People In Rural Bangladesh Research Articles

Gender Differentials In Nutritional Status of Elderly People In Selected Rural Areas of Bangladesh

Background: The present cross sectional study was undertaken to assess the food habits and nutritional status among elderly people in rural Bangladesh and to compare the same between male and female. A simple random sampling and geographical re-conciliation method was used to select the study population. All the patients in a pre-publicized medical camp were approached and a total of 186 male and 237 female participated in the study. Data were collected through face to face interview with a semi-structured questionnaire and anthropometric measures were collected using instruments. Associations between dietary intake and World Health Organization (WHO) referred Body Mass Index (BMI) range was done using cross tabulation. Results: The mean age of male was 67.69 years and that of female was 65.46 years. The female subjects were higher than males in number in this study. The rate of male literacy was found to be 39.8% where literacy among the female was 13.9%. Among all, 79.6% males were found to be living with their spouse where the rate of living with spouse among the female amounted 53.2%. About half of elderly people were found to be living under poor and 32% in low middle class socio-economic condition. Study revealed that 80.6% male and 78.9% female got no opportunity to take protein-rich food more than three days per week. Again 95.7% male and 97.5% female had no opportunity take more than two servings of protein rich food per week. The similar case occurred in case of taking fatty food, vegetable and fruits per week. Similarly 100 % male and 99.6% female reported that they were taking more than two servings of fatty food per week. No significant association was found between BMI and food intake. The significance was tested by Pearson chi-square. In this test the p –value for protein rich food was 0.234 (p?0.05), while fatty food (0.712), vegetable (0.502) and fruits (0.274) which was more than referred significance p-value ?0.05. Hence, the study confirmed that malnutrition remains a common problem among older people living in rural Bangladesh though there is no significant association was found between food intake and nutrition. Conclusion: Management of malnutrition in case of elderly population requires a multidisciplinary approach that treats pathology and uses both social and dietary forms of intervention. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 150-157 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14943

UDDER-HALVE-WISE COMPARATIVE PREVALENCE OF CLINICAL AND SUB-CLINICAL MASTITIS IN LACTATING GOATS WITH THEIR BACTERIAL PATHOGENS AND ANTIBIOTIC SENSITIVITY PATTERNS IN BANGLADESH

Goats are the major parts of subsidiary economy of the rural people in Bangladesh. Dairy animals including lactating goats are prone to the intramammary infection (IMI) and associated with a lot of economic impact on the farmers but the reports on caprine mastitis are very limited in inland literature. This study was undertaken to determine the udder-halve-wise comparative prevalence of clinical and sub-clinical caprine mastitis with their associated bacterial pathogens and antibiotic sensitivity patterns during the period from January to May 2010. The teat and udder of a lactating population of 1025 Black Bengal goats maintained under rural (village) condition in two different districts (Joypurhat and Mymensingh) of Bangladesh were physically examined, of which 54 (5.27%) goats had clinical mastitis which constituted as experimental animals for this study. Of the 54 selected goats, 59 (54.63%) udder-halves were affected with clinical mastitis whereas the remaining 49 (45.37%) udder-halves of the selected goats were found physically normal. Out of 59 udder-halves, 49 (90.74%) were unilaterally and 5 (9.26%) were bilaterally affected with clinical mastitis. The prevalence of clinical mastitis was found significantly (p < 0.01) higher in left udder-haves (H = 47; 79.66%) in comparison to the right (H = 12; 20.34%) udder-halves. Milk samples collected from all the 108 udder-halves were examined bacteriologically, of which 102 (94.44%) udder-halves had bacterial infection. No significant differences was observed on the status of bacterial pathogens between clinically (H = 55; 93.22%) and sub-clinically (H = 47; 95.92%) affected udder-halves, and between the single (CH = 45; 76.27% and SCH = 35; 71.43%) and mixed (CH = 10; 16.95% and SCH = 12; 24.49%) bacterial infections in both the clinical and sub-clinical mastitis udder-halves. The major bacterial pathogens isolated were Staphylococcus spp. which showed to be highest frequency (38.98%), followed by Escherichia coli (27.12%) and Bacillus spp. (10.17%) as a single clinical IMI whereas mixed IMI were also detected in both clinically and sub-clinically affected udder-halves. Antibiotic sensitivity results showed a relatively high level of resistance to ampicillin, amoxycillin and streptomycin, whereas gentamicin and ciprofloxacin were found to be the most effective drugs. These results indicate the high prevalence of sub-clinical mastitis in apparently normal quarters of lactating goats than those had clinical mastitis in other udder-halves, and therefore, there is a need for the prudent use of antibacterial in animal health and production through bacteriological and antibiogram studies in Bangladesh.DOI: http://dx.doi.org/10.3329/bjvm.v9i2.13456

Coping strategies with floods in Bangladesh: an empirical study

In the time of the flooding, rural people in Bangladesh suffer from the lingering effects of labor market disruption and income deficiency. This study shows a model based analysis on the research question, ‘what coping strategies are followed by the flooded households in Bangladesh and how?’. Data are collected through a three stage stratified random sampling technique on 595 flooded and rural households’. Survey is carried out aftermath of the flood in the year 2005, from four different districts in Bangladesh. A major proportion of households are found to borrow money or resources from informal sources, such as nearby shops or the pharmacy, friends or relatives, or local money lenders, to buy food items and other essentials. A censored tobit model analysis shows that households initiate coping with borrowing money after the realization of floods, and gradually lead to cope with savings and selling assets as the duration of flood increases.

NGOs and the Political Empowerment of Poor People in Rural Bangladesh: Cultivating the Habits of Democracy?

Recent research in Bangladesh highlights an interesting paradox: impressive development outcomes combined with extremely poor quality of governance. The country’s active development NGO sector has been credited with some of the more positive development achievements. The question that this paper sets out to address is why the sector has not made an equivalent contribution on the governance front. It draws on primary survey data to explore the hypothesis that the problem lies in the increasing homogenization of NGOs around the delivery of services, primarily microfinance services, and its shift away from social mobilization organizations.

Prevalence and Patterns of Multimorbidity among Elderly People in Rural Bangladesh: A Cross-sectional Study

Data on multimorbidity among the elderly people in Bangladesh are lacking. This paper reports the prevalence and distribution patterns of multimorbidity among the elderly people in rural Bangladesh. This cross-sectional study was conducted among persons aged > or = 60 years in Matlab, Bangladesh. Information on their demographics and literacy was collected through interview in the home. Information about their assets was obtained from a surveillance database. Physicians conducted clinical examinations at a local health centre. Two physicians diagnosed medical conditions, and two senior geriatricians then evaluated the same separately. Multimorbidity was defined as suffering from two or more of nine chronic medical conditions, such as arthritis, stroke, obesity, signs of thyroid hypofunction, obstructive pulmonary symptoms, symptoms of heart failure, impaired vision, hearing impairment, and high blood pressure. The overall prevalence of multimorbidity among the study population was 53.8%, and it was significantly higher among women, illiterates, persons who were single, and persons in the non-poorest quintile. In multivariable logistic regression analyses, female sex and belonging to the non-poorest quintile were independently associated with an increased odds ratio of multimorbidity. The results suggest that the prevalence of multimorbidity is high among the elderly people in rural Bangladesh. Women and the non-poorest group of the elderly people are more likely than men and the poorest people to be affected by multimorbidity. The study sheds new light on the need of primary care for the elderly people with multimorbidity in rural Bangladesh.

Health education improves both arthritis-related illness and self-rated health: An intervention study among older people in rural Bangladesh

To examine changes in self-reported arthritis-related illness and self-rated health as a result of a health education intervention, and the association between self-reported arthritis-related illness and self-rated health. A quasi-experimental study was conducted in eight randomly selected villages in rural Bangladesh (intervention = 4; control = 4). The intervention consisted of home-based physical activities, health advice and aspects of healthcare management over 15 months followed by a 3-month latent period. Data were collected before the intervention and after the latent period. Analyses included 839 participants (≥60 years of age) who participated in both surveys. Participants in the intervention area were further categorized into two groups who self-reported compliance or non-compliance with recommended health advice. Self-rated health was assessed using a single global question. Self-reported arthritis-related illness was indicated by the presence of arthritis, back and joint pain, biting sensation, swelling and inflammation in the joints. Hierarchical logistic regression analyses revealed that positive effects on episodes of arthritis-related illness [odds ratio (OR) 1.9, 95% confidence interval (CI) 1.3-2.8] and self-rated health (OR 1.4, 95% CI 1.0-1.9) were more likely among the compliant group compared with the control group. Furthermore, positive self-rated health was more likely among participants reporting a positive change in their arthritis-related illness (OR 2.2, 95% CI 1.5-3.2). The results also showed that literate and non-poor participants were more likely to report positive health, and participants with advancing age were less likely to report positive health. Community-based health education is effective in reducing the burden of arthritis-related illness and in enhancing general health in old age.

Economic viability of solar home systems: Case study of Bangladesh

Bangladesh is richly endowed with solar energy. Solar Photovoltaic (PV) system seems to be an appropriate form of renewable energy despite the monsoon type of climate in Bangladesh. The most attractive use of solar home system (SHS) in Bangladesh is the lighting system. People in rural Bangladesh predominantly use kerosene oil based lamps for illuminating their homes at night. Dry cell batteries are used for radio and gradually car batteries are becoming popular for running TV near grid areas where the charging facilities are available. The cost of kerosene and charging cost of battery are quite high and solar home system can compete with them in this particular field. Six cases were analyzed to find out the economic sustainability of the solar home systems at selected villages in Gazipur district, Bangladesh during October 2004–December 2004 and also questionnaire survey method was followed to collect data. This study reveals that the solar home system is financially attractive for small rural business and household lighting with entertainment. Only for household lighting purpose the system is not financially and economically viable without considering social benefits.

Perceptions of rural people about childhood burns and their prevention: A basis for developing a childhood burn prevention programme in Bangladesh

This study was conducted to gain an in-depth understanding of people's perceptions of childhood burns and their prevention in rural areas of Bangladesh. Qualitative study. Five focus group discussions were conducted in this study. Eight to twelve members were present in each group. Groups were composed of mothers of children under 5 years of age, adolescent male and female students in Grades IX and X, fathers and local leaders such as school teachers and religious leaders. The study was conducted in a rural community of Bangladesh in 2003. Focus group participants were aware of the devastating consequences of childhood burn injuries. They reported that younger boys and older girls are at higher risk of burn injuries. They identified home as the most common place for childhood burn injuries, and stated that occurrence was more common in winter. They held the household members or caregivers responsible because of their lack of supervision and carelessness. The focus group participants suggested that people should supervise their children more carefully, and should take initiatives to modify their homes and premises as necessary so that children would not have access to fires and heat sources. Regarding first aid, the focus group participants reported prevailing harmful practices which are likely to make injuries worse. A safety education programme could be an effective intervention to improve knowledge and practices of rural people in Bangladesh with regard to prevention of burns injuries in children.

Dropout Youth and Small Entrepreneurship: An Approach to Improve Livelihoods of Rural People in Bangladesh

This study analyzed the performance of the six-selected small enterprises of rural dropout youth at Nilphamari district of Bangladesh. It examined the youth's participation in different small enterprises and its impact on socioeconomic development of rural poor youth. Initially 150 rural dropout youths were selected for getting overall information. Thereafter, 30 rural dropout youths were identified who had taken agricultural entrepreneurship as their means of living. It revealed dropout rate at primary and secondary level schools decreased over the year. The rate of taking agricultural entrepreneurship was comparatively lower than wage laborer. The average annual income from enterprises such as livestock and poultry, nursery, fish farming, homestead gardening, horticultural and stock business were Tk. 62444, Tk. 24333, Tk. 40500, Tk. 21000, Tk. 34000 and Tk. 58571 respectively. Average change in household income was 101 percent after being involved with different small enterprises. Household assets value was increased by 164 per cent after involvement with different small enterprises. There was 138 percent increased in working days which indicated self employment opportunities of rural poor youth. Participation of the rural drop out youth to small enterprises contributed significantly towards socioeconomic upliftment of them in general and reduced the poverty gap in particular.

The multidimensional background of malnutrition among rural older individuals in Bangladesh – a challenge for the Millennium Development Goal

To investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh. A multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant. Matlab, Bangladesh. A total of 625 randomly selected individuals (>or=60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women. Twenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P < 0.001), gastrointestinal disorders (P < 0.01), depressive symptoms (P < 0.001) and impaired cognitive function (P < 0.01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P < 0.05), having no income (P < 0.01), being illiterate (P < 0.01) and not receiving regular financial support (P < 0.05) were also independently associated with poor nutritional status. Malnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.

Dynamics of Health Care Seeking Behaviour of Elderly People in Rural Bangladesh

Bangladesh is projected to experience a doubling of its elderly population from the current level of 7 million to 14 million by the end of the next decade. Drawing upon qualitative evidence from rural Bangladesh, this article focuses on coping strategies in cases of illness of elderly people and the contributing factors in determining the health-seeking behaviour of elderly persons. The sample for this study consisted of elderly men and women aged 60 years or older and their caregivers. Nine focus group discussions and 30 in-depth interviews were conducted. Findings indicate that old age and ill-health are perceived to be inseparable entities. Seeking health care from a formally qualified doctor is avoided due to high costs. Familiarity and accessibility of health care providers play important roles in health-seeking behaviour of elderly persons. Flexibility of health care providers in receiving payment is a crucial deciding factor of whether or not to seek treatment, and even the type of treatment sought.

Social Capital and Quality of Life in Old Age

The objective of this article is to identify determinants of quality of life (QoL) and investigate their association with individual- and community-level social capital among older people in rural Bangladesh. A cross-sectional study of 1,135 elderly persons (aged >/= 60 years) was conducted in a rural district in Bangladesh. Independent variables included age, sex, education, economic status of the elderly person, and individual- and community-level social capital. Self-rated QoL was the dependent variable. Descriptive analyses were done to show group differences in QoL and logistic regression analyses to identify determinants of QoL. Advanced age, poor household economic status, and low social capital at individual and community levels were significant determinants of poor QoL among the elderly. This population-based study provided empirical evidence that social capital both at individual and community levels was directly associated with the QoL of elderly people in rural Bangladesh.

Turning liabilities into resources: informal village doctors and tuberculosis control in Bangladesh

In 1998, the Damien Foundation Bangladesh invited semi-qualified, private "gram dakter" (Bangla for "village doctors") to participate in tuberculosis (TB) programmes in a population of 26 million people in rural Bangladesh. The organization trained 12 525 village doctors to not only refer suspected TB cases for free diagnosis but also to provide directly observed treatment (DOT) free of charge. Source of referral and place of DOT was recorded as part of the standardized TB recording and reporting system, which enabled us to quantify the contribution of village doctors to case detection rates and also allowed disaggregated cohort analysis of treatment outcome. During 2002 and 2003, 11% of all TB cases with positive sputum smears in the study area had been referred by village doctors; the rate of positive tests in patients referred by village doctors was 14.4%. 18 792 patients received DOT from village doctors, accounting for between 20% and 45% of patients on treatment during the 1998-2003 period. The treatment success rate was about 90% throughout the period. Urine samples taken during random checks of treatment compliance were positive for isoniazid in 98% of patients treated by village doctors. Within the framework of Public-Private Mix DOTS, services provided by semi-qualified private health care providers are a feasible and effective way to improve access to affordable high quality TB treatment in poor rural populations. The large informal health workforce that exists in resource poor countries can be used to achieve public health goals. Involvement of village doctors in TB control has now become national policy in Bangladesh.

Prevalence of sputum smear-positive tuberculosis in a rural area in Bangladesh

The objective of the study was to determine the prevalence of smear-positive tuberculosis (TB) in a rural area in Bangladesh at Matlab. A TB surveillance system was established among 106,000 people in rural Bangladesh at Matlab. Trained field workers interviewed all persons aged > or = 15 years to detect suspected cases of TB (cough > 21 days) and sputum specimens of suspected cases were examined for acid-fast bacilli (AFB). Of 59,395 persons interviewed, 4235 (7.1%) had a cough for > 21 days. Sputum specimens were examined for AFB from 3834 persons, 52 (1.4%) of them were positive for AFB. The prevalence of chronic cough and sputum positivity were significantly higher among males compared to females (P < 0.001). The population-based prevalence rate of smear-positive TB cases was 95/100,000 among persons aged > or = 15 years. Cases of TB clustered geographically (relative risk 5.53, 95% CI 3.19-9.59). The high burden of TB among rural population warrants appropriate measures to control TB in Bangladesh. The higher prevalence of persistent cough and AFB-positive sputum among males need further exploration. Factors responsible for higher prevalence of TB in clusters should be investigated.

Role and function: Aspects of quality of life of older people in rural Bangladesh

The aim of this study is to explore the meaning of quality of life (QoL) for elderly people in a rural community in Bangladesh. Data were obtained through in-depth interviews with 11 elderly persons aged 63–86 years. Interview data were analysed using content analysis to determine the conceptual meaning of elderly peoples' experiences of QoL. Two major themes emerged from the data as being of utmost importance in QoL of elderly people in rural Bangladesh. These were: (i) having a role in the family and the community and (ii) being functional, both physically and economically. Results also showed that elderly people in rural Bangladesh prioritise being healthy, having a good social network, social support and a secure financial situation in order to have good QoL. This study is a step towards a better understanding of QoL experienced by the elderly people themselves in a rural Bangladeshi context.

Assessing health-related quality of life among older people in rural Bangladesh.

The purpose of this study was to review instruments of health-related quality of life (HRQoL) to identify an instrument appropriate for elderly people in rural Bangladesh. In addition, it hypothesizes that it is important to include physical, psychological, social, spiritual, economic, and environmental dimensions when assessing HRQoL in this group. Sixteen generic instruments found through PubMed were reviewed with regard to content and construct. None of the reviewed instruments fully met the criteria required in the intended context. In-depth interviews were conducted with 11 elderly people in rural Bangladesh to explore the dimensions of HRQoL they considered important. Content analysis of the interview transcripts supported the hypothesis that all six dimensions were important. Suggestions for a new HRQoL instrument appropriate for elderly people in rural Bangladesh are presented.

Irritable bowel syndrome in a rural community in Bangladesh: Prevalence, symptoms pattern, and health care seeking behavior

OBJECTIVE: The aim of this study was to investigate the prevalence of irritable bowel syndrome (IBS) and the pattern of symptoms and health care seeking behavior of IBS subjects in the rural population in Bangladesh. METHODS: This was an observational study to do a positive diagnosis of IBS. A total of 2426 persons ≥15 yr old were interviewed by a predesigned questionnaire based on the Rome criteria. Two villages of a northern district in Bangladesh were included. RESULTS: A response of 95.4% yielded 2426 questionnaires for analysis. Mean age of the surveyed sample was 32.3 ± 14.2 yr. In total, 1113 (45.9%) were men, and 1313 (54.1%) were women. Farmers and housewives comprised 2058 (84.8%) persons. The apparent prevalence of IBS was 24.4% with a prevalence of 20.6% in men and 27.7% in women. With strict Rome criteria, the overall prevalence was 8.5% (10.7% in women and 5.8% in men). Age was not found to influence the prevalence in either sex. Other than abdominal pain, the most common IBS symptom was altered stool passage (81.1%). Others in order of frequency were passage of mucus with stool (56.8%), abdominal distension (46.2%), altered stool form (46%), and altered stool frequency (18.2%). Spastic colon pain was noted in 339 (57.2%). IBS subjects with more prevalence of colonic symptoms in the nonspastic group. Drinking milk was found to have a little impact on IBS. A total of 35% IBS subjects consulted doctors for symptoms. Age, sex, and number of symptoms did not influence health care seeking behavior. CONCLUSIONS: IBS is also a problem in rural people in Bangladesh with a prevalence almost identical to most other countries, and only a minority of them seeks health care. Positive diagnosis of IBS can be done by precisely enquiring colonic symptoms in apparently healthy people.

Irritable bowel syndrome in a rural community in Bangladesh: prevalence, symptoms pattern, and health care seeking behavior.

The aim of this study was to investigate the prevalence of irritable bowel syndrome (IBS) and the pattern of symptoms and health care seeking behavior of IBS subjects in the rural population in Bangladesh. This was an observational study to do a positive diagnosis of IBS. A total of 2426 persons > or =15 yr old were interviewed by a predesigned questionnaire based on the Rome criteria. Two villages of a northern district in Bangladesh were included. A response of 95.4% yielded 2426 questionnaires for analysis. Mean age of the surveyed sample was 32.3+/-14.2 yr. In total, 1113 (45.9%) were men, and 1313 (54.1%) were women. Farmers and housewives comprised 2058 (84.8%) persons. The apparent prevalence of IBS was 24.4% with a prevalence of 20.6% in men and 27.7% in women. With strict Rome criteria, the overall prevalence was 8.5% (10.7% in women and 5.8% in men). Age was not found to influence the prevalence in either sex. Other than abdominal pain, the most common IBS symptom was altered stool passage (81.1%). Others in order of frequency were passage of mucus with stool (56.8%), abdominal distension (46.2%), altered stool form (46%), and altered stool frequency (18.2%). Spastic colon pain was noted in 339 (57.2%). IBS subjects with more prevalence of colonic symptoms in the nonspastic group. Drinking milk was found to have a little impact on IBS. A total of 35% IBS subjects consulted doctors for symptoms. Age, sex, and number of symptoms did not influence health care seeking behavior. IBS is also a problem in rural people in Bangladesh with a prevalence almost identical to most other countries, and only a minority of them seeks health care. Positive diagnosis of IBS can be done by precisely enquiring colonic symptoms in apparently healthy people.

Implications of Grameen banking system in Europe: prospects and prosperity

The philosophy of Grameen (rural) banking system was invented by a maverick economist (Dr Yunus) in a tiny village of Bangladesh in 1976, with the aim to eliminate poverty and improve the socio‐economic condition of the rural poor. The bank provides loans to poor people who are unable to provide collateral and indoctrinated in Grameen social values, known as the “sixteen decisions”. Grameen borrowers also vow to observe the bank’s “four basic principles”, and they are the owners (92 per cent) of the bank. Grameen bank began its operations by giving a small amount of money ($30) to 40 people. Today, it employs 14,000 staff and has disbursed more than $1 billion dollars of loan among two million rural people in Bangladesh of which 95 per cent are women, and the rate of its loan repayment is 98 per cent. The Grameen is functioning not only in Bangladesh but also in 50 countries across Asia, Europe, Africa, Oceania, and in the USA. Moving onto the implementation of Grameen‐type micro‐credit systems in Europe, or elsewhere, the differences in socio‐culture, economics and politics (between Bangladesh and the region concerned) should be considered. Thus, this paper is an attempt to investigate the prospects of the implementation of Grameen/micro‐credit banking system in European socio‐economic and cultural contexts.

Prevention and Cure from around the Home: Homestead Forests and Primary Health Care in Rural Bangladesh

This paper explores the inter-linkages between homestead forests, health care and the rural people of Bangladesh. In rural Bangladesh, where poverty is endemic, ill health is widespread. Yet, the provision of primary health care is perfunctory, to say the least. So, how do people get by? In this paper, we look at the role the so-called homestead forests, i.e. the trees, shrubs, plants and other ‘gifts of nature’ that grow around peoples’ homes, play in providing valuable, often the only, means of preventing and/or curing many common physical ailments. A brief socio-anthropological survey of herbal medicines is conducted first to background the importance humankind has historically placed on nature in the matter of health care. The place of such medication in the culture of the Indian subcontinent is explored next. Data from field surveys conducted in four Bangladeshi villages are then analysed to show how homestead forests meet the demands of health care in rural Bangladesh. Implications for public policy in regard to homestead forests and their contribution to health care are also addressed in the paper.