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Health policies and public health studies in Bangladesh primarily focus on physical aspects of health, thus creating a gap in the literature regarding the assessment of the emotional-social environment for children and their developmental vulnerabilities. Interactions though literacy activities, such as shared reading times between child and parents, are possible ways to address the developmental and cognitive needs of children. This study explores the district-wise presence of books for children (aged 0-4 years) in households and identifies vulnerable households by exploring the association between sociodemographic status and household book ownership. The Bangladesh Multiple Indicator Cluster Survey 2012-13 was used to map the spatial heterogeneity of average availability of children's books, which revealed that ownership of age-appropriate books was clustered around divisional cities, with one exception. Around 65% of the households did not have any suitable books for children. The presence of children's books was significantly (p < 0.005) associated with children's age, mother's age and education, financial status of the household, education of the head of the house, mother's mobile phone ownership, and mother's access to media (newspaper and television). Parents in high-income households and with highly educated mothers were nearly three times more likely to own children's books. Similarly, parents in a household with the mother having a mobile phone were 42% more likely to own children's books. The findings suggest that a household's lack of financial capacity to purchase books, the role of public health media in promoting the mother's awareness of the need for children's books, and a lack of understanding of children's cognitive developmental needs could be more effectively addressed in Bangladesh.

Two early childhood development aspects: carer involvement with children, and their ownership of age‐appropriate books, were evaluated. Children aged 0–4 years from Bangladesh, extracted from population‐based Multiple Indicator Cluster Survey 2019, were assessed using survey adjusted logistic regression models and district‐wise spatial distribution. Among 13 806 children, 11.2% had no shared activities with carers, and 60.7% had at least four shared activities. Among 22 796 children, 27.4% owned at least one book. Higher carer–child shared activities and more child‐friendly books in households were observed in the Western part of Bangladesh. Children from higher socioeconomic households with educated mothers and greater exposure to media, had higher carer–child interaction and greater availability of books. These findings can aid policies targeting psychological and cognitive development of children in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Maternal morbidities especially life-threatening pregnancy complications are major health concerns in developing countries. The main aim is to investigate the prevalence of maternal morbidity during pregnancy and its determinants among women from urban areas of Bangladesh. Methods: The secondary data were used and extracted from the latest Bangladesh Urban Health Survey (BUHS) 2013. Several statistical models: Poisson, negative binomial (NB) and mixed Poisson were adapted and compared to explore the best model for investigating potential determinants of maternal morbidity. Pearson chi-square statistic was used for the detection of overdispersion in the data. Results Overall 13.5% of the urban women in Bangladesh suffered from at least two pregnancy complications. The study detected the overdispersion existing in the maternal morbidity count data and found the NB regression as the best choice for analyzing the data because of its smallest Akaike information criterion. Administrative division (Rangpur: p = 0.003, incidence rate ratio, IRR = 1.34, 95% confidence interval, CI: 1.11 to 1.63; Sylhet: p = 0.006, incidence rate ratio, IRR = 1.42, 95% CI: 1.11 to 1.82), unwanted pregnancy (p<0.001, IRR = 1.25, 95% CI: 1.11 to 1.40), place of delivery (p<0.001, IRR = 1.68, 95% CI: 1.53 to 1.86) and wealth index (Poor: p<0.001, IRR = 1.34, 95% CI: 1.19 to 1.50; Middle: p = 0.003, IRR = 1.21, 95% CI: 1.08 to 1.36) were found to be statistically significant determinants for maternal morbidity during pregnancy among the urban women in Bangladesh. Conclusions: Urban women in Bangladesh with an unwanted pregnancy, from the poor/middle-income group; and living in Rangpur and Sylhet divisional cities have a higher risk of maternal morbidity during pregnancy. Study findings may help the government and relevant authorities to take necessary steps for reducing maternal morbidity and mortality due to pregnancy-related complications. [ABSTRACT FROM AUTHOR]

Background: Occupational stress is common among nurses and is thought to be one of the key factors for the global shortages of nurses. To the best of our knowledge, no study has been done to assess occupational stress among Bangladeshi nurses. This study aimed to investigate the association of sociodemographic characteristics and occupational characteristics with stress experienced by nurses working in a specialized hospital in Dhaka, Bangladesh. Methods: A cross-sectional study design was employed involving 155 nurses working in the National Institute of Cardiovascular Disease (NICVD). Data were collected using a self-administered questionnaire with the Bengali version of the Occupational Stress Index (OSI). Both univariate (Student t-test or ANOVA) and multivariate analyses (linear regression) were performed to identify the sociodemographic and work-related factors associated with occupational stress. Results: The average score on the OSI was 147.1 – moderate level of occupational stress among nurses. The OSI score was higher in males (150.25) than in females (143.94). Nurses who were aged >40 years, and single, had nursing experience between 10 and 20 years and were considering promotion tended to suffer more stress than their peers. Findings from linear regression showed that the OSI score was significantly (p < 0.001) associated with the work conditions: role overload, role ambiguity, role conflict, responsibility, support from colleagues and rational coping. Conclusion: The findings indicated the importance of occupational characteristics in relation to occupational stress among nurses. Further results of this study can be utilized by researchers and policymakers to guide preventative measures to reduce occupational stress among nurses. [ABSTRACT FROM AUTHOR]

Background: Smoking is one of the bad habits in social environment and is one of the main causes of immature death in Bangladesh. Rajshahi is one of the cleanest, most peaceful cities in Bangladesh, but the inhabitants often feel uncomfortable about smokers who smoke in public places and often on transport. Smoking frequency is very high among males compared to females, and a large number of smokers are building or road construction laborers and people involved in offering different services such as transportation, vending from vans, etc. The practice of smoking in this area is destructive for mental and physical health especially for students compared to other professionals because the city is known as the City of Education. Methods: The study analyzes smokers' characteristics, general health, and their (smokers) perception of smoking in public places. Cross-sectional data were collected randomly from 160 smokers through face-to-face questionnaire survey. The determinants of complexities with regard to social environment and human health were studied using frequency distribution, chi-square test, and binary and multinomial logistic regression analysis using IBM SPSS version 24. Results: Frequency distributions reveal that 93.8% of smokers believe that smoking creates public health hazards, 51.3% of smokers think it causes breathing complexities for non-smokers, 48.8% of smokers feel smoking causes air pollution, 68.8% of smokers think smoking causes gastric problems, 24.4% of smokers had headache problems due to smoking and cigarette fumes, 86.3% of smokers learnt smoking from friends, 48.8% of smokers smoke due to their addiction and 25.6% for depression, and 80.6% usually smoke after having a meal. The chi-square test reveals that class of smokers was significantly associated with frequency of heartbeat rate, starting smoking at specific age level was significantly associated with suffering from diseases, category of smoking articles was significantly associated with suffering from disease, class of smokers was significantly associated with causes for smoking, and starting smoking at specific age level was significantly associated with profession of the smokers at 1% level of significance respectively. A significant odds ratio was found (OR = 6.363, 95% CI 1.918–21.104, p < 0.01) for the profession group of students/labour at 1% level; their outcomes for suffering from diseases such as gastric problem and fever/headache/others were 6.363 times those for the profession group of service/other smokers. Conclusion: Smoking in public places should be restricted because non-smokers cannot breathe freely and it is not healthy for them to inhale smoke indirectly, which has many adverse effects on public health. The study also reveals that the majority of the smokers have gastric problems, abnormal heartbeat rates, frequent headaches, depression and addiction problems, etc., and that they believe that smoking causes significant health hazard on human health and social environment. Therefore, necessary interventions should be taken immediately by policy-makers to prevent smoking in public places. [ABSTRACT FROM AUTHOR]

This study aimed to quantify the inequalities and identify the associated factors of the UN sustainable development goal (SDG) targets in relation to safe drinking water. The concentration of the gut bacterium Escherichia coli in drinking water at the point of use (POU) and other information were extracted from the latest wave of the nationally representative Bangladesh Multiple Indicator Cluster Survey (MICS 2019). Bivariate and multivariable multinomial logistic regression models were used to identify potential predictors of contamination, whereas, classification trees were used to determine specific combinations of background characteristics with significantly higher rates of contamination. A higher risk of contamination from drinking water was observed for households categorized as middle or low wealth who collected water from sources with higher concentrations of E. coli. Treatment of drinking water significantly reduced the risk of higher levels of contamination, whereas owning a pet was significantly associated with recontamination. Regional differences in the concentrations of E. coli present in drinking water were also observed. Interventions in relation to water sources should emphasize reducing the level of E. coli contamination. Our results may help in developing effective policies for reducing diarrheal diseases by reducing water contamination risks. [ABSTRACT FROM AUTHOR]

There has been a gradual rise in the number of cesarean sections (CSs) in Bangladesh. The present study identified the cohort of women, who were more likely to opt for an elective CS based on their sociodemographic characteristics, pre-delivery care history, and media exposure, using the Bangladesh Multiple Indicator Cluster Survey-2019. The survey stratification adjusted logistic regression model and interpretable machine learning method of building classification trees were utilized to analyze a sample of 9202 women, alongside district-wise heat maps. One-in-five births (20%) were elective CSs in the 2 years prior to the survey. Women residing in affluent households with educated house-heads, who accessed antenatal care prior to delivery (AOR 4.12; 95% CI 3.06, 5.54) with regular access to media (AOR 1.31; 95% CI 1.10, 1.56) and who owned a mobile phone (AOR 1.25; 95% CI 1.04, 1.50) were more likely to opt for elective CSs, which suggests that health access and health literacy were crucial factors in women's mode of delivery. Spatial analyses revealed that women living in larger cities had more elective CS deliveries, pointing towards the availability of better health and access to multiple safe delivery options in peripheral areas. [ABSTRACT FROM AUTHOR]

On low-lying land in the Ganges Delta, waterlogging, salinity, and poor soil structure are constraints to intensifying cropping systems. Early sowing of dry season (rabi) crops in this area is hypothesized to increase yield potential because the current late sowing exposes the crop to less favourable temperature conditions, soil dryness, and salinity stresses. Field experiments were conducted over 2 years to identify the opportunities and challenges of early sowing between mid-November and mid-December for maximizing sunflower yield in Southern Bangladesh. Sunflower was dibbled into untilled wet soil on five occasions (23 and 30 November and 10, 20, and 30 December in 2016–2017 and 25 November, 14 and 25 December, and 10 and 25 January in 2017–2018), with two mulching treatments (rice straw at ~ 5 t ha−1 and 15–20% rice residue retention). Sowing before 15 December was associated with larger heads, more seeds per head, greater seed weight, and higher grain yield (3.5–4 t ha−1) in the first year, but early sowing was also risky since, in the second year, the sunflower sown on 25 November was hampered by heavy rainfall, which depressed yield compared to crops sown on 15 December. Increased yield from early sowing before 15 December was associated with higher soil water, lower soil salinity, and higher solute potential compared to sowing after 15 December. Lower yield in late sown crops was also associated with increased temperature at grain-filling stage. The rice straw mulch significantly improved soil water availability, reduced soil salinity, increased soil solute potential, and increased yield in the second year. In this paper, we show for the first time that sunflower sown before 15 December in the Ganges Delta has higher yield potential, but to gain the benefits of the earliest sowing, growers will need to manage the increased risk of yield loss due to waterlogging. [ABSTRACT FROM AUTHOR]

Background: The prevalence of overweight and obesity in women has increased significantly over the last few decades in Bangladesh, a rapidly urbanising developing country. However, little is known regarding the association between the interaction of the place of residence and household wealth with overweight and obesity, particularly in women from developing countries. Objective: The objective of this study is to find the association between the interaction of the place of residence and wealth with overweight and obesity among Bangladeshi women. Methods: This study utilised data from the four Bangladesh Demographic Health Surveys conducted in 2004, 2007, 2011 and 2014 with a total of 54337 women aged 15–49 years. Multivariate logistic regression was used for the analyses. Results: The prevalence of overweight and obesity among women aged 15–49 years in Bangladesh has considerably increased from 9.96% in 2004 to 24.43% in 2014. The interaction between wealth and place of residence has been found to be associated with obesity. Urban wealthy and richest women were 4.23 (OR: 4.23, 95% CI: 1.25–14.34) and 5.99 (OR: 5.99, 95% CI: 1.91–18.74) times more likely to be obese compared to their rural counterparts in the period 2004. Urban richest were 2.94 times (OR: 2.94, 95% CI: 1.20–7.24) more likely to be obese against their rural counterparts for the survey year 2014. Conclusions: The place of residence is not associated with obesity, but its interaction with wealth is significant. [ABSTRACT FROM AUTHOR]

Overdispersion in count data analysis is very common in many practical fields of health sciences. Ignorance of the presence of overdispersion in such data analysis may cause misleading inferences and thus lead to incorrect interpretations of the results. Researchers should account for the consequences of overdispersion and need to select the correct choice of models for the analysis of such data. In this paper, Generalized Linear Models (GLMs) are applied in modelling and analysis of antenatal care (ANC) count data extracted from the Bangladesh Demographic and Health Survey (BDHS) 2014. Pearson chi-square and different score tests are used to investigate the effect of overdispersion in the analysis. Overdispersion is found to be significant in the antenatal health care count data and so appropriate modelling is used to produce valid inferences for the regression parameters. The zero-truncated negative binomial regression (0-NBR) is found to be the best choice for analysing such data while excluding zero counts. Study findings reveal that place of residence, order of birth, exposure to mass media, wealth index and education of mother have significant impacts on the ANC status of women during pregnancy in Bangladesh. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: Bangladesh is an underdeveloped country that has recently joined the ranks of low‐middle‐income countries. This study aims to investigate how socioeconomic and developmental factors have influenced women towards a shift in their body mass index (BMI). Methods: The trend was analysed using data on ever‐married women from 6 nationwide surveys covering the years 1996 to 2014, conducted by the Bangladesh Demographic and Health Survey (BDHS). To assess the relationship between the socioeconomic factors and BMI, binary regression models were fitted for 6 surveys and forest plots were applied to display the results. Results: Factors such as age, education, residence, economic status, and contraceptive use were found to have had an increasing influence on BMI over the years that were being analysed. Age and education for women were potential factors influencing BMI. Growing urbanization and economic inequality were found to have been substantial over time, and marital status and contraceptive use were influential whilst the employment status of women held no consequence. Conclusions: Rapid urbanization allied with growing wealth inequality and dietary alteration seems to have forced a change in the capacity of women in Bangladesh to control their weight. Additional information is still needed on such factors as the amount of time that women are inactive and sitting down, for example, as well as their daily calorie intake in order to assemble all the pieces for addressing necessary health policy changes in Bangladesh. These factors will also help to indicate a shift of focus from rural malnutrition to urban obesity. [ABSTRACT FROM AUTHOR]

Bangladesh is a culturally conservative nation with limited freedom for women. A number of studies have evaluated intimate partner violence (IPV) and spousal physical violence in Bangladesh; however, the views of women have been rarely discussed in a quantitative manner. Three nationwide surveys in Bangladesh (2007, 2011, and 2014) were analyzed in this study to characterize the most vulnerable households, where women themselves accepted spousal physical violence as a general norm. 31.3%, 31.9% and 28.7% women in the surveys found justification for physical violence in household in 2007, 2011 and 2014 respectively. The binary logistic model showed wealth index, education of both women and their partner, religion, geographical division, decision making freedom and marital age as significant household contributors for women’s perspective in all the three years. Women in rich households and the highly educated were found to be 40% and 50% less likely to accept domestic physical violence compared to the poorest and illiterate women. Similarly, women who got married before 18 years were 20% more likely accept physical violence in the family as a norm. Apart from these particular groups (richest, highly educated and married after 18 years), other groups had around 30% acceptance rate of household violence. For any successful attempt to reduce spousal physical violence in the traditional patriarchal society of Bangladesh, interventions must target the most vulnerable households and the geographical areas where women experience spousal violence. Although this paper focuses on women’s attitudes, it is important that any intervention scheme should be devised to target both men and women. [ABSTRACT FROM AUTHOR]

Objective: This paper reflected on the prevalence of hypertension and diabetes in Bangladesh, which is spreading rapidly in low-income countries. The rationale of constructing more health centers for addressing NCDs was assessed in this paper by determining the relationship between prevalence of NCDs, particularly hypertension and diabetes, and distance to health facilities. Methods: From BDHS (Bangladesh Health and Demographic Survey) 2011 data set, 7544 samples were analyzed to demonstrate association between Non-communicable diseases (NCD) and distance from respondents’ home to health facilities like hospitals, community clinics, pharmacies or doctors’ chambers, and community facilities like market, post office or cinema hall. Bivariate analysis was conducted between accessibility to health facilities and prevalence of the diseases. The causal relationship between the spatial effects and the prevalence of the diseases were analyzed by applying Generalized Linear Mixed Model (GLMM) was fitted. Results: Fitting linear mixed effect models, we found that hypertension and diabetes react differently with various spatial effects. Distance from home to hospital had significant effect (P < 0.001) on hypertension showing people living further from the facilities or town centers seemed to be less hypertensive, whereas diabetes showed no such affiliation. Conclusion: Higher prevalence of diabetes (40.9%) over hypertension (26.5%) in people aging 35 or higher, have appeared to have caused the difference, which concluded that each non-communicable disease should be dealt to its own merit for policy making instead considering as a group of diseases. [ABSTRACT FROM AUTHOR]

Puddling of clay soils for rice transplanting causes a loss of soil structure and vertical shrinkage cracks that are hypothesized to hamper sunflower root growth in the following dry season. To alleviate soil constraints for sunflower root growth and yield, we examined the effects of three levels of mulch and two irrigation regimes in the dry season on a clay-textured soil in the coastal zone of Bangladesh. These treatments were no-mulch, rice straw mulch at 5 t ha−1 and 10 t ha−1, irrigation applied to the field capacity (I1) and a water supply double that of the I1 treatment (I2). The rice straw mulch significantly increased soil water content by 3–9% and decreased soil penetration resistance by 28–77% and crack volume by 84–91% at A 0–30 cm soil depth relative to the no-mulch treatment. The better root development with the rice straw mulch increased sunflower yield by 23%. No benefit or further reduction in soil penetration resistance or yield improvement was obtained from increasing the level of mulch from 5 to 10 t ha−1 or the volume of irrigation water. It is concluded that ameliorating soil constraints by mulch application led to better root growth in the upper root zone and the increased yield in the clay soil. [ABSTRACT FROM AUTHOR]

• Preference by groups for COVID-19 vaccine by public is yet to be researched in Bangladesh. • Primary data were collected via an online survey (n = 2291) during countrywide lockdown (December 2020–January 2021). • Strong public preference of early vaccination was towards the frontline workers, severely sick and the elderly. • Preference rankings varied across sociodemographic factors including differences between urban and rural residents. • Effective communication on vaccine delivery are needed for any future health crisis for effective national immunization. One of the most challenging aspects of the COVID-19 pandemic is the inability to ensure equitable distribution of vaccines to fight the pandemic. Many governments around the globe had to prioritize and perform a triage in distributing the vaccines due to the limited supply as well as a lack of financial strength to acquire a sufficient number of vaccines in time. The present study assessed the public opinion in Bangladesh regarding vaccination prioritization strategy and its associated aspects. Due to the infectious nature of the viral transmission, the study used an online survey and collected a sample of 2291 respondents, distributed proportionally across sex, and income groups. Descriptive statistics and multinomial logistic regression modelling were utilized to conduct the analyses. The results emphasized unanimous preference of prioritized vaccination leaning towards the frontline workers, the severely sick and the elderly. However, the segregation across ethnicity was noted with no major preference among sexes or religion. The results reinforce the Bangladesh government's undertaken strategy of prioritization. However, the preference rankings varied across sociodemographic factors including self-assessed COVID-19 knowledge and income tiers, among others. The findings underline the necessity of improved risk communication strategies to ensure public confidence and conformity to vaccination efforts and their effective deployment across the country. [ABSTRACT FROM AUTHOR]

A complicating factor for child marriage in Bangladesh is age heaping or digital preference, where young girls misreport their age, claiming to be older or younger than they are. Analysis based on four nationally representative cross-sectional surveys over the last 10 years has shown that the age adjusted results are similar to the reported age results in terms of the direction of the associated socioeconomic factors; however, their effect sizes have changed. Data from 2004 to 2014 of the Bangladesh Demographic and Health Survey (BDHS) were used and cumulative link mixed models (CLMM) were fitted to ascertain the risk factors by adjusting cluster effects, where the outcome variable was categorized by women's age of marriage (ordinal in nature). Even after age adjustment, education of respondents and their partners, age of both the head of the house and their partner, and the geographic division showed a significant association in all surveys. Although the year wise effect showed significant improvement over the years in pooled data, the rate of improvement was not encouraging. Notable cluster (or community) level variations have been observed over the years, indicating that community specific factors such as regional culture and local environments should be considered during the intervention design. • Adjusted age misreporting of women reporting their age for assessing child marriage in Bangladesh • Age adjustment does not change the severity of child marriage in Bangladesh. • Community level variations were found significant in the results. • Significant improvements were observed over the years, but the rate is low. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic has stretched Bangladesh government's capability for disaster engagement. As normalcy is interrupted, people's confidence in the government in ending the crisis needs evaluation, especially considering the past vaccination successes in Bangladesh and growing worldwide vaccine hesitancy amidst the COVID-19 misinfodemic. This study assessed the level of public life disruption due to the pandemic at the micro-level and how much impact it had on people's trust in the government's capacity for successful national immunisation., Methods: Given the infectious nature of the pandemic, the study conducted an online survey of 2291 respondents, distributed proportionally across sex and income groups. We conducted bivariate analyses and fitted generalised linear models to assess disruption to respondents' lives, and their trust in the government's immunisation ability, which were measured using multiple parameters., Results: Nearly 50% of the respondents reported multifaceted disputations in their daily lives, with 90% suffering financially. Trust in the government was very low at the time of the survey as only 11.3% of respondents had faith that the government could successfully conduct a mass vaccination campaign. Rural residents and non-earning members of families found their lives to be less disrupted. Comparatively higher income families and highly educated individuals had lesser confidence in the government's inoculation capabilities., Conclusions: For the vaccine campaign to be successful, effective risk communication and timely display of data-driven decision-making efforts targeting the groups who are more sceptical of immunisation campaigns could be of significance to the Bangladesh government., (© 2023 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Objective: To investigate the prevalence of the number of children ever born (CEB) and its associated determinants among women aged 15-49 years in Bangladesh., Study Design and Setting: We used clustered data extracted from the last two Bangladesh Demographic and Health Surveys (BDHS 2014 and BDHS 2017-2018). A two-stage stratified sampling was used in both surveys. Mixed logistic regression modelling approach for binary responses was adapted to accommodate clustering effects via the generalised linear mixed model framework., Participants: The study is based on 15 924 ever-married women in BDHS 2017-2018 (14 119 in BDHS 2014) of Bangladesh., Results: As per the latest BDHS 2017-2018, 42.1% of reproductive women had three or more children. Age at first marriage (p<0.001, OR 0.74, 95% CI 0.666 to 0.825), age at first birth (p<0.001, OR0.54, 95% CI 0.480 to 0.607), place of residence (p<0.001, OR 0.79, 95% CI 0.712 to 0.872), exposure of media (p<0.001, OR 0.71, 95% CI 0.647 to 0.768), religion (p<0.001, OR 1.47, 95% CI 1.277 to 1.690), husband's desire more child (p<0.001, OR 1.60, 95% CI 1.428 to 1.784), women empowerment (p<0.001, OR 1.19, 95% CI 1.075 to 1.3) and wealth index (p<0.001, OR1.61, 95% CI 0.435 to 1.796) were found to be statistically significant determinants of the number of CEB among ever-married women. The number of CEB among women was negatively associated with their own educational status (p<0.001) and husbands level of education (p<0.001)., Conclusion: The CEB appears to be higher among women who were married before 18 years, Muslim, illiterate, living in rural areas, had first birth before 20 years, non-exposure of media and husband's desire for more children., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)