| 1. |
- Huq, Nafisa Lira, et al.
(author)
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Community-based integrated intervention for skilled maternal health care utilization in riverine remote areas, Bangladesh
- 2023
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In: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 37
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Journal article (peer-reviewed)abstract
- Introduction: Despite the decrease in maternal mortality ratio, many women in Bangladesh are still at high-risk of death due to pregnancy-related morbidities. Increasing the rate of skilled maternal healthcare service utilization is effective to reduce maternal mortality rate. This paper examines the intervention effect of an integrated community-based maternal healthcare project implemented by a non-government organization, Friendship, aiming to provide maternal health services to women living in the remote riverine regions of Bangladesh.Methods: We examined the skilled maternal healthcare service utilization before and after project implementation of the mothers with birth experience of 0-6 months from the intervention (N =1,304) and comparison areas (N = 1,304). A difference-in-differences logistic model measured the effect of the intervention.Results: After the intervention, mothers were three times more likely to receive & GE; 4 ANC visits from skilled providers (AOR: 2.9; 95 % CI: 2.1-4.2), 1.5 times more likely to have skilled birth attendants during deliveries (AOR: 1.5; 95 % CI: 1.1-2.1) and 1.5 times more likely to seek at least one PNC within 42 days after delivery (AOR: 1.5; 95 % CI: 1.1-2.2) as compared to the comparison group.Conclusion: The intervention showed positive effect on improving the ANC coverage, skilled delivery, and PNC among the mothers residing the remote riverine areas. Therefore, it opens up the opportunity for adaptation of such integrated community and facility-based interventions by other LMICs.
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| 2. |
- Mazumder, Tapas, et al.
(author)
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Nutritional status of a young adult population in saline-prone coastal Bangladesh
- 2023
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In: Frontiers In Public Health. - : FRONTIERS MEDIA SA. - 2296-2565. ; 11
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Journal article (peer-reviewed)abstract
- Introduction: Like many low- and middle-income countries, understanding the nutritional status of the young population in Bangladesh has had less attention. With projected climate change and associated sea level rise, the existing problem of salinity in coastal Bangladesh will significantly increase and further worsen agrobiodiversity. This research aimed to examine the nutritional status of a young population in climate-vulnerable coastal Bangladesh to inform appropriate intervention strategies to reduce the burden on health and economic outcomes.Methods: A cross-sectional survey was conducted in 2014, and anthropometric measures were conducted for 309 young people aged 19-25 years in a rural saline-prone subdistrict in southwestern coastal Bangladesh. Body mass index (BMI) was calculated from body height and weight, and data about socio-demographic factors were collected. To identify the socio-demographic risk factors affecting undernutrition (BMI <18.5 kg/m(2)) and overweight/obesity (BMI >= 25.0 kg/m(2)), multinomial logistic regression analysis was used.Results: Overall, one-fourth of the study population was classified as underweight, and nearly one-fifth were overweight or obese. The proportion of underweight was significantly higher in women (32.5%) compared to that of men (15.2%). Overall, employment, especially in women, was associated with reduced odds of being underweight (adjusted odds ratio-aOR: 0.32; 95% confidence interval - CI: 0.11, 0.89). Subjects with secondary education incomplete (grades 6-9) compared to those with primary or below education (grades 0-5; aOR: 2.51; 95% CI: 1.12, 5.59) and employed compared to those unemployed groups (aOR: 5.84; 95% CI: 2.67, 12.74) were more likely to be overweight or obese in this study population. These associations were more pronounced in women.Discussion: Multisectoral program strategies are required to tackle the growing burden of malnutrition (both under and overweight) in this young age group tailored to local contexts including in climate-vulnerable coastal Bangladesh.
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| 3. |
- Mazumder, Tapas, et al.
(author)
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Prevalence and Risk Factors of Gestational Diabetes Mellitus in Bangladesh : Findings from Demographic Health Survey 2017-2018
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:5
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Journal article (peer-reviewed)abstract
- Gestational diabetes mellitus (GDM) has serious consequences for both maternal and neonatal health. The growing number of noncommunicable diseases and related risk factors as well as the introduction of new World Health Organization (WHO) diagnostic criteria for GDM are likely to impact the GDM prevalence in Bangladesh. Our study aimed to assess the national prevalence and identify the risk factors using the most recent WHO criteria. We used the secondary data of 272 pregnant women (weighted for sampling strategy) from the Bangladesh Demographic and Health Survey 2017-2018. Multivariate logistic regression was performed to determine the risk factors of GDM. The overall prevalence of GDM in Bangladesh was 35% (95/272). Increased odds of GDM were observed among women living in the urban areas (adjusted odds ratio (aOR) 2.74, 95% confidence interval (CI) 1.43-5.27) compared to rural areas and those aged >= 25 years (aOR 2.03, 95% CI 1.13-3.65). GDM rates were less prevalent in the later weeks of pregnancy compared to early weeks. Our study demonstrates that the national prevalence of GDM in Bangladesh is very high, which warrants immediate attention of policy makers, health practitioners, public health researchers, and the community. Context-specific and properly tailored interventions are needed for the prevention and early diagnosis of GDM.
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| 4. |
- Shamba, Donat, et al.
(author)
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Barriers and enablers to routine register data collection for newborns and mothers: EN-BIRTH multi-country validation study.
- 2021
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In: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 21:Suppl 1
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Journal article (peer-reviewed)abstract
- Policymakers need regular high-quality coverage data on care around the time of birth to accelerate progress for ending preventable maternal and newborn deaths and stillbirths. With increasing facility births, routine Health Management Information System (HMIS) data have potential to track coverage. Identifying barriers and enablers faced by frontline health workers recording HMIS source data in registers is important to improve data for use.The EN-BIRTH study was a mixed-methods observational study in five hospitals in Bangladesh, Nepal and Tanzania to assess measurement validity for selected Every Newborn coverage indicators. We described data elements required in labour ward registers to track these indicators. To evaluate barriers and enablers for correct recording of data in registers, we designed three interview tools: a) semi-structured in-depth interview (IDI) guide b) semi-structured focus group discussion (FGD) guide, and c) checklist assessing care-to-documentation. We interviewed two groups of respondents (January 2018-March 2019): hospital nurse-midwives and doctors who fill ward registers after birth (n = 40 IDI and n = 5 FGD); and data collectors (n = 65). Qualitative data were analysed thematically by categorising pre-identified codes. Common emerging themes of barriers or enablers across all five hospitals were identified relating to three conceptual framework categories.Similar themes emerged as both barriers and enablers. First, register design was recognised as crucial, yet perceived as complex, and not always standardised for necessary data elements. Second, register filling was performed by over-stretched nurse-midwives with variable training, limited supervision, and availability of logistical resources. Documentation complexity across parallel documents was time-consuming and delayed because of low staff numbers. Complete data were valued more than correct data. Third, use of register data included clinical handover and monthly reporting, but little feedback was given from data users.Health workers invest major time recording register data for maternal and newborn core health indicators. Improving data quality requires standardised register designs streamlined to capture only necessary data elements. Consistent implementation processes are also needed. Two-way feedback between HMIS levels is critical to improve performance and accurately track progress towards agreed health goals.
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| 5. |
- Tahsina, Tazeen, et al.
(author)
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EN-BIRTH multi-country validation study : EN-BIRTH multi-country validation study
- 2021
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In: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 21:SUPPL
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Journal article (peer-reviewed)abstract
- BackgroundImmediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. "Every Newborn Birth Indicators Research Tracking in Hospitals" (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF.MethodsThe EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women's exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording.ResultsCoverage of EIBF among 7802 newborns observed for >= 1h was low (10.9, 95% CI 3.8-21.0). Survey-reported (53.2, 95% CI 39.4-66.8) and register-recorded results (85.9, 95% CI 58.1-99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5-93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3-73.5%) and drying (7.3-29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5-3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting.ConclusionsOur study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement.
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| 6. |
- Tahsina, Tazeen, et al.
(author)
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Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study.
- 2021
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In: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 21:Suppl 1
-
Journal article (peer-reviewed)abstract
- Immediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. "Every Newborn Birth Indicators Research Tracking in Hospitals" (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF.The EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1 h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women's exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording.Coverage of EIBF among 7802 newborns observed for ≥1 h was low (10.9, 95% CI 3.8-21.0). Survey-reported (53.2, 95% CI 39.4-66.8) and register-recorded results (85.9, 95% CI 58.1-99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5-93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3-73.5%) and drying (7.3-29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5-3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting.Our study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement.
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