) and 82 (SD = 14) out of 100, respectively. The inpatient register recorded 96% (95% confidence interval (CI) = 95-97) of under-five children who were admitted to the inpatient department (adoption - actual use). The proportions of completed data elements in the inpatient register were above the preset benchmark of 70% for all the assessed data elements except 'investigation done' (24%; 95% CI = 23-26) (fidelity - completeness). The percentage agreements between government-appointed nurses posted and study-appointed nurses were above the preset benchmark of 70% for all the reported variables (fidelity - accuracy). The kappa coefficient for the overall level of agreement between these two groups regarding reported variables indicated moderate to substantial agreement. The proportion of newborns with sepsis receiving injectable antibiotics was 62% (95% CI = 47-75) (utility - quality of care). We observed some variability in the completeness and accuracy of the inpatient register by district and facility type. The inpatient register was positively received by health care providers, with evaluations of implementation outcome variables showing encouraging results. Our findings could inform evidence-based decision-making on the implementation and scale-up of the inpatient register in Bangladesh, as well as other low- and middle-income countries.

Association between Child Mortality and Healthcare Facility Level Factors: Evidence from Nationally Representative Survey

Child mortality is an important indicator of child health and overall national development. Under-five mortality is unacceptably high in Low- and Middle-Income Countries (LMICs) including Bangladesh. Increased availability and access to the healthcare services can play a significant role to reduce under-five mortality. The aim of this study was to explore the associations of several forms of child mortality with health facility level factors. Data were extracted from the 2017-18 Bangladesh Demographic and Health Survey data and 2017 Bangladesh Health Facility Survey data. Three outcome variables were considered: neonatal mortality, infant mortality, and under-five mortality in this study. Health facility level factors were considered as major explanatory variables. They were the availability of the child healthcare services at the nearest healthcare facility, readiness of the nearest healthcare facility to provide child healthcare services and the average distance of the nearest healthcare facility providing child healthcare services. Multilevel mixed-effect logistic regression model was used to determine the associations between the outcome variables and explanatory variables adjusted for covariates. We reported under-five, infant and neonatal mortality were 40, 37, and 30 per 1000 live births, respectively. The likelihood of neonatal and infant mortality was found to be declined for one-unit increase on the availability and readiness of the mothers’ homes nearest healthcare facilities to provide child healthcare services. On contrary, for every kilometre increased distance between mothers’ homes and their nearest healthcare facility was found to be associated with increased in the likelihoods of neonatal, infant and under-five mortality. The availability of health facilities providing child healthcare services close to residence and their improved management, infrastructure, and readiness to provide child healthcare services play a significant role in reducing under-five mortality in Bangladesh. Policies and programs should prioritize to increase the availability and accessibility of health facilities that provide child healthcare services.

Determinants of Full Vaccination Coverage among Children Aged 12-23 Months in Bangladesh: A Comparison between High- and Low-Performing Divisions.

A better understanding of the significant factors behind childhood vaccination is important for designing strategies to increase vaccination coverage and reduce child mortality and morbidity. The study is aimed at identifying the determinants of full vaccination coverage among children aged 12-23 months in Bangladesh and at comparing the determinants between high- and low-performing areas. This study used the latest available Bangladesh Demographic and Health Survey 2017-18 data. A weighted sample of 1678 children was included in this study. The association between full vaccination coverage and explanatory variables was identified using chi-square test. Multivariable logistic regression analysis was employed to identify associated factors of full vaccination coverage. Findings showed that about 88% of the children had full vaccination coverage. The odds of full vaccination coverage was significantly higher among children of mothers with secondary education compared to children of mothers with no formal education (AOR = 2.07, 95%CI = 1.16 to 3.70). Mother's working status was another significant factor behind full vaccination coverage (AOR = 1.53, 95%CI = 1.002 to 2.34). In addition, we identified that higher age of mother (AOR = 2.76, 95%CI = 1.28 to 5.96 for 20-34 years group and AOR = 12.14, 95%CI = 1.21 to 122.41 for 35 and above age group) and being in middle-income household (AOR = 4.66, 95%CI = 1.33 to 16.34) were significantly associated with full vaccination coverage in high-performing areas. On the other hand, children of mothers with secondary education level (AOR = 2.31, 95%CI = 1.86 to 4.49) and exposure to media (AOR = 1.58, 95%CI = 1.001 to 2.50) had higher odds of having full vaccination coverage in low-performing areas. This study identified the associated factors of full vaccination coverage among children. The findings indicate the importance of maternal education and mothers' employment for children's vaccination uptake. In low-performing areas, investment in education and awareness raising initiatives may play instrumental role in achieving full vaccination coverage.

Determinants of low birth weight and its effect on childhood health and nutritional outcomes in Bangladesh

BackgroundThe high incidence of low birth weight (LBW) is associated with an increased risk of infant mortality, adverse pregnancy outcomes for mothers, and a decline in overall health and well-being. The current study aimed to identify the various determinants of LBW and its effect on adverse health and nutritional outcomes of children aged 0–23 months in Bangladesh.MethodsBangladesh Demography and Health Survey (BDHS) 2017-18 data was used. A chi-square test and multivariable logistic regression analysis were used to find out the associations between independent variables and outcomes (e.g., LBW, child illness and undernutrition).ResultsThe overall prevalence of LBW among was 16.3%. Mother with no formal education (AOR = 2.64, 95% CI = 0.55–3.30, p = 0.01), female child (AOR = 1.31, 95% CI = 1.04–1.65, p = 0.023); and poorest economic status (AOR = 1.69, 95% CI = 1.13–2.51, p = 0.010), were identified significant determinants of LBW. Of home environment and hygiene factors, unimproved toilet facilities (AOR = 1.38, 95% CI = 1.03–1.84, p = 0.030) had a significant effect on LBW. In addition, children born with LBW were more likely to suffer fever (AOR = 1.26, 95% CI = 1.05–1.60, p = 0.050), stunting (AOR = 2.42, 95% CI = 1.86–3.15, p = < 0.001), wasting (AOR = 1.47, 95% CI = 1.02–2.25 p = 0.049), and underweight (AOR = 3.19, 95% CI = 2.40–4.23, p = < 0.001).ConclusionOne out of five children was LBW in Bangladesh. Maternal education, sex of child, wealth index, and toilet facilities had significant effects on LBW. In addition, LWB contributed to children’s poor health and nutritional outcomes. Enhancing maternal pregnancy, and child health outcomes necessitates policies addressing poverty, gender inequality, and social disparities. Key strategies include promoting regular prenatal care, early medical intervention, reproductive health education, and safe hygiene practices. To combat the negative impacts of LBW, a comprehensive strategy is vital, encompassing exclusive breastfeeding, nutritional support, growth monitoring, accessible healthcare, and caregiver education.

Women’s Economic Empowerment and Mental Health in the COVID-19 Pandemic

COVID-19 is a serious worldwide health emergency that is affecting many nations. The financial standing and mental health of women are negatively impacted by such widespread epidemics. Thus, the purpose of this study was to evaluate, among married women in Bangladesh during the COVID-19 pandemic, the level of women’s economic empowerment and mental health and related determinants. The author used secondary research from numerous published research articles, review articles, and published international and national reports like the World Health Organization (WHO), UNDP, and United Nations (UN) to examine women’s economic empowerment and mental health during the COVID-19 pandemic. The COVID-19 condition made it more common for women to experience loneliness, melancholy, anxiety, and sleep disruption. Women face the greatest risk because they make up 70% of the healthcare workforce and work in caregiving facilities. According to COVID-19, the primary causes of poor mental health in Bangladesh were being unemployed, being obese, lack of concealing, and having no family. Bangladesh’s patriarchal family system and physical weakness of women leads to increased mental disorders, workplace dangers, abuse, exploitation, harassment, and physical harm during crises and quarantine. This will promote women’s economic empowerment and improve mental health conditions. For this reason, more research about these vulnerable populations is required.

E- Health in Bangladesh: Are we Ready for the Commuter?

Abstract not available J Rang Med Col. March 2024; Vol. 9, No. 1:1-2

Association of child marriage and nutritional status of mothers and their under-five children in Bangladesh: a cross-sectional study with a nationally representative sample

BackgroundChild marriage remains an important problem around the world with young mothers and their under-five children often experiencing under-nutrition. The problem is rarely studied in the Bangladeshi population. This paper was designed to identify the association between child marriage and nutritional status of mothers and their under-five children in Bangladesh.MethodsNationally representative secondary data was used for this study, data was extracted from the Bangladesh Demographic and Health Survey (BDHS) 2017–18. The sample consisted of 7235 mothers aged 18–49 years and their under-five children. The mothers were classified into two classes according to their age at first marriage: (i) child marriage (marriage at < 18 years) and (ii) not child marriage (marriage at ≥ 18 years). The nutritional status of mothers was measured by body mass index (BMI), and under-five children’s nutritional status was measured by (i) height-for-age (z-score) (stunting), (ii) weight-for-age (z-score) (underweight), and (iii) weight-for-height (z-score) (wasting). The chi-square test and two-level logistic regression model were used for data analysis using SPSS software (IBM version 20).ResultsThe prevalence of child marriage among Bangladeshi women was 69.0%, with the mean and median of age at the first marriage being 16.57 ± 2.83 years and 16 years, respectively. Of the mothers, 15.2% suffered from chronic energy deficiency (underweight), and 72.8% were married at < 18 years. The prevalence of stunting, underweight, and wasting among under-five children in Bangladesh was 31.0%, 22.0%, and 8.5%, respectively. Compared to women married at the age of ≥ 18 years, there was a significantly higher likelihood of chronic energy deficiency among women who married at < 18 years [Adjusted OR = 1.27, CI: 1.05–1.82; p < 0.05]. Under-five children of mothers married before the age of 18 were more likely to have stunting [Adjusted OR = 1.201, CI: 1.11–1.72; p < 0.05], wasting [Adjusted OR = 1.519, CI: 1.15-2.00; p < 0.01], and underweight [Adjusted OR = 1.150, CI: 1.09–1.82; p < 0.05] compared to children of mothers who married at age ≥ 18.ConclusionThe rate of child marriage among Bangladeshi women is high, and it is significantly associated with malnutrition among mothers and their under-five children. The Bangladesh government can use the findings of this study to prevent and reduce child marriage and malnutrition among mothers and their under-five children to achieve sustainable development goals by 2030.

Vayu bubble continuous positive airway pressure is a promising solution with favorable treatment outcomes for respiratory distress syndrome in newborns: a qualitative study in Bangladesh.

According to Bangladesh Demographic and Health Survey (2022), neonatal mortality, comprising 67% of under-5 deaths in Bangladesh, is significantly attributed to prematurity and low birth weight (LBW), accounting for 32% of neonatal deaths. Respiratory distress syndrome (RDS) is a prevalent concern among preterm and LBW infants, leading to substantial mortality. The World Health Organization (WHO) recommends bubble continuous positive airway pressure (bCPAP) therapy, but the affordability and accessibility of conventional bCPAP devices for a large number of patients become major hurdles in Bangladesh due to high costs and resource intensiveness. The Vayu bCPAP, a simple and portable alternative, offers a constant flow of oxygen-enriched, filtered, humidified, and pressurized air. Our study, conducted in five health facilities, explores the useability, acceptability, and perceived treatment outcome of Vayu bCPAP in the local context of Bangladesh. A qualitative approach was employed in special care newborn units (SCANUs) of selected facilities from January to March 2023. Purposive sampling identified nine key informants, 40 in-depth interviews with service providers, and 10 focus group discussions. Data collection and analysis utilized a thematic framework approach led by trained anthropologists and medical officers. Service providers acknowledged Vayu bCPAP as a lightweight, easily movable, and cost-effective device requiring minimal training. Despite challenges such as consumable shortages and maintenance issues, providers perceived the device as user-friendly, operable with oxygen cylinders, and beneficial during referral transportation. Treatment outcomes indicated effective RDS management, reduced hospital stays, and decreased referrals. Though challenges existed, healthcare providers and facility managers expressed enthusiasm for Vayu bCPAP due to its potential to simplify advanced neonatal care delivery. The Vayu bCPAP device demonstrated useability, acceptability, and favorable treatment outcomes in the care of neonates with RDS. However, sustained quality service necessitates continuous monitoring, mentoring and retention of knowledge and skills. Despite challenges, the enthusiasm among healthcare providers underscores the potential of Vayu bCPAP to save lives and simplify neonatal care delivery. Development of Standard Operating procedure on Vayu bCPAP is required for systematic implementation. Further research is needed to determine how the utilization of Vayu bCPAP devices enhances accessibility to efficient bCPAP therapy for neonates experiencing RDS.

Impact of Recent Heat Wave on Public Health in Bangladesh

Bangladesh, a country already grappling with a challenging climate, recently experienced a severe heat wave. This study investigates the impact of this heat wave on public health. We conduct a comprehensive literature review to understand the established health risks associated with heat waves. Next, we describe the methodology employed for data collection and analysis. This includes gathering data on hospital admissions, emergency department visits, and mortality rates during the heat wave period compared to historical controls. Additionally, we explore sociodemographic factors that might have exacerbated health risks. Statistical analysis will be performed to identify correlations between heat wave intensity and health outcomes. The findings will be presented, highlighting the prevalence of heat-related illnesses, vulnerable populations, and potential long-term health consequences. Finally, the study will discuss limitations and propose recommendations for future heat wave preparedness and response strategies in Bangladesh.

Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh.

To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location. We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes. The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension. Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings.

Women’s reproductive health in the aftermath of natural disasters in Bangladesh: Prospects for empowerment

In this study, the authors examine the effect of Cyclone Sidr in 2007 on selected aspects of women’s reproductive decision-making in Bangladesh. We used Person in Environment theories to model the effect of cyclone Sidr on the reasons for non-contraception among women who did not want a child. The difference-in-difference approach was used as a research design using Bangladesh Demographic and Health Surveys of 2004 and 2011 to test a model of reasons for non-contraception among a subsample of women who did not want a child. Our results indicated that women experienced fewer social controls on contraceptive use decision-making in the aftermath of a natural disaster.

Burden of undernutrition among under-five Bengali children and its determinants: Findings from Demographic and Health Surveys of Bangladesh and India.

Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children. Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the National Family Health Survey of India 2015-16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children. Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties. The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals.

Availability and readiness of healthcare facilities and their effects on antenatal care services uptake in Bangladesh

BackgroundSustainable Development Goal (SDG) 3.7 aims to ensure universal access to sexual and reproductive healthcare services, where antenatal care (ANC) is a core component. This study aimed to examine the influence of health facility availability and readiness on the uptake of four or more ANC visits in Bangladesh.MethodsThe 2017/18 Bangladesh Demographic and Health Survey data were linked with the 2017 Health Facility Survey and analyzed in this study. The associations of health facility-level factors with the recommended number of ANC uptakes were determined. A multilevel mixed-effect logistic regression model was used to determine the association, adjusting for potential confounders.ResultsNearly 44% of mothers reported four or more ANC uptakes, with significant variations across several areas in Bangladesh. The average distance of mothers' homes from the nearest health facilities was 6.36 km, higher in Sylhet division (8.25 km) and lower in Dhaka division (4.45 km). The overall uptake of the recommended number of ANC visits was positively associated with higher scores for the management (adjusted odds ratio (aOR) 1.85; 95% CI, 1.16–2.82) and infrastructure (aOR, 1.59; 95% CI, 1.09–2.19) of health facilities closest to mothers' homes. The odds of using the recommended number of ANC in mothers increased by 3.02 (95% CI, 2.01–4.19) and 2.36 (95% CI, 2.09–3.16) folds for each unit increase in the availability and readiness scores to provide ANC services at the closest health facilities, respectively. Every kilometer increase in the average regional-level distance between mothers' homes and the nearest health facilities reduced the likelihood of receiving the recommended number of ANC visits by nearly 42% (aOR, 0.58, 95% CI, 0.42–0.74).ConclusionThe availability of healthcare facilities close to residence, as well as their improved management, infrastructure, and readiness to provide ANC, plays a crucial role in increasing ANC services uptake. Policies and programs should prioritize increasing the availability, accessibility, and readiness of health facilities to provide ANC services.

The burden of diabetes and hypertension on healthy life expectancy in Bangladesh

Diabetes and hypertension are among the leading causes of death in Bangladesh. This study examined hypertension, diabetes, and either or both, free life expectancy, to measure the effect of the diseases on the overall health of individuals in Bangladesh with regional variations. We utilized data from Bangladesh Sample Vital Statistics 2018 for mortality and Bangladesh Demographic and Health Survey 2017–2018 for diabetes and hypertension. The Sullivan method was employed to estimate age-specific hypertension and diabetes-free life expectancy. Altogether, 10.3% of the people aged 18–19 years lived with either diabetes or hypertension. The hypertension-free life expectancy was 40.4 years, and the diabetes-free life expectancy was 53.2 years for those aged 15–19. Overall, individuals would expect to spend 38.7% of their lives with either of the diseases. Females suffered more from hypertension and males from diabetes. Still, females suffered more from the aggregate of both. Rural people had more diabetes and hypertension-free life expectancy than those of urban. Individuals of Mymensingh had the highest life expectancy free of both diseases compared to other divisions of Bangladesh. Diabetes and hypertension affect a considerable proportion of the life of the population in Bangladesh. Policy actions are needed to guide the prevention, diagnosis, and treatment of both diseases, specifically focusing on women and urban populations. Widespread health-enhancing actions need to be taken to diminish the effect of these two diseases in Bangladesh.

Piecewise Linear Multiple Change Point Modelling for Under-Five Child Mortality

Using a piecewise linear multiple change-point model instead of more traditional survival techniques is more beneficial when dealing with mortality data. Utilizing this technique, the hazard model is estimated and the number of cut-point locations is found. Using various covariates, such as sociodemographic, biological, and proximate co-factors, this piecewise hazard model is fitted to the Infant Mortality Data of Bangladesh Demographic and Health Survey 2014. Finding the change point and the impact of covariates on the hazard rate is done using the maximum likelihood estimation process. The parameter&amp;apos;s significance is subsequently supported by the Wald test statistic. It turns out that the mother&amp;apos;s educational status, religion, mother&amp;apos;s age in years, the number of children they have ever had, currently breastfeeding, the size of the child, desire for more children, cesarean delivery, ANC visits, and birth orders are all significant factors. It is also discovered that the detected change point of the hazard rate is extremely important for the child until they reach the age of five. Through the various time cut points, it is found that a piecewise linear multiple change-point model is very important for under-five child mortality. Public health specialists, researchers, and clinicians can all benefit from this piecewise hazard model. One of the most crucial elements in lowering child mortality is time.

Women’s Struggles for Empowerment in Bangladesh

Women have made substantial gains in health, education, and political representation in Bangladesh, which has been led by female prime ministers since 1991. Women play a key role in the garment industry, the country’s main export sector, and entrepreneurial ventures funded by microcredit loans have also boosted women’s empowerment. But entrenched patriarchal norms have pushed back against these changes, limiting women’s mobility, their presence in public spaces, their sexuality, and their reproductive choices.

Prevalence and determinants of malnutrition among women of reproductive age in Bangladesh

BackgroundMalnutrition among women of reproductive age is an important public health issue with significant implications for maternal and child health. A complex interplay of socioeconomic, cultural, and environmental factors influences the prevalence and determinants of malnutrition in this demographic status.This study aims to determine the socioeconomic, cultural, and demographic factors that significantly impact the nutritional status of women of reproductive age in Bangladesh. MethodsThis study considered 19798 women who underwent nutritional status assessment from the Bangladesh Demographic and Health Survey 2017–18 (BDHS 2017–18). A chi-square test of association and multinomial logistic regression analysis were performed to identify the factors that substantially influenced nutritional status. ResultsOdds ratios (OR) and 95% confidence intervals (CI) were used to evaluate the risk factors associated with body mass index (BMI). This study revealed that the average body mass index of ever-married women in Bangladesh was 23.32 ±4.24 kg/m². The odds ratio of being overweight and obese was higher among women who lived in urban areas (OR=1.094 and 1.254, p<0.05) and those who lived in the Chattogram division (OR=4.249 and 6.341, p<0.05). In addition, those exposed to mass media (OR=1.247 and 1.882) and involved in business (OR=1.644 and 2.162, p<0.05) were found to be overweight compared to their complementary group. ConclusionEffective prevention and control programs should be implemented to target women with a higher risk of developing the disease to reduce the prevalence of malnutrition.

Exploration of modern contraceptive methods using patterns among later reproductive-aged women in Bangladesh.

With the rapid increase in the number of women in their later reproductive years (aged 35 and above) in the present decade, the concern surrounding their contraceptive considerations has reached a critical point of importance. This study aims to examine the trends and determinants of modern contraceptive uptake among later reproductive-aged women in Bangladesh. A total of 17,736 women aged 35 and above were included in the analysis, utilizing data from three consecutives Bangladesh Demographic and Health Surveys conducted in 2011, 2014, and 2017-18. The outcome variable was the uptake of modern contraceptive methods (yes or no). The explanatory variables encompassed survey years, individual characteristics of the women, as well as characteristics of their partners and the community. Multilevel logistic regression model was used to explore the association of the outcome variable with explanatory variables. We found that approximately 54% of women aged 35 and more do not use modern contraceptive methods, and there have been no significant shifts in their usage observed over the survey years. Compared to women aged 35-39, women aged 40-45 (aOR = 0.53, 95% CI: 0.49-0.57) and 45-49 (aOR = 0.24, 0.22-0.26) reported lower likelihoods of modern contraceptive method uptake. Higher education correlated with increased uptake of modern contraceptive methods (112%-142%), while partner's education showed a negative association. Later reproductive-aged women in richer (aOR = 0.83, 95% CI: 0.74-0.94) and richest (aOR = 0.76, 95% CI: 0.66-0.88) quintiles reported lower uptake of modern contraceptive methods compared to their counterparts in the poorest quintile. Later reproductive-aged women in Dhaka (aOR = 1.22, 95% CI: 1.07-1.38) and Rajshahi (aOR = 1.37, 95% CI: 1.19-1.59) regions had higher uptake of modern contraception than those residing in the Barishal division. Modern contraceptive methods uptake was 1.22 times higher among women who reported exposure to mass media and 1.19 times higher among women who reported engagement in paid work compared to among women who reported no exposure to mass media and participation in no formal work, respectively. Modern contraceptive methods uptake was 43% higher (aOR = 1.43, 95% CI: 1.32-1.55) in women with more than 2 children compared to those with ≤2 children. The study highlights no significant change in modern contraception uptake among later reproductive-aged women in Bangladesh. This raises concerns about the elevated risk of unintended pregnancies and shorter birth intervals, emphasizing the need for targeted interventions to address the specific needs and preferences of this demographic.

Mediating effect of BMI on the association of economic status and coexistence of hypertension and diabetes in Bangladesh: A counterfactual framework-based weighting approach.

Non-communicable diseases such as hypertension and diabetes are matters of huge concern worldwide, with an increasing trend in prevalence over the previous decade. First of all, this study aimed to evaluate the association between economic status (ES) and body mass index (BMI), ES and comorbidity of hypertension and diabetes, and BMI and comorbidity independently. Second, it explored the mediating role of BMI in the association between ES and comorbidity of hypertension and diabetes. Finally, it investigated whether the mediating effect differs with the place of residence, gender, and education levels. A total of 11,291 complete cases from the Bangladesh demographic and health survey 2017-18 were utilized for this study. Survey-based binary logistic regression or multiple logistic regression was used to find the association among outcome, exposure, and mediator variables, and a counterfactual framework-based weighting approach was utilized for mediation analysis. Middle-income (adjusted odds ratio [AOR]: 1.696, 95% confidence interval [CI]: 1.219, 2.360) and rich (AOR: 2.770, CI: 2.054, 3.736) respondents were more likely to have comorbidity of hypertension and diabetes compared to the poor. The odds of comorbidity increased with the increase in BMI. A positive association was observed between ES and BMI. A significant mediating role of BMI in the association between ES and comorbidity was found. We observed that 19.85% (95% CI: 11.50%, 49.6%) and 20.35% (95% CI: 14.9%, 29.3%) of total effect was mediated by BMI for middle and rich respondents, respectively, compared to the poor. The mediating role of BMI was greater for female, no or primary educated respondents, and respondents from rural areas. Therefore, the study will facilitate policymakers of Bangladesh and other countries with a similar set-up to decide on health policies regarding hypertension and diabetes.