Assessing the Quality and Coverage of Maternal Postnatal Care in Bangladesh: A Comparative Analysis of Quality Postnatal Care among Home and Facility Births.

BACKGROUND: Bangladesh has achieved remarkable progress in reducing maternal mortality, yet postpartum deaths remain a significant issue. Emphasis on quality postnatal care (qPNC) is crucial, as increased coverage alone has not sufficiently reduced maternal morbidity and mortality. METHODS: This study included data from the Bangladesh Maternal Mortality Survey of 32,106 mothers who delivered within three years prior to the survey. Descriptive statistics were used to report coverage and components of postnatal care stratified by covariates. Log-linear regression models were used to assess the determinants of quality postnatal care among facility and home births. RESULTS: From 2010 to 2016, postnatal care coverage within 48 h of delivery by a qualified provider rose from 23% to 47%. Of the births, 94% were facility births that received timely PNC, contrasted with only 6% for home births. Despite the increased coverage, quality of care remained as low as 1% for home births and 13% for facility births. Key factors affecting qPNC utilization included socio-demographic factors, pregnancy complications, type of birth attendant, delivery method, and financial readiness. CONCLUSION: Importantly, deliveries assisted by skilled birth attendants correlated with higher quality postnatal care. This study reveals a significant gap between the coverage and quality of postnatal care in rural Bangladesh, especially for home births. It underscores the need for targeted interventions to enhance qPNC.

Association of dietary diversity of 6-23 months aged children with prenatal and postnatal obstetric care: evidence from a nationwide cross-sectional study.

BACKGROUND: Dietary diversity is a key determinant of infant and young child eating patterns for a variety of food groups taken by children between the ages of 6-23 months. The study aimed to examine the association between prenatal and postnatal obstetric care factors of mother and child's dietary diversity, and specific food practices in Bangladesh. METHODS: This study analyzed the data of 2497 children between the age of 6-23 extracted from the latest countrywide Bangladesh Demographic Health Survey 2017-2018 and explored relationships between prenatal and postnatal obstetric care received by mother and dietary diversity score (DDS), minimum dietary diversity (MDD), and introduction of solid, semi-solid, and soft foods (ISSSF) of their children. RESULTS: Findings revealed that ≥ 4 antenatal care (ANC) visits care visits increased the DDS (adjusted [Formula: see text]: 0.32, 95% CI [0.21, 0.43]), increased the likelihood of MDD (AOR 1.54, 95% CI [1.23, 1.93]), and ISSSF (AOR 1.24, 95% CI [1.08, 1.48]), consuming eggs (AOR 1.47, 95% CI [1.23, 1.76]), and vitamin A vegetables and fruits (AOR 1.38, 95% CI [1.15, 1.66]). Moreover, DDS (adjusted ß: 0.05, 95% CI [0.00, 0.11]) and MDD (AOR 1.66, 95% CI [1.31, 2.11]) are linked to childbirth in a medical facility. The C-section delivery influences the DDS (adjusted [Formula: see text]: 0.05, 95% CI [0.00, 0.10]), MDD (AOR 1.39, 95% CI [1.10, 1.75]), and ISSSF (AOR 1.22, 95% CI [1.02, 1.48]). Besides, postnatal visits within 48 h of delivery linked to MDD (AOR 0.66, 95% CI [0.49, 0.89]) and ISSSF (AOR 0.76, 95% CI [0.59, 0.97]), and physicians or professionals providing postnatal checkups were significantly associated with DDS (adjusted [Formula: see text]: 0.09, 95% CI [0.02, 0.16]), MDD (AOR 1.69, 95% CI [1.26, 2.26]), and ISSSF (AOR 1.30, 95% CI [1.04, 1.62]). CONCLUSION: Knowledge of child nutritional feeding should emphasize during prenatal and postnatal obstetric care of mother, particularly during antenatal and postnatal visits, C-section delivery, and birth in a healthcare facility to eradicate malnutrition and establish healthy child feeding practices.

Factors associated with depression and determining dimensions of job satisfaction among physicians in Bangladesh.

Background: Depression in physicians emerges early in their academic and professional careers. Lengthy and irregular duty time, high levels of obligation, job dissatisfaction, workstation culture, organizational rules, and so on significantly increased the psychological pressure on physicians. Objectives: The study's aim was to measure the level of depression, association, and influence of socio-demographic characteristics and job satisfaction on depression among physicians in Bangladesh, as well as to explore the factor structure of job satisfaction measure and examine its internal reliability. Methods: Data were collected using a self-administered questionnaire in a cross-sectional survey of 301 physicians. The factors related to depression were investigated using a multivariable logistic regression model, and factor analysis was done to identify the important factors associated with job satisfaction. Results: Male respondents made up 49.5 percent of the sample overall, while female respondents made up 50.5 percent. 24.58% of the physicians had mild depression, whereas 13.29%, 7.31%, and 0.66% of the participants had moderate, moderately severe, and severe depression, respectively. In multivariable analysis, sex (male vs. female, AOR: 2.16, 95% CI:1.28-3.62), monthly income <15000 BDT vs. >40000 BDT, (AOR: 0.35, 95% CI: 0.14-0.89), and income <15000 BDT vs. 15,000-24,999 BDT (AOR: 0.36, 95% CI: 0.15-0.89) were the essential factors associated with depression. Furthermore, with each unit increase in the job satisfaction score was related to a 71% decrease in the odds of physicians having depression. Conclusion: The findings of this study indicate that providing appropriate organizational support, proper work assignments, and an adequate opportunity to develop their professional skills and career irrespective of sex may increase overall job satisfaction. Ultimately, this will serve to improve patient care as well as the whole health system's output.