Urban Slums Of Bangladesh Research Articles

Is mid-upper arm circumference alone sufficient for deciding admission to a nutritional programme for childhood severe acute malnutrition in Bangladesh?

Mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) identify different populations of children with severe acute malnutrition (SAM) with only some degree of overlap. In an urban slum in Bangladesh, we conducted a prospective cohort study on children assessed as being severely malnourished by WHZ (<-3) but not by MUAC (>115 mm), to: 1. Assess their nutritional outcomes, and 2. Report on morbidity and mortality. Children underwent 2-weekly prospective follow-up home visits for 3 months and their anthropometric evolution, morbidity and mortality were monitored. Of 158 children, 21 did not complete follow-up (six were lost to follow-up and 15 changed residence). Of the remaining 137 children, nine (7%) required admission to the nutrition programme because of: MUAC dropping to <115 mm (5/9 children), weight loss ≥ 10% (1/9 children) and severe medical complications (3/9 children, of whom one died). Of the remaining 128 children who completed follow-up, 91 (66%) improved in nutritional status while 37 (27%) maintained a WHZ of <-3. Cough was less frequent among those whose nutritional status improved. It seems acceptable to rely on MUAC as a single assessment tool for case finding and for admission of children with SAM to nutritional programmes.

Water Supply and Sanitation Facilities in Urban Slums: A Case Study of Rajshahi City Corporation Slums

Slum population has been increasing in Bangladesh over the last three decades along with the growth and expansion of cities and towns. But slum facilities are very much unsatisfactory for them due to the lack of proper water supply and sanitation system. Therefore, the major portion of the households use unsafe latrine and deposit their children's excreta into road side drain and open places, which pollutes water sources, groundwater and the general environment. As a result, majority of the population in Bangladesh suffer from different kinds of water and excreta-borne diseases that aggravate their poverty situations. So, the main objective and essential goal of the study is to investigate the water supply system and sanitation facilities in urban slums of Bangladesh. During the study period, data has been collected by questionnaire survey from each slum households (15 slums and 5324 households in RCC). However, the hygienic practice has been found to be significantly low among the all households in slums although they have enough knowledge about it. The study has showed that majority slum households use tube well water for drinking but significant numbers of them are found to use open latrine for defecation. Normally, pit and water seal latrines are found which are partially hygienic. These may cause ground water contamination depending on the soil characteristics and distance between the water sources and latrines. The open disposal of excreta pollutes the nearby water bodies, canals and drains causing severe environmental pollution. Many motivational work and idea marketing from government and NGO sides help to improve their awareness level.

Distinct Distal Gut Microbiome Diversity and Composition in Healthy Children from Bangladesh and the United States

BackgroundOur current understanding of the composition and stability of the human distal gut microbiota is based largely on studies of infants and adults living in developed countries. In contrast, little is known about the gut microbiota and its variation over time in older children and adolescents, especially in developing countries.Methodology/Principal FindingsWe compared the diversity, composition, and temporal stability of the fecal microbiota of healthy children, ages 9 to 14 years, living in an urban slum in Bangladesh with that of children of the same age range in an upper-middle class suburban community in the United States. We analyzed >8,000 near full-length 16S rRNA gene sequences and over 845,000 pyrosequencing reads of the 16S rRNA V1–V3 region. The distal gut of Bangladeshi children harbored significantly greater bacterial diversity than that of U.S. children, including novel lineages from several bacterial phyla. Bangladeshi and U.S. children had distinct fecal bacterial community membership and structure; the microbiota of Bangladeshi children was enriched in Prevotella, Butyrivibrio, and Oscillospira and depleted in Bacteroides relative to U.S. children (although similar to Bangladeshi adults). Furthermore, community membership and structure in Bangladeshi children was significantly less stable month-to-month than U.S. children.Conclusions/SignificanceTogether, these results suggest that differing environmental or genetic factors may shape the microbiota of healthy children in the two countries. Further investigation is necessary to understand the mechanisms and factors that underlie these differences, and to incorporate these findings into new strategies for the prevention and treatment of childhood and adolescent diseases.

Severe malnutrition in children presenting to health facilities in an urban slum in Bangladesh.

An urban slum in Kamrangirchar, Bangladesh. Among children aged 6-59 months seeking medical care from the two Médecins Sans Frontières-supported primary health centres, to determine 1) the prevalence of severe acute malnutrition (SAM) and severe chronic malnutrition (SCM), and 2) the extent of overlap between SAM and SCM. In a retrospective record review, data were analysed from out-patient registers on age, sex, height, weight and mid-upper arm circumference (MUAC) of children attending for medical care from April to September 2011. SAM was defined as weight for height < -3 Z scores of the median and/or MUAC <115 mm. SCM was defined as height for age < -3 Z scores of the median. World Health Organization growth standards were used as reference. Data were complete in the records of 7318 (98%) children, of whom 322 (4%) had SAM and 1698 (23%) had SCM. Among the 322 children with SAM, 162 (50%) also had SCM. In an urban Bangladesh slum, SAM and SCM co-exist, with a predominance of SCM. The current national guidelines for severe malnutrition, which focus on identification and management only for SAM, urgently need to be expanded to include SCM if substantial childhood morbidity and mortality are to be reduced.

Beliefs and practices during pregnancy and childbirth in urban slums of Dhaka, Bangladesh

BackgroundWorldwide urbanization has become a crucial issue in recent years. Bangladesh, one of the poorest and most densely-populated countries in the world, has been facing rapid urbanization. In urban areas, maternal indicators are generally worse in the slums than in the urban non-slum areas. The Manoshi program at BRAC, a non governmental organization, works to improve maternal, newborn, and child health in the urban slums of Bangladesh. This paper describes maternal related beliefs and practices in the urban slums of Dhaka and provides baseline information for the Manoshi program.MethodsThis is a descriptive study where data were collected using both quantitative and qualitative methods. The respondents for the quantitative methods, through a baseline survey using a probability sample, were mothers with infants (n = 672) living in the Manoshi program areas. Apart from this, as part of a formative research, thirty six in-depth semi-structured interviews were conducted during the same period from two of the above Manoshi program areas among currently pregnant women who had also previously given births (n = 18); and recently delivered women (n = 18).ResultsThe baseline survey revealed that one quarter of the recently delivered women received at least four antenatal care visits and 24 percent women received at least one postnatal care visit. Eighty-five percent of deliveries took place at home and 58 percent of the deliveries were assisted by untrained traditional birth attendants. The women mostly relied on their landladies for information and support. Members of the slum community mainly used cheap, easily accessible and available informal sectors for seeking care. Cultural beliefs and practices also reinforced this behavior, including home delivery without skilled assistance.ConclusionsBehavioral change messages are needed to increase the numbers of antenatal and postnatal care visits, improve birth preparedness, and encourage skilled attendance at delivery. Programs in the urban slum areas should also consider interventions to improve social support for key influential persons in the community, particularly landladies who serve as advisors and decision-makers.

Safe Motherhood Practices Among Women of Urban Slums in Bangladesh

In this article we examine the prevalence and factors associated with the utilization of safe motherhood practices among slum-dwelling women of Bangladesh using the 2006 Bangladesh Urban Health Survey data. Overall, the utilization of maternal health care services was very low. The binary logistic regression analyses yielded significantly increased skilled services utilization for women with higher education levels, nonworking women, non-Muslims, women undergoing their first pregnancy, women who had lived in the slum longer, and amongst the rich. Awareness should be created through information, education, and communication programs, and services should be provided with minimum cost to promote safe motherhood practices among the urban poor in Bangladesh.

Contribution of Enteric Infection, Altered Intestinal Barrier Function, and Maternal Malnutrition to Infant Malnutrition in Bangladesh

Malnourished children are at increased risk for death due to diarrhea. Our goal was to determine the contribution of specific enteric infections to malnutrition-associated diarrhea and to determine the role of enteric infections in the development of malnutrition. Children from an urban slum in Bangladesh were followed for the first year of life by every-other-day home visits. Enteropathogens were identified in diarrheal and monthly surveillance stools; intestinal barrier function was measured by serum endocab antibodies; and nutritional status was measured by anthropometry. Diarrhea occurred 4.69 ± 0.19 times per child per year, with the most common infections caused by enteric protozoa (amebiasis, cryptosporidiosis, and giardiasis), rotavirus, astrovirus, and enterotoxigenic Escherichia coli (ETEC). Malnutrition was present in 16.3% of children at birth and 42.4% at 12 months of age. Children malnourished at birth had increased Entamoeba histolytica, Cryptosporidium, and ETEC infections and more severe diarrhea. Children who became malnourished by 12 months of age were more likely to have prolonged diarrhea, intestinal barrier dysfunction, a mother without education, and low family expenditure. Prospective observation of infants in an urban slum demonstrated that diarrheal diseases were associated with the development of malnutrition that was in turn linked to intestinal barrier disruption and that diarrhea was more severe in already malnourished children. The enteric protozoa were unexpectedly important causes of diarrhea in this setting. This study demonstrates the complex interrelationship of malnutrition and diarrhea in infants in low-income settings and points to the potential for infectious disease interventions in the prevention and treatment of malnutrition.

Socioeconomic Factors Associated With Contraceptive Use and Method Choice in Urban Slums of Bangladesh

This article explores the socioeconomic factors affecting contraceptive use and method choice among women of urban slums using the nationally representative 2006 Bangladesh Urban Health Survey. Both bivariate and multivariate statistical analyses were applied to examine the relationship between a set of sociodemographic factors and the dependent variables. Overall, the contraceptive prevalence rate was 58.1%, of which 53.2% were modern methods. Women's age, access to TV, number of unions, nongovernmental organization membership, working status of women, number of living children, child mortality, and wealth index were important determinants of contraceptive use and method preference. Sex composition of surviving children and women's education were the most important determinants of contraceptive use and method choice. Programs should be strengthened to provide nonclinical modern methods free of cost among the slum dwellers. Doorstep delivery services of modern contraceptive methods may raise the contraceptive prevalence rate among the slum dwellers in Bangladesh.

Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study

BackgroundAlthough many studies have been carried out to learn about maternal care practices in rural areas and urban-slums of Bangladesh, none have focused on ultra poor women. Understanding the context in which women would be willing to accept new practices is essential for developing realistic and relevant behaviour change messages. This study sought to fill in this knowledge gap by exploring maternal care practices among women who participated in a grant-based livelihood programme for the ultra poor. This is expected to assist the designing of the health education messages programme in an effort to improve maternal morbidity and survival towards achieving the UN millennium Development Goal 5.MethodsQualitative method was used to collect data on maternal care practices during pregnancy, delivery, and post-partum period from women in ultra poor households. The sample included both currently pregnant women who have had a previous childbirth, and lactating women, participating in a grant-based livelihood development programme. Rangpur and Kurigram districts in northern Bangladesh were selected for data collection.ResultsWomen usually considered pregnancy as a normal event unless complications arose, and most of them refrained from seeking antenatal care (ANC) except for confirmation of pregnancy, and no prior preparation for childbirth was taken. Financial constraints, coupled with traditional beliefs and rituals, delayed care-seeking in cases where complications arose. Delivery usually took place on the floor in the squatting posture and the attendants did not always follow antiseptic measures such as washing hands before conducting delivery. Following the birth of the baby, attention was mainly focused on the expulsion of the placenta and various maneuvres were adapted to hasten the process, which were sometimes harmful. There were multiple food-related taboos and restrictions, which decreased the consumption of protein during pregnancy and post-partum period. Women usually failed to go to the healthcare providers for illnesses in the post-partum period.ConclusionThis study shows that cultural beliefs and norms have a strong influence on maternal care practices among the ultra poor households, and override the beneficial economic effects from livelihood support intervention. Some of these practices, often compromised by various taboos and beliefs, may become harmful at times. Health behavior education in this livelihood support program can be carefully tailored to local cultural beliefs to achieve better maternal outcomes.

Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study

BackgroundRecognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities. This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC.MethodsThis cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's chi-square test, t-test and Mann-Whitney test were performed.ResultsThe median time for making the decision to seek care was significantly longer among women who were referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was significantly shorter in the case of life-threatening complications among those who were referred from DC than home (0.9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial constraints. Role of gender was found to be an important issue in decision making. First delay was significantly higher among elderly women, multiparity, non life-threatening complications and who were not involved in income-generating activities.ConclusionsManoshi program reduces the first delay for life-threatening conditions but not non-life-threatening complications even though providing financial assistance. Programme should give more emphasis on raising awareness through couple/family-based education about maternal complications and dispel fear of clinical care to accelerate seeking EmOC.

Using formative research to develop MNCH programme in urban slums in Bangladesh: experiences from MANOSHI, BRAC

BackgroundMANOSHI, an integrated community-based package of essential Maternal, Neonatal and Child Health (MNCH) services is being implemented by BRAC in the urban slums of Bangladesh since 2007. The objective of the formative research done during the inception phase was to understand the context and existing resources available in the slums, to reduce uncertainty about anticipated effects, and develop and refine the intervention components.MethodsData were collected during Jan-Sept 2007 in one of the earliest sites of programme intervention in the Dhaka metropolitan area. A conceptual framework guided data collection at different stages. Besides exploring slum characteristics, studies were done to map existing MNCH service providing facilities and providers, explore existing MNCH-related practices, and make an inventory of community networks/groups with a stake in MNCH service provision. Also, initial perception and expectations regarding the community delivery centres launched by the programme was explored. Transect walk, observation, pile sorting, informal and focus group discussions, in-depth interviews, case studies, network analysis and small quantitative surveys were done to collect data.ResultsFindings reveal that though there are various MNCH services and providers available in the slums, their capacity to provide rational and quality services is questionable. Community has superficial knowledge of MNCH care and services, but this is inadequate to facilitate the optimal survival of mothers and neonates. Due to economic hardships, the slum community mainly relies on cheap informal sector for health care. Cultural beliefs and practices also reinforce this behaviour including home delivery without skilled assistance. Men and women differed in their perception of pregnancy and delivery: men were more concerned with expenses while women expressed fear of the whole process, including delivering at hospitals. People expected 'one-stop' MNCH services from the community delivery centres by skilled personnel. Social support network for health was poor compared to other networks. Referral linkages to higher facilities were inadequate, fragmentary, and disorganised.ConclusionsFindings from formative research reduced contextual uncertainty about existing MNCH resources and care in the slum. It informed MANOSHI to build up an intervention which is relevant and responsive to the felt needs of the slum population.

Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study

BackgroundUrbanization is occurring at a rapid pace, especially in low-income countries. Dhaka, Bangladesh, is estimated to grow to 50 million by 2015, with 21 million living in urban slums. Although health services are available, neonatal mortality is higher in slum areas than in urban non-slum areas. The Manoshi program works to improve maternal, newborn, and child health in urban slums in Bangladesh. This paper describes newborn care practices in urban slums in Dhaka and provides program recommendations.MethodsA quantitative baseline survey was conducted in six urban slum areas to measure newborn care practices among recently delivered women (n = 1,256). Thirty-six in-depth semi-structured interviews were conducted to explore newborn care practices among currently pregnant women (n = 18) and women who had at least one delivery (n = 18).ResultsIn the baseline survey, the majority of women gave birth at home (84%). Most women reported having knowledge about drying the baby (64%), wrapping the baby after birth (59%), and cord care (46%). In the in-depth interviews, almost all women reported using sterilized instruments to cut the cord. Babies are typically bathed soon after birth to purify them from the birth process. There was extensive care given to the umbilical cord including massage and/or applying substances, as well as a variety of practices to keep the baby warm. Exclusive breastfeeding was rare; most women reported first giving their babies sweet water, honey and/or other foods.ConclusionThese reported newborn care practices are similar to those in rural areas of Bangladesh and to urban and rural areas in the South Asia region. There are several program implications. Educational messages to promote providing newborn care immediately after birth, using sterile thread, delaying bathing, and ensuring dry cord care and exclusive breastfeeding are needed. Programs in urban slum areas should also consider interventions to improve social support for women, especially first time mothers. These interventions may improve newborn survival and help achieve MDG4.

Child immunization coverage in urban slums of Bangladesh: impact of an intervention package

The study assessed the impact of an EPI (Expanded Programme on Immunization) intervention package, implemented within the existing service-delivery system, to improve the child immunization coverage in urban slums of Dhaka, Bangladesh. This intervention trial used a pre- and post-test design. An intervention package was tested from September 2006 to August 2007 in two urban slums. The intervention package included: (a) an extended EPI service schedule; (b) training for service providers on valid doses and management of side-effects; (c) a screening tool to identify immunization needs among clinic attendants; and (d) an EPI support group for social mobilization. Data were obtained from random sample surveys, service statistics and qualitative interviews. Analysis of quantitative data was based on a 'before and after' assessment of selected immunization-coverage indicators. Qualitative data were analysed using content analysis. Ninety-nine per cent of the children were fully immunized after implementation of the interventions compared with only 43% before implementation. Antigen-wise coverage after implementation was also significantly higher compared with before implementation. Only 1% drop-out was observed after implementation of the interventions while it was 33% before implementation. At baseline, a significantly higher proportion of children of non-working mothers (75%) were fully immunized compared with children of working mothers (14%). Although the proportion of fully immunized children of both non-working and working mothers was significantly higher at endline, fully immunized children of working mothers dramatically improved at endline (99%) compared with baseline (14%). The findings suggest the effectiveness of a 'package of interventions' in improving child immunization coverage in urban slums. However, further research is needed to fully assess the effectiveness of the package, to assess the individual components in order to identify those that make the biggest contribution to coverage, and to assess the sustainability of this package within the existing service delivery system, particularly on a wider scale.

Small Powers, Little Choice: Contextualising Reproductive and Sexual Rights in Slums in Bangladesh

How do young married women fare in an urban slum in Bangladesh? This article is based on in-depth ethnographic fieldwork among 153 married girls aged 15–19 in a Dhaka slum, carried out during December 2001–January 2003. The author finds a shift away from the traditional arranged marriage practice, with 81 of the 153 young women having ‘love’ marriages. Young women now have greater mobility and freedom to choose their own partners, but at the same time face greater instability in marital relations. The lived experiences of engaging in sexual relations with their spouses are fraught with contradictions. Without economic independence and social autonomy, many young women tolerate bad marriages, and unsafe and painful sex as a survival strategy. Some however have more leeway to set the terms of engagement, using their sexuality as a resource to attract their husbands and secure his material support, and may even enjoy doing so.

PREBIOTIC EFFECT OF DAILY FRUCTOOLIGOSACCHARIDE INTAKE ON WEIGHT GAIN AND REDUCTION OF ACUTE DIARRHEA AMONG CHILDREN IN A BANGLADESH URBAN SLUM: A Randomized Double-masked Placebo-controlled Study

Fructooligosaccharide (FOS) is a typical prebiotic agent. A randomized, double-masked, placebo- controlled study was performed to evaluate the prebiotic effect of daily intake of an isotonic solution containing FOS on body weight gain and the reduction of diarrhea in children in an urban slum in Bangladesh over six con- secutive months. We enrolled a total of 150 children, aged 25-59 months. Sixty-four children in the FOS group re- ceived 50 mL of isotonic solution with 2go f FOS added, and 69 children in the placebo group were given an iden- tical solution with 1go f glucose added, once ad ay. The measurement ofbody weight was carried out every other day; height and arm circumference were measured once a month; and the children's mothers were interviewed to obtain data about diarrhea, the consistency and constitution of stool, other symptoms, and antibiotic treatment. As a result, the body weight gain during the six-month period was 0.86±0.55 kg in the FOS group and 0.89±0.48 kg in the placebo group, while the increase in height and arm circumference were not significantly different between the two groups. The number of diarrhea episodes during the six-month period was not significantly different. A significant reduction in the duration of diarrhea days and of duration per episode was observed in the FOS group (p =0.039 and p=0.008, respectively). In conclusion, daily intake of FOS was associated neither with the children's growth nor with the number of diarrhea episodes, but a significant reduction in the duration of diarrhea days was observed. Further studies are needed to confirm the effects of FOS by changing the doses and eliminating the in- fluence of antibiotics.

Spousal Abuse Against Women and Its Consequences on Reproductive Health: A Study in the Urban Slums in Bangladesh

Spousal violence is common and results in costly problems both for society and for the reproductive health of women. Despite the recognition that violence may be associated with serious consequences for women's reproductive health, our understanding of the relationship between the two remains limited. In this study, we assessed the association between spousal violence and women's reproductive health. Data from an interviewer-administered questionnaire assessing socioeconomic, demographic, behavioral profiles, and spousal violence-related information was collected from 496 women. Subjects were chosen from eight randomly selected urban slums from four metropolitan cities. Spousal violence was significantly higher amongst the group of less educated women who had been in several marriages; indicating that the social and behavioral traits of women act as catalysts for spousal violence. Abusive husbands also had been married several times and were more likely to be addicted to alcohol or drugs. This demonstrates that the behavioral traits of husbands were also responsible for spousal violence. Spousal violence injuries adversely affect the health and well-being of women. More than three-quarters of physically violated women suffered injuries as a result of this violence. About 50% of these injuries were minor and about 10% serious. Sexual violence adversely affected women's health; more than 80% of sexually violated women complained of pelvic pain, more than 50% reported reproductive tract infections, and more than 50% reported symptoms of irritable bowel syndrome. Abused women suffered from gynecological problems at the time of pregnancy significantly more than non-abused women (p<0.05) and abused women suffered from reproductive tract infections significantly more than non-abused women (p<0.01). Abusive husbands suffered from sexually transmitted diseases (STD) significantly more than non-abusive husbands (p<0.05). Abused women used contraception significantly less than non-abused women (p<0.01). Logistic regression analysis suggested that spousal violence was the most important contributing factor for reproductive health problems in women. The findings of this study may enhance our understanding of the impact of spousal violence against women and their reproductive health and therefore highlight the importance of spousal violence prevention measures. Increasing the awareness and understanding of the relationship between violence against women and reproductive health could be achieved if lawyers, researchers, clinicians, practitioners, and government workers from multiple disciplines and agencies worked together.

Characteristics of young foster children in the urban slums of Bangladesh

To identify the reasons for the fostering of children, and to describe their feeding practices and assess their health and nutritional status. Forty-six pairs of mothers and their young foster children (up to 24 mo of age) were interviewed in a cross-sectional study in the urban slums of Dhaka, Bangladesh. Another 82 pairs of mothers and their biological children of a similar age group were interviewed for comparison. Sixty-five percent of the children were fostered because of the death of their biological mothers. Eighty-three percent of the biological mothers died because of complications during delivery or the immediate postpartum period and the remainder died after the postpartum period of diseases unrelated to their pregnancies. More than half (52%) of the foster mothers were childless and a quarter (24%) fostered children for reasons of gender preference. Almost a quarter (24%) of the children were placed in foster homes because of extreme parental poverty. Divorce or separation of the biological parents accounted for only 7% of children fostered. Approximately 90% of the foster children were given animal and/or formula milk in their first month of life while all children in the comparison group were given breast milk. Among the foster children, 58% were given semisolid or solid food before completion of 4 mo compared with 14% in the comparison group. Significantly more children in the foster group suffered from diarrhoea and acute respiratory infection than in the comparison group. Maternal death, poverty and childlessness and child gender preference of foster mothers were important factors in fostering of children in the study group. Inappropriate feeding practices compounded by diseases may have contributed to the poor nutritional status of the foster children.

Characteristics of young foster children in the urban slums of Bangladesh

Characteristics of young foster children in the urban slums of Bangladesh

Family planning choice behaviour in urban slums of Bangladesh: An econometric approach

Bangladesh's urban population is projected to account for 26% of the country's total population by the year 2000 and 37% by 2015. A 1991 Bangladesh census report found that about 21 million of the total 111.5 million population were living in urban areas. 1551 currently-married women of reproductive age in 1551 households sampled from a representative sample of 91 slums in the metropolitan areas of Dhaka, Chittagong, and Khulna participated in a study of family planning behavior choice. 673 of the women were practicing family planning. The authors describe the construction of the econometric model used for analysis. Economic status as indicated by household income was found to considerably influence people's decisions concerning family planning practices. Higher women's educational status is also positively correlated with family planning practice. Husband's educational status has a less significant effect upon family planning practice. The change of a person from non-Muslim to Muslim has an insignificant, though positive, impact upon family planning practice. The more a woman feels empowered, being over age 19 years, the greater the number of living children, and the lower the level of preference for sons, the more likely a woman is to practice family planning.

Enzyme polymorphisms in Ascaris lumbricoides in Bangladesh

Fourteen enzymes of Ascaris lumbricoides were analysed electrophoretically on cellulose acetate plates; 8 stained well and 3 were found to be polymorphic. Allelic and genotypic frequencies at the 3 polymorphic enzyme loci, Mpi, Pgi and 6- Pgd, were determined in a sample of 117 worms from 8 children living in different houses in an urban slum in Bangladesh. Allele frequencies in samples of parasites from the different children were compared to test for the possibility of non-random distribution of parasite genotypes between people. No strong evidence of differences was found. Diploid genotype frequencies did not deviate significantly from those expected from the Hardy-Weinberg equilibrium. Significant linkage disequilibrium was observed in one of 3 pairs of enzyme loci tested, which might suggest that some genetic subdivision exists in the local A. lumbricoides population, although no strong interference should be made from this single result. Overall, the results suggest that the worms sampled formed part of a single population which appears to be randomly mating.