Urban Bangladesh Research Articles

The Cost of Coordination Failures: Impacts on Urban Development Projects and Citizen Services in Bangladesh

Rapid urbanization in Bangladesh places significant pressure on City Corporations to effectively plan and implement urban development projects, often in collaboration with national agencies. However, coordination failures are prevalent, leading to significant costs and hindering urban development. This study investigates the challenges in service delivery coordination faced by City Corporations in Bangladesh, focusing on Cumilla and Dhaka as case studies to understand the complexities of coordination in varying urban contexts. A qualitative research approach was employed, involving semi-structured interviews with 110 stakeholders across both cities. This included 40 City Corporation officials, 30 government agency representatives, and 70 community representatives, ensuring a multi-faceted understanding of the issue. Data was analyzed using thematic analysis and interpretive techniques to identify recurring patterns and themes related to coordination challenges, their consequences, and potential solutions. Rigor and trustworthiness were ensured through data triangulation, member checking, and reflexivity. The study identified several key coordination challenges, including dysfunctional coordination committees, power struggles between City Corporations and national agencies, non-compliance with regulations, unclear roles and responsibilities, dual control over tasks, breaches of agreements, political interference, self-serving leadership, and inadequate corrective measures. These challenges hinder project progress and negatively impact citizens, leading to subpar work quality, project delays, funding withdrawals, poor service delivery, financial waste, and increased public distress. In conclusion, this study underscores the urgent need for improved coordination mechanisms, accountability frameworks, and capacity-building initiatives to enhance urban development and service delivery in Bangladesh.

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

This study documents the labor market outcomes and time-use patterns of women in urban Bangladesh. Using survey data collected in 2018 in low-income neighborhoods of Dhaka, the paper finds that women with children aged 0–5 years have lower likelihood of labor market participation, lower likelihood of being employed, and lower likelihood of being an earner, compared to women with no children and women with children aged 6 years or older. While all mothers of young children face a labor market penalty, those who have young children but have no access to childcare support face the largest penalty. Time-use patterns indicate that mothers of young children generally spend less time on market work and more time on unpaid work, compared to those without children or with older children. When mothers have access to childcare support, they tend to spend more time on market work than those without childcare support, yet still devote the same amount of time to unpaid work as mothers without childcare support. They are also equally likely to perform childcare as a secondary activity, which could impact both their productivity and the quality of care they provide.

Assessment of socioeconomic and health vulnerability among urban slum dwellers in Bangladesh: a cross-sectional study

BackgroundBangladesh is rapidly urbanizing and approximately half of its urban population resides in deprived slums with limited access to basic needs. However, there is a dearth of information on vulnerability levels among slum dwellers. We aimed to assess the level of vulnerability within and between slums via various socioeconomic and health indicators.MethodsA cross-sectional survey of 810 randomly selected households was conducted in two purposively selected slums, Korail and Shyampur, in Dhaka from November to December 2021. Data was collected on various indicators, including demographics, education, employment, access to utility, and healthcare services. Principal component factor analysis was employed to identify the key indicators to construct the socioeconomic and health vulnerability index for the urban slums of Bangladesh (SEHVI-BD). Kaiser-Meyer-Olkin, Bartlett’s test, and Cronbach’s alpha coefficient test were used to assess indicators’ suitability. The selected indicators were used to generate an index on a scale of 100, with a higher index value indicating a higher level of vulnerability. The estimated scores were used to categorize the vulnerability status into three levels: mild, moderate, and severe vulnerability. The Mann-Whitney-U test and Kruskal-Wallis test were applied between the generated index and other socioeconomic variables to validate the relationship.ResultsA total of 27 socioeconomic and health indicators were identified that explained 60% of the variance. The indicators were then grouped into six domains on the basis of their relevance. The prevalence of severe vulnerability in the Korail slum was approximately 9% and moderate vulnerability was 30% whereas these values were approximately 58% and 37%, respectively, in the Shyampur slum. The difference in the vulnerability level between the two slums was also evident across the domains. Households in the poorest wealth quintile, with lower education levels of household heads, and having irregular income experienced higher levels of vulnerability.ConclusionsThe SEHVI-BD offers a critical tool for policymakers to identify and address vulnerabilities, facilitating more targeted public health interventions in urban Bangladesh and similar low-income settings. This study further emphasizes the importance of integrating comprehensive vulnerability assessments into public health policies to reduce inequalities and improve well-being, especially for the urban marginalized slum population.

Dengue Fever in Urban Bangladesh: Atypical Presentations and Platelet Count Dynamics

Dengue fever, an arboviral infection transmitted by Aedes mosquitoes, remains a significant public health challenge in urban Bangladesh, especially in densely populated areas like Dhaka. This retrospective study investigates atypical clinical manifestations and platelet count dynamics among dengue patients, analyzing the association between thrombocytopenia and disease severity. Twenty patients treated in Dhaka were analyzed for clinical and hematological markers, with a specific focus on atypical presentations and platelet-hematocrit correlations. The findings highlight that while thrombocytopenia is a well-established indicator of dengue severity, several patients with critically low platelet counts did not exhibit typical warning signs, necessitating a more nuanced clinical approach.

Factors associated with essential newborn care practices among non-institutional births in urban Bangladesh: evidence from Bangladesh Urban Health Survey 2021

ABSTRACT Background Non-institutional births remain prevalent in low- and middle-income countries, associated with a majority of adverse maternal and child health outcomes, including maternal and child mortality. Ensuring essential newborn care (ENC) practices for these non-institutional births is crucial for reducing these adverse outcomes. This study aimed to identify the prevalence, and factors associated with the adoption of ENC practices among non-institutional births in urban Bangladesh. Methods A total of 2,165 children’s data were analyzed, extracted from the 35,186 ever-married women interviewed in the 2021 Bangladesh Urban Health Survey. Six ENC components and their level (lowest/none, moderate, and highest) were considered as the outcome variables. Several socio-demographic factors were considered as the explanatory variables. Multivariate binary and multinomial logistic regression model were used to explore the association between outcome and explanatory variables. Results Approximately 49% of all mothers reported practicing the highest level of ENC. Among the individual components, the highest adherence was observed for the use of a disinfected instrument to cut the umbilical cord (90%). The likelihood of adopting the highest level of ENC practices was higher among mothers with relatively higher education and wealth quintiles and lower among those residing in slum and other urban areas of city corporations compared to non-slum areas. Mothers living in the Khulna and Sylhet divisions had a lower likelihood of adopting the highest level of ENC practices. Conclusion Awareness building programs are needed to educate the population, particularly mothers, about the importance of practicing ENC for improving maternal and child health outcomes.

Health-Related Quality of Life among Elderly Patients in Urban Bangladesh: A Cross-Sectional Study.

Quality of life (QoL) focuses on a person's ability to live a fulfilling life. It helps in determining successful aging in the elderly population. Because of a scarcity of information regarding predictors of QoL in the elderly population in developing countries, this study was undertaken to assess the overall QoL and its predictors in the elderly population in an urban setting of Bangladesh. In this cross-sectional study, 275 participants were enrolled by systematic sampling at the outpatient department of a tertiary care hospital in Dhaka, Bangladesh. Data were collected by using a pretested semi-structured standard questionnaire for QoL (OPQOL-35). Pearson's correlation was used to assess the association between QoL and sociodemographic factors. Multivariate linear regression was conducted to identify predictors of QoL, after controlling for potential confounders. The median age of the participants (n = 275) was 65 years (range, 60 to 85; 25th and 75th percentile, 60 and 68, respectively). The majority (78%) of them were married, and 20% were widowed or divorced. The median score of QoL was 113 (25th and 75th percentile, 101 and 124, respectively). Most of the participants had very poor (bad as can be) or poor (bad) QoL. Only 7.3% were observed to have "good" QoL (scores 140 or more). Females had significantly poorer QoL scores compared to males (p < 0.001). Age, gender, educational status, smoking, and sleep duration significantly predicted QoL in a multiple regression analysis. In conclusion, the QoL of the elderly individuals in Bangladesh was very poor or poor. Future research should focus on service-oriented interventions, especially targeting women. Counseling elderly people to enhance their quality of life may include improving sleep patterns, healthy diets, regular exercise, and caring for their mental health.

Vegetable Recipe Variations in Urban and Periurban Bangladesh: Recipe Survey, Recipe Standardization, And Nutrient Analysis

Recipe variation has social, economic, geographical, cultural, and other roots. The Analysis of each recipe’s composition is not plausible from a chemical as well as an economic point of view. Instead, a standardized recipe from a set of similar recipes could be ideal for cooking and chemical analysis of the nutrient composition of cooked recipes. This type of data has been found to be scanty in conventional food composition tables (FCT) across the globe. Recipe calculation from raw ingredients has always been problematic because cooking is regarded as an unpredictable process on every occasion. Therefore, analysis of cooked recipes is preferred for FCTs which are used for more authentic and accurate in menu planning for individual or community health purposes. The present study seeks to partially fill the information gap on compositional data for vegetable and leafy vegetable recipes consumed by the lower to middle-income urban and peri-urban households of Bangladesh because they have been observed to be the main consumer of these recipes. The study was conducted into three phases. In phase I, a recipe survey was conducted among purposely selected housewives (n=100) representing Dhaka (n=33), Rangpur (n=37), Rajshahi (n=18) and Chattogram (n=12) divisions. In phase II, 10 selected homemade vegetable and leafy vegetable recipes were selected and standardized from the most cited recipe list obtained from consecutive recipe surveys. In phase III, chemical analyses for proximate nutrients were carried out followed by compilation of vitamin and mineral values from local and global food composition databases. The result revealed that the Moisture, Ash, Protein, Fat, Total Dietary Fiber and Available Carbohydrate content (g/100 g) and Calorie of the samples ranged from 71.57-83.68%, 1.30-4.94%, 1.17-5.86%, 0.20-9.18%, 2.63-7.28%, 1.43-14.66%, and 64.94 to 126.28 Kcal respectively. Method validation and analytical quality assurance program was carried out along with all standard operating procedure (SOP) to ensure quality data generation. Therefore, the data obtained in this study can be taken as reliable data which will enrich the food composition database of Bangladesh. Bioresearch Commu. 10(2): 1565-1572, 2024 (July)

Determinants of unhealthy BMI among women of childbearing age in Bangladesh

This paper investigated the determinants of unhealthy BMI categories, namely underweight, overweight, and obesity, for urban and rural women of childbearing age in Bangladesh. Multilevel nested logistic models were estimated using data from multiple waves (2004–18) of the Demographic and Health Surveys of Bangladesh. After controlling for community and regional effects, the underweight status showed an inverse relationship with years of education for urban and rural women. Conversely, the fitted model estimates revealed a positive association between overweight risk and education for both urban and rural women populations. However, the association between obesity and education was significant for only urban women. Employment status appeared to be negatively associated with the risks of being overweight and obese in both population groups. Moreover, the women were found less likely to be underweight and more likely to be overweight and obese when their household socio-economic status improved. Study findings have the potential to inform a wide range of interventions, policies and programs that simultaneously address the adverse consequences of underweight, overweight, and/obese population health conditions in rural and urban Bangladesh.

Child-related factors associated with depressive symptoms among mothers of school-going children in urban Bangladesh: A cross-sectional study.

This study aimed to identify the child-related factors associated with depressive symptoms among mothers of school-going children in Dhaka city of Bangladesh. The study followed a cross-sectional design and was conducted between June and December 2019 among mothers of school-going children from Dhaka City, Bangladesh. A multistage sampling technique was adopted, and a total of 324 mothers of school-going children studying in the same school for at least six months were selected. Depressive symptoms of mothers were measured using a 20-item Self-Rating Depression Scale weighted to 100 percent, with 25-49 categorized as no depression and ≥ 50 as having depression. A binary logistic regression model was executed to identify the child-related factors associated with depressive symptoms among mothers. All statistical analyses were performed using the statistical software, Stata (Version 14.0). More than half of the participants (54.3%) were aged 40 years or above and had up to HSC level education (52.5%). The majority of the participants were homemakers (67.0%), mothers of a girl child (53.1%), and had a family income of 50,000 BDT or more (52.8%). Adjusted analyses revealed that the mother's depressive symptoms were associated with their child's frequent complaints of headaches or stomach aches (aOR = 13.19, 95% CI 3.03-57.37), having an injury (aOR = 4.05, 95% CI 1.44-11.41), and unfriendly relationship with mothers (aOR = 21.46, 95% CI 5.04-91.28). The present study highlighted several child-related factors that are associated with depressive symptoms among mothers that need to be considered while designing any intervention to address depressive symptoms among mothers of school-going children. It is also important to counsel mothers and fathers of the children about the importance of having a sound mother-child relationship while addressing depressive symptoms among mothers.

Understanding Driving Stress in Urban Bangladesh: An Exploratory Study, Wearable Development and Experiment

Driving stress significantly impacts driving behavior primarily from roadside factors, where driving is more challenging in developing countries (i.e., Bangladesh) for unique cultural and infrastructural setups. We conduct an exploratory study (Qualitative n = 26, and Subjective Feedback n = 80) and a correlational analysis involving professional and private car drivers in urban Bangladesh. The study reveals drivers' demography and driving stress factors on the road. These findings motivate us to identify driving stress from physiological factors by developing a low-cost wearable, Stress Wear . This can detect stress from varying Heart Rates, validated by expensive commercial wearables. Between subject experiments on drivers (total n = 14 in two phases) with wearables, we also found that road factors are responsible for driving stress. Therefore, the developed system is helpful for these drivers to self-sense their stress.

Assessing the choice of smoke-free policies for multiunit housing and its associated determinants in Bangladesh: a cross-sectional study

ObjectivesThis study aimed to assess the desire for smoke-free housing, determine the choice of smoke-free policies for multiunit housing (MUH), and identify the factors associated with policy choice among MUH...

Exploring the burden of postpartum depression in urban Bangladesh: Prevalence and its associations with pregnancy-related factors from a cross-sectional study.

Postpartum depression (PPD) is a globally recognized public health concern, yet research focusing on women in urban areas of Bangladesh remains unexplored. This study aimed to address this research gap by investigating the prevalence and associated factors of PPD within the first 2 years after childbirth. A cross-sectional study was conducted, enrolling 259 women (26.66 ± 4.57 years) residing in urban areas who were attending healthcare delivery centers. Sociodemographic factors, child-related issues, pregnancy-related complications, and PPD using the Edinburgh Postnatal Depression Scale (EPDS) were used for data collection. Data analysis involved the application of χ 2 tests and logistic regression analysis using SPSS software. This study found a 60.6% prevalence of PPD using a cutoff of 10 (out of 30) on the EPDS scale. Logistic regression analysis identified several significant factors associated with PPD, including high monthly family income (odds ratio [OR] = 47.51, 95% confidence interval [CI]: 8.34-270.54, p < 0.001), income dissatisfaction (OR = 14.28, 95% CI: 4.75-42.87, p < 0.001), up to two gravidities (OR = 2.94, 95% CI = 1.25-6.90, p = 0.013), pregnancy-related complications (OR = 2.70, 95% CI = 1.05-6.96, p = 0.039), increased antenatal care visits, and higher childbirth expenses. This study underscores the high prevalence of PPD among urban mothers in Bangladesh. The identified risk factors emphasize the need for targeted mental health initiatives, specifically tailored to support the vulnerable group. Implementing such initiatives can effectively address the challenges posed by PPD and enhance the well-being of postpartum women in urban areas.

Residential variations in hypertension prevalence and trends among adults in Bangladesh

IntroductionHypertension is a widespread and life-threatening condition globally, with its prevalence increasing rapidly, particularly among adults. This study aims to examine the trend in adult hypertension prevalence and associated risk factors in both urban and rural areas of Bangladesh from 2011 to 2018.MethodsNationally representative cross-sectional data from the Bangladesh Demographic and Health Survey was used at two time points, 2011 and 2018. In our study, we used a two-step approach for variable selection, combining traditional statistical methods (χ2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\\chi }^{2}$$\\end{document} test) with a machine learning algorithm (Boruta algorithm).. This study also employed two different multivariate binary logistic regression models to identify the risk factors that are most closely connected to the presence of hypertension (respectively for urban and rural locations).ResultsAccording to the study, hypertension has been on the rise in Bangladesh. In 2011, over a third of adults (38.7%) in urban Bangladesh had hypertension, a number that rose by 22.6% in 2017-18. Though rural areas had a lower hypertension prevalence in 2011 (36%), it surged to 64% in 2017-18, surpassing the rate in urban areas. The results of the multivariate analysis showed that age, gender, education, wealth status, area, and survey year had a significant influence on the determinants of hypertension status in connection to place of residence. According to the odds ratio, the prevalence was significantly higher among older respondents, female respondents, wealthy families and higher-educated respondents.ConclusionA large proportion of Bangladesh’s adult population suffers from hypertension. A health education program is required to develop appropriate strategies, including appropriate weight control, appropriate physical activity, and healthier eating habits. Health authorities should take initiatives to spread awareness among people, particularly at an older age.

Families adapting to COVID-19 in urban Bangladesh: "It felt like the sky fell apart and we were in shock".

The COVID-19 epidemic has especially impacted the urban population in Bangladesh. Studies on COVID-19 have primarily focused on the patient's perspective. It is important to understand the experience of family members who adopt caregiving roles, as the experience of COVID-19 also impacts, and is impacted by, household members. This study aimed to explore the challenges, preventative practices, health-seeking behaviour, and perspectives of navigating the health care system from the perspective of family members of persons who had recovered from COVID-19 during its initial outbreak in Bangladesh. Participants of this qualitative study were family members (n = 7) of persons who had recovered from COVID-19 (either suspected or confirmed). Semi-structured in-depth interviews were conducted over telephone. Thematic analysis was used to analyse the data. Analysis revealed three key themes: changes in everyday practices and choice of health care, challenges and constraints, and unexpected positive outcomes. All the themes had temporal dimension to them with four distinct phases: early stage of COVID-19, strict lockdown phase, COVID-19 diagnosis and illness period and post COVID-19 recovery. The importance of maintaining social contact for psychological wellbeing during critical times was evident in the study. Online communication and social media enabled participants to remain 'socially connected' which further supported their mental health. Increased attention to hygiene practices both before, during and subsequent to COVID-19 infections within families was reported. Physical distancing in case of a suspected or confirmed COVID-19 case was found logistically and socially impractical in a densely populated city.

Socio-sexual norms and young people's sexual health in urban Bangladesh, India, Nepal and Pakistan: A qualitative scoping review.

In South Asia, young people face myriad challenges and opportunities regarding their sexual lives relating to varied experiences of norms and restrictions; gender norms and socio-sexual taboos limit communication around sexual health which in turn can affect sexual health outcomes. In this article we focus on norms affecting young people's sexual health experiences in urban settings in Bangladesh, India, Nepal, and Pakistan. We conducted a scoping review of peer reviewed empirical studies based on qualitative data pertaining to young people's experiences of sexuality and sexual health in Bangladesh, India, Nepal, and Pakistan. We searched four electronic databases for articles published (2010-2022), using terms relating to sexual health, young people, and South Asia. Sixteen articles met the inclusion criteria with sample size ranging from 9 to 180. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for the design and analysis of this study. We synthesised the included articles using thematic analysis. The studies covered topics such as sexual health services and contraceptive use; sexuality education and communication; and gender and sexual violence. Recurring findings included: parental and societal expectations around premarital 'sexual purity' through abstinence; limited communication around sexuality between young people and parents/adults; gender norms limiting young women's sexual and reproductive decision making; and an absence of research on experiences of sexual and gender minorities. We identified common themes as well as prominent gaps which must be addressed if we are to capture diverse experiences and build a better evidence base to improve sexual health services for young people in the region. The body of research fails to include experiences of young people with diverse gender, sexual orientation, and sex characteristics.

Understanding the impact of socioeconomic and health factors on geriatric depression: A comparative study in rural and urban Bangladesh.

The prevalence of depression among the elderly is a growing concern, and this study examines the differences between urban and rural areas in terms of geriatric depression. Using a two-stage random sampling approach in urban areas and a multistage random sampling approach in rural areas, the study surveyed 944 elderly individuals of both sexes. The results indicate that the prevalence of depression was high, with 52.5% of the elderly population experiencing mild to severe depression. The study found that increasing age, female gender, nuclear family structure, and involvement of housewives or others were significant factors affecting depression in urban areas, while increasing age and elderly people without spouses were significant factors in rural areas. Additionally, the study identified hearing impairment, asthma, and arthritis as risk factors for depression in rural areas, and bronchitis, heart disease, and thyroid illness as significant factors in urban areas. These findings highlight the need for policymakers to focus on addressing the mental health needs of older people, particularly women and those without spouses.

Feeding Practices among Infants and Young Children of Female Workers in Urban Bangladesh: A Cross-sectional Study in Dhaka and Gazipur

Feeding Practices among Infants and Young Children of Female Workers in Urban Bangladesh: A Cross-sectional Study in Dhaka and Gazipur

Factors associated with children's cognitive, language, and motor development in deprived urban settings in Bangladesh.

Children's development is multifactorial. Although there have been several studies exploring the association of children's development with maternal, child, and environmental factors, we are unaware of any study that assessed those factors in children whose mothers were enrolled in a social safety net programme in low- and middle-income countries. This study aimed to identify the factors associated with disadvantaged children's cognitive, language, and motor development at age 6-16 months in deprived settings of urban Bangladesh and to identify relative importance of these factors of children's development. We also explored if there were any gender differences in child development. This cross-sectional study was conducted in a deprived setting of urban Bangladesh. Bayley III was used for assessing children's cognitive, language, and motor development. Multivariable linear regression model was used to find the factors associated with children's development, and dominance analysis was used to explore the relative importance of the factors. Out of the total 599 mother-child dyads, 303 (50.58%) were girls. The factors associated with children's development were length-for-age Z-score (cognitive: B = 1.21 [95% CI = 0.31, 2.11], P = 0.008; language: 1.67 [0.79, 2.55] P < 0.001; motor: 2.15 [1.01, 3.29] P < 0.001) and home environment (cognitive: 0.58 [0.27, 0.89] P < 0.001; language: 0.59 [0.27, 0.92], P < 0.001; motor: 0.44 [0.09, 0.79] P = 0.013). Girls had higher cognitive (1.90 [0.17, 3.6], P = 0.031) and language (2.53 [0.55, 4.51], P = 0.013) development compared with boys. Families with a higher number of under five children within the households had lower language (-1.57 [-2.78, -0.36], P = 0.011) development. Violence against the mother and the families' food security status were not associated with the children's development. Children's length-for-age Z-score (27%) and home stimulation environment (23%) were the most important factors of cognitive development. Children's nutritional status and home environment are important factors for disadvantaged children's development in deprived urban settings of Bangladesh. Both early child development-focussed parenting and nutrition interventions should be considered when designing child development programmes in urban settings in low- and middle-income countries.

Diffracting young people’s perceptions and agency on adaptation to climate change in Bangladesh: through socioecological, posthuman, and postcolonial positioning

ABSTRACT Bangladesh is extremely vulnerable to climate change and Bangladeshi children and young people witness immense changes taking place in their everyday lives due to the catastrophic impacts of climatehood (climate change and childhood). This paper explores Bangladeshi young people's perceptions and agency towards climatehood, and it employs a child and youth framed methodology where young people carry out visual ethnographic research alongside the university researcher. In this research, four young people (aged from 14 to 16) in urban and rural Bangladesh give voice to their knowledge, beliefs, and practices on adaptation to climatehood through interviews, group discussions, photographs, and drawings. The theoretical underpinnings of this study are socioecology, posthumanism, and postcolonialism and analysis involves a diffractive process where it cuts across, past, present, and future Bangladesh. The narratives, drawings, and photos, provide rich insight into young people's ecological, cultural, educational, and religious responses and activities to climatehood, in Bangladesh.

1838. Determinants of Antimicrobial Resistance among ≤5-Year Children in Low-Income Urban Bangladesh

Abstract Background Antimicrobial resistance (AMR) is a growing global concern, with the most significant health and financial implications for low- and middle-income countries. Due to irrational and inappropriate use, AMR is rapidly increasing in Bangladesh, especially among low-income urban populations. This study explored the factors for antimicrobial resistance among ≤ 5 years children in low-income urban Bangladesh. Methods From February 2018 to April 2019, we did quantitative and qualitative assessments of antibiotic use among urban ≤5-year children. We conducted a cross-sectional survey among 626 low-income urban ≤5-year children's parents in four cities in Bangladesh. We used a semi-structured questionnaire to collect data related to antibiotic use through face-to-face interviews. We also conducted eight focus group discussions among the parents to gather in-depth information on antibiotic use to treat their children. Bivariate and multivariate analysis was done to see the causes and associated factors. Results The study identified that 62.9 % (394/626) of parents used antibiotics last year to treat their children. More than half (52.7%) of the parents bought antibiotics from local drug stores without a prescription. 46.5% (291/626) of the parents stopped antibiotics soon after the symptom disappeared, and 62.6% used leftover antibiotics for similar symptoms. However, 82.9% of parents opined that qualified physicians' advice is important to treat children with antibiotics. Inappropriate antibiotic use was significantly associated with participants' education (p=0.02), family income (p=0.01), and profession (p=0.04). Qualitative investigation revealed the convenience of getting treatment and medicine from the drug store, the financial burden to buy the full course, the distance and waiting time at qualified physicians, and parents' inadequate knowledge were identified as the key causes of irrational antibiotic use. Pattern of Antibiotic Consumption among ≤5-Year Children in Low-Income Urban Bangladesh Conclusion Intervention packages are required to improve parents’ knowledge and awareness on the rational use of antibiotic. Strengthening the health system could enhance the optimum use of antibiotics and combat antibiotic resistance. Antibiotic dispensing, prescription, purchase, and selling policy required with enforcement of the policy to reduce AMR. Disclosures All Authors: No reported disclosures