Urban Bangladesh Research Articles

Child Mouthing of Soil and Contaminated Fomites and Unimproved Sanitation are Associated with Subsequent Poor Child Developmental Outcomes in Urban Bangladesh (CHoBI7 Program)

To evaluate the relationship between mouthing of soil and living in unsanitary conditions and child cognitive development in urban Bangladesh. This prospective cohort study of 224 children under 5years of age was conducted in urban Dhaka, Bangladesh. Developmental outcomes were assessed by communication, fine motor, gross motor, personal social, problem solving, and combined developmental scores measured by the Extended Ages and Stages Questionnaire (EASQ) at a 12-month follow-up visit. Children who had caregiver reports of puting soil in their mouths at the majority of surveillance visits had significantly lower combined EASQ Z scores (coefficient, -0.53; 95% CI, -0.83 to -0.22) at the 12-month follow-up visit. Children who had caregiver reports of putting visibly dirty objects in their mouths at the majority of visits had significantly lower combined EASQ Z scores (-0.50; 95% CI, -0.79 to -0.22). Children in households with unimproved sanitation had significantly lower combined EASQ Z scores (-0.63; 95% CI, -1.11 to -0.16). Children found to frequently put soil and visibly dirty objects in their mouths, and those who resided in households using unimproved sanitation, had lower subsequent cognitive developmental outcomes. These findings demonstrate the importance of interventions targeting child mouthing behaviors and sanitation infrastructure to decrease exposure to fecal pathogens and improve child cognitive developmental outcomes.

Exploring the Tensions between the Owners and the Drivers of Uber Cars in Urban Bangladesh

Most scholarly discussions around ridesharing applications center on the experiences of the drivers and the riders (passengers), and thus the role of the owners of the cars, if they are different from the drivers, remain understudied. However, in many countries in the Global South, the car owners are often different from the car drivers, and the tensions between them often shape the experience with these ridesharing apps in those countries. In this paper, we address this issue based on our interview-based study in Dhaka, Bangladesh, which incorporates semi-structured interviews of 31 Uber drivers and 10 car owners. From our interviews, we identify the contract models that facilitate the partnership between prospective Uber drivers without a car and car owners seeking to rent their cars for Uber, describe the tensions between these two parties, provide a nuanced cultural portrayal of their negotiation mechanisms, and highlight the reasons for which the driver or the owner leaves Uber. Our analysis reveals how the local adoption of sharing economy amplifies existing inequalities and disrupts the prevailing social dynamics. We also connect our findings to the broader interests of CSCW around work, privacy, power and discuss their implications for design and policy formulations.

The Burden of Neonatal Mortality in Urban Slums of Bangladesh: Evidence from Bangladesh Urban Health Survey 2013 Data

Children in slums are in a vulnerable situation because of their low living standard and poor access to healthcare services. It is melancholic that newborns are the worst victims of this devastating condition. This paper aims at finding out the potential determinants of neonatal death in urban slums using Bangladesh Urban Health Survey 2013 data. For the purpose of analyses, bivariate analysis has been conducted using chi-square test and multiple logistic regression model is used to assess the adjusted effects of potential determinants of neonatal mortality in slum area. Results indicate that type of birth, mother’s education, working status, NGO membership, migration status, pregnancy complication and water source played significant role in occurring neonatal death in slum areas. In order to reduce neonatal mortality in slums, migrant mothers should get the highest priority; awareness building programs should be held frequently in slums regarding maternal health and health care practices for the pregnant mothers as well as their newborn babies.
 Dhaka Univ. J. Sci. 69(1): 31-35, 2021 (January)

Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh.

Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings.

Modelling faecal pathogen flows and health risks in urban Bangladesh: Implications for sanitation decision making.

Faecal-oral infections are a major component of the disease burden in low-income contexts, with inadequate sanitation seen as a contributing factor. However, demonstrating health effects of sanitation interventions - particularly in urban areas - has proved challenging and there is limited empirical evidence to support sanitation decisions that maximise health gains. This study aimed to develop, apply and validate a systems modelling approach to inform sanitation infrastructure and service decision-making in urban environments by examining enteric pathogen inputs, transport and reduction by various sanitation systems, and estimating corresponding exposure and public health impacts. The health effects of eight sanitation options were assessed in a low-income area in Dhaka, Bangladesh, with a focus on five target pathogens (Shigella, Vibrio cholerae, Salmonella Typhi, norovirus GII and Giardia). Relative to the sanitation base case in the study site (24% septic tanks, 5% holding tanks and 71% toilets discharging directly to open drains), comprehensive coverage of septic tanks was estimated to reduce the disease burden in disability-adjusted life years (DALYs) by 48-72%, while complete coverage of communal scale anaerobic baffled reactors was estimated to reduce DALYs by 67-81%. Despite these improvements, a concerning health risk persists with these systems as a result of effluent discharge to open drains, particularly when the systems are poorly managed. Other sanitation options, including use of constructed wetlands and small bore sewerage, demonstrated further reductions in local health risk, though several still exported pathogens into neighbouring areas, simply transferring risk to downstream communities. The study revealed sensitivity to and a requirement for further evidence on log reduction values for different sanitation systems under varying performance conditions, pathogen flows under flooding conditions as well as pathogen shedding and human exposure in typical low-income urban settings. Notwithstanding variability and uncertainties in input parameters, systems modelling can be a feasible and customisable approach to consider the relative health impact of different sanitation options across various contexts, and stands as a valuable tool to guide urban sanitation decision-making.

Changing trends in nutritional status of adolescent females: a cross-sectional study from urban and rural Bangladesh

ObjectivesMalnutrition remains a major problem among adolescents worldwide, but the types of nutritional problem impacting this group are changing significantly. This study aims to describe and analyse the trends in...

Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh.

As the world's longest running pandemic, cholera poses a substantial public health burden in Bangladesh, where human vulnerability intersects with climatic variability. Barriers to safe water and sanitation place the health of millions of Bangladeshis in jeopardy - especially those who have highly constrained choices in preventing and responding to cholera. In this paper we investigate demand for cholera prevention among residents in the Mirpur and Karail slum areas of urban Dhaka. Using survey data from 2023 households in two slum areas, we analyze responses from a contingent valuation questionnaire that elicited willingness to pay (WTP) for cholera vaccines across household members and under varying disease risk scenarios, finding higher valuation for cholera prevention for children and under scenarios of greater epidemic risk. We estimate the average WTP for a cholera vaccine for a child ranges from TK 134-167 (US$ 1.58-1.96). Consistently, respondents with prior knowledge of the cholera vaccine reported lower WTP valuations, providing suggestive evidence of concerns about vaccine effectiveness and preferences for cholera treatment over prevention. We supplement the contingent valuation analysis with cost of illness estimates from both our household sample as well as from administrative hospital records of over 34,000 cholera patients. We estimate that a household incurs costs of TK 801-922 (US$ 9.43-10.50) per episode of cholera that requires medical treatment. Taken together, these findings indicate higher WTP for cholera treatment compared to prevention, but increased interest in prevention under early warning system scenarios of high disease risk.

An Exploratory Study, Wearable Development and Experiment to Understand Driving Stress in Urban Bangladesh

An Exploratory Study, Wearable Development and Experiment to Understand Driving Stress in Urban Bangladesh

Community-based screening to determine the prevalence, health and nutritional status of patients with CKD in rural and peri-urban Bangladesh.

Background:Studies have labelled chronic kidney disease (CKD) among the adult population in urban Bangladesh. To address knowledge gaps on CKD, we aimed to generate data on prevalence, health and nutrition of CKD individuals living in rural and peri-urban Bangladesh.Methods:Participants were recruited from the Mirzapur Demographic Surveillance System by age-stratified random sampling. We screened participants by measuring serum creatinine and urine albumin to creatinine ratio, and collected socio-demographic, lifestyles and health information (phase I). After 3 months (phase II), we repeated the urine and blood tests as per the Kidney Disease Outcomes Quality Initiative guidelines. The glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation.Results:Among 928 participants, 872 completed the study. In phase I, probable CKD cases were 281 (32.2%); in phase II, confirmed cases were 192 (22.0%) (stage 1, 4.0%; stage 2, 11.8%; stage 3, 5.5%; stage 4, 0.6%; stage 5, 0.1%). In multivariable analysis, associated factors for prevalent CKD included aged ⩾60 years [adjusted odds ratio (aOR) 5.02; 95% confidence interval (CI) 1.85–13.65], hypertension (aOR 3.08; 95% CI 2.07–4.59), diabetes (aOR 2.52; 95% CI 1.60–3.96), presence of red blood cell in urine (aOR 3.20; 95% CI 1.71–5.98) and anemia (aOR 2.50; 95% CI 1.63–3.84).Conclusions:This is the first ever research on CKD prevalence in rural and peri-urban Bangladesh and recorded about 22%, which is higher than urban settings. Monitoring systems are needed to evaluate the overall burden and to mitigate risk factors with an emphasis on the rural and peri-urban population.

Women’s Economic Participation, Time Use, and Access to Childcare in Urban Bangladesh

Women’s Economic Participation, Time Use, and Access to Childcare in Urban Bangladesh

Cybercrime Experiences, Handling and Practices: A Reality Check in the Perspective of Urban Bangladesh

Cybercrime Experiences, Handling and Practices: A Reality Check in the Perspective of Urban Bangladesh

A SIX-DECADE REVIEW: RESEARCH ON CATTLE PRODUCTION, MANAGEMENT AND DAIRY PRODUCTS IN BANGLADESH

Background: Historical changes in the demand of animal protein sources (milk & meat) for human consumption have been largely increased due to increased growth of human population, income and urbanization in Bangladesh. Research on cattle production and management especially cattle breeding, feeds and fodders, milk production and products have contributed to increase potential production and genetic gains of cattle. A comprehensive review on the published inland research reports on cattle production, management and dairy products are lacking in literature which is required for further research for the cattle development and production. Objectives: An attempt to review on the published inland research reports on the advances in science and technology on cattle production, management and dairy products in Bangladesh Materials and Methods: A systematic literature review of research articles on cattle production, management and dairy products published between 1962 and 2020 from Bangladesh has been reviewed. A total of 1185 research articles on cattle production, management and dairy products supported with some international related articles have been reviewed and analyzed. Results: Research data on cattle production, management and dairy products are compiled from 1185 different research reports supported with some international reports. This review covers the status of cattle breeds and varieties with tabulated summary of 21 reports on draught cattle, 83 on fodder production, 97 on nutrition, feeds and feeding, 88 on trials of different feed formulations in non-dairy cattle and 68 on dairy cattle, 5 on the effects of heat stress on health and production, 39 on fattening of cattle, 27 on genetics and breeding, 75 on semen and AI, 20 on factors associated with conception rate (CR), 8 on oocyte and embryo collection, 9 on genotypes of dairy cows, 7 on management of smallholder dairy farms, 48 on milk production status of dairy cattle, 32 on economics of rearing cattle, 99 on productive and reproductive performances of cattle, 7 on estrus and pregnancy diagnosis, 7 problems of dairy farmers, 23 on preservative and adulteration of milk, 20 on constituents and methods of sweet preparation, 11 on cheese preparation, 9 on ice-cream, 56 on yoghurt, 4 on beef cattle production, 34 on birth weight, and 15 on calf rearing including calf milk replacer and calf starter. Conclusions: Data based reports are important for priority setting and targeting with mandate for cattle development and increase production. Currently, one of the biggest gaps in the inland datasets on cattle research and this review addresses this gap by bringing together in a review and highlighting some of the major findings. Cross-breeding remains an attractive option for cattle improvement because of the quick results that can be obtained by its use and the potential benefits it has farmers. This review would serve as an archive of research reports on cattle production, management and dairy products for the concerned academicians, research scientists, organizations and government for future planning for education, research and extension on cattle production. Keywords: Systematic review, Six decades, Cattle, Management, Production, Dairy products, Bangladesh

Family Socioeconomic Determinants and Students’ Demand for Private Supplementary Tutoring in English in Urban and Rural Bangladesh

The article examines family socioeconomic determinants that stimulate students’ demand for private supplementary tutoring in English in urban and rural areas. It identifies the scale disparities of tutoring demand factors between urban and rural settings. Usually private supplementary tutoring is called shadow education that parallels mainstream school education before or after school hours on extra fee basis. This study found in a 2014–2015 survey that 84.7% urban and 60.7% rural secondary students received private supplementary tutoring in English. The research employed an explanatory sequential mixed method design including quantitative and qualitative data collected from a survey and individual interview. In spite of emergence of tutoring demand, a few students could not be capable to receive private English tutoring. Family socioeconomic standpoints shake forms of students’ claims for learning through tutoring. The study draws on Bourdieu’s theory of capital, which is then linked with family ability for children’s tutoring.

Micro-credit vs. Group savings – different pathways to promote affordable housing improvements in urban Bangladesh

The housing condition of the urban poor is associated with the provision of housing finance. To address this challenge micro-finance has been considered as an alternative option in different literatures. Bangladesh is no exception in this regard. This paper highlights that the urban poor living in diverse forms of settlements in Bangladesh are making use of micro-credit from NGOs for housing-related upgrading activities that is not officially targeted for housing microfinance, but for supporting livelihood strategies. Another model of housing finance presented in this paper is community group savings programme which has been operationalised in Bangladesh over the last few years and promoted especially through the urban development projects by international agencies. This paper is an attempt to identify the salient features of these two provisions of finance in low-income urban settlements of Bangladesh. The paper follows a tradition of research in understanding different modes of housing provision of the urban poor that is related with the access to different form of finance to improve the housing condition of the urban poor. To do so two different cases from Gopalganj and Khulna city are presented, analysed and compared to deepen the understanding of how housing finance is operationalised in practice.

Making information and communications technologies (ICTs) work for health: protocol for a mixed-methods study exploring processes for institutionalising geo-referenced health information systems to strengthen maternal neonatal and child health (MNCH) service planning, referral and oversight in urban Bangladesh

IntroductionDisparities in health outcomes and access to maternal neonatal and child health (MNCH) are apparent among urban poor compared with national, rural or urban averages. A fundamental first step in...

Nexus Between Urban Green Streets and the Sustainability: Case on Khulna City Corporation (KCC) Area, Bangladesh

Rapid Urbanization in Bangladesh has created a negative impact on the ecosystem and it’s resulting a change in the climate. In this research, Khulna City Corporation (KCC) is chosen to be the study area. The main objective of this study is to propose feasible models of green streets to reduce environmnetal pollution. Then it proposes green belts to alleviate the effect of harmful gases while maintaining ecological balance to achieve Sustainable Development Goals (SDGs) 11th goal. The study is completed in three phases. Firstly, Land Use Land Cover (LULC) detection and public opinion survey was conducted considering the existing scenario. Secondly, green street system was proposed in different intersection points, highways and neighborhoods of Khulna city on the basis of some successful cases and finally a conceptual framework for achieving SDG’s 11th goal is shown. This research shows that about 5% vegetation has decreased over the last 20 years. Also it shows the total amount of carbon-di-oxide (CO2) that can be consumed by big trees after 10 years is approximately 32,340 kg per year. The total amount of CO2 that can be consumed by shrubs is 34,810 kg per year. According to user satisfaction survey more than 90% people like the idea of green street and more than 60% people thinks that using the streets will be more convenient after its implementation. The successful adoption of green streets will help to achieve livable and healthy communities and also it will push the urban area towards sustainability by achieving SDG’s 11th goal.

Work and breast milk feeding: a qualitative exploration of the experience of lactating mothers working in ready made garments factories in urban Bangladesh

BackgroundIn Bangladesh 65% of children under 6 months of age were exclusively breastfed with maternal employment being a risk factor that has jeopardized exclusive breastfeeding. As Ready Made Garment (RMG) factories have been the largest employer of low income women in Bangladesh, the objective of our study was to explore the barriers and facilitators of breastfeeding and perceptions about use of expressed breast milk among mothers who worked in the RMG sector.MethodsThis formative research was conducted during July–September 2015 in two slums of Dhaka among RMG workers who were mothers and the caregivers of 0–12 month old infants. Qualitative data was obtained from purposively selected participants of 8 in-depth interviews and 4 focus group discussions (mothers and caregivers), and 2 key informant (RMG factory official) interviews. Mothers were from multiple RMG factories while factory officials were from a single factory. Thematic analysis was conducted.ResultsThe main themes of qualitative exploration were knowledge and experience of breastfeeding; structural barriers (home and workplace); consequences of inadequate breastfeeding; and perception and experience of using expressed breast milk. Despite knowledge both of the benefits of breast milk and of the importance of breastfeeding for 6 months, most mothers introduced formula as early as 2 months to prepare for their return to work. Barriers such as excessive workload, inadequate crèche facilities at work, and lack of adequate caregivers at home impeded exclusive breastfeeding. Mothers and caregivers had very little knowledge about the use of expressed breast milk and were concerned about contamination.ConclusionAs RMG factories are the largest employer of low-income women in Bangladesh, facilitating RMG factory working mothers’ ability to use breast milk could help to promote infant health and help women remain in the workforce.

Overweight and obesity among urban women with iron deficiency anaemia in Bangladesh.

In this study, we aimed to determine the prevalence and factors associated with overweight and obesity among nonpregnant and nonlactating (NPNL) women of reproductive age with iron deficiency anaemia (IDA) in urban Bangladesh. We obtained data from the baseline assessment of a randomized control trial conducted among 525 women of reproductive age (18–49 years) with IDA (Hb < 12 gdl−1 and serum ferritin <30 μg L−1). The study was carried out in Mirpur, Dhaka, Bangladesh, between December 2017 and January 2019. We collected information on women's socio‐demographic characteristics and anthropometry. Body mass index (BMI) was calculated using the following formula: weight in kilograms per height in square metres. BMI ≥ 25–29.9 kg m−2 was considered as overweight, whereas BMI ≥ 30 kg m−2 as obese. A multivariable logistic regression model was used to ascertain the risk factors of overweight and obesity. The prevalence of overweight and obesity was 29.9% (95% CI: 26.0–34.0) and 13.1% (95% CI: 10.4–16.3), respectively. The combined prevalence of overweight and obesity was 43.0% (95% CI: 38.7–47.4). The multivariable analysis showed married women (aOR: 4.4; CI: 1.8–11.1), women aged 30–49 years (aOR: 7.6; CI: 2.4–24.1), unemployed women (aOR 1.5; CI: 1.0–2.4) and women from the wealthier households (aOR 3.9; CI: 2.3–6.8) had the highest risk of being overweight and obese compared with their counterparts. Both age and household wealth statuses showed dose–response relationships. Combination of overweight and obesity with IDA poses a particular challenge for public health interventions. The policymakers should consider what new interventions and policy initiatives are needed to address this combination of overweight and obesity with IDA.

Developing and testing community-based tuberculosis (TB) screening intervention to increase TB referral, case detection and knowledge among sexual minority people in urban Bangladesh: a mixed-method study protocol

IntroductionAlthough Bangladesh is a country of generalised tuberculosis (TB) epidemic, the HIV prevalence is low among general populations, and 3.9% among key populations. Despite the high possibility of HIV–TB coinfection,...

Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings.

IntroductionAccompanying rapid urbanization in Bangladesh are inequities in health and healthcare which are most visibly manifested in slums or low-income settlements. This study examines socioeconomic, demographic and geographic patterns of self-reported chronic illness and healthcare seeking among adult slum dwellers in Bangladesh. Understanding these patterns is critical in designing more equitable urban health systems and in enabling the country’s goal of Universal Health Coverage by 2030.MethodsThis descriptive cross-sectional study compares survey data from slum settlements located in two urban sites in Bangladesh, Tongi and Sylhet. Reported chronic illness symptoms and associated healthcare-seeking strategies are compared, and the catastrophic impact of household healthcare expenditures are assessed.ResultsSignificant differences in healthcare-seeking for chronic illness were apparent both within and between slum settlements related to sex, wealth score (PPI), and location. Women were more likely to use private clinics than men. Compared to poorer residents, those from wealthier households sought care to a greater extent in private clinics, while poorer households relied more on drug shops and public hospitals. Chronic symptoms also differed. A greater prevalence of musculoskeletal, respiratory, digestive and neurological symptoms was reported among those with lower PPIs. In both slum sites, reliance on the private healthcare market was widespread, but greater in industrialized Tongi. Tongi also experienced a higher probability of catastrophic expenditure than Sylhet.ConclusionsStudy results point to the value of understanding context-specific health-seeking patterns for chronic illness when designing delivery strategies to address the growing burden of NCDs in slum environments. Slums are complex social and geographic entities and cannot be generalized. Priority attention should be focused on developing chronic care services that meet the needs of the working poor in terms of proximity, opening hours, quality, and cost.