Prevalence and determinants of utilizing skilled birth attendance during home delivery of pregnant women in India: Evidence from the Indian Demographic and Health Survey 2015-16.

BACKGROUND: Utilization of skilled birth attendance during home delivery of pregnant women is proven to reduce complications during and after childbirth. Though the utilization of skilled birth attendance (SBA) during home delivery has increased significantly in recent times, the rate of utilizing skilled birth attendance is still low in several regions across India. The objective of this study is to analyze the prevalence and to identify the determinants of the utilization of skilled birth attendance during home delivery of pregnant women in India. METHODS: To conduct this study, data and information from the Indian Demographic and Health Survey 2015-16 have been utilized. The sample size for this study is a weighted sample of 41,171 women. The sample consisted of women who had given a live birth in the three years preceding the survey. For women with more than one child, only the first live birth was considered. The binary logistic regression model and the log-binary logistic regression analysis have been applied as the adjusted odds ratios (AORs) with 95% confidence intervals for identifying the determinants of home-based skilled birth attendance during delivery. That allows us to select the most appropriate model for our study objective by ensuring that the determinants of skilled birth attendance for home delivery are accurately assessed based on the characteristics of the data. RESULTS: The analyses show that only 18.8% of women had utilized skilled birth attendance during delivery. Women residing in urban areas are more likely to utilize skilled birth attendance during home delivery (AOR: 1.14; 95% CI: 1.08-1.20). Women having higher education levels are associated with increased use of SBA during home delivery (AOR: 1.15; 95% CI: 1.04-1.28). Exposure to media is associated with increased utilization of SBA (AOR: 1.17; 95% CI: 1.11-1.23). Overweight women are also more likely to avail the SBA during home delivery (AOR: 1.11; 95% CI: 1.03-1.19). Women belonging to affluent households have higher odds of utilizing skilled birth attendance (AOR: 1.41; 95% CI: 1.33-1.49). Having 3+ tetanus injections is associated with the utilization of SBA (AOR: 1.56; 95% CI: 1.43-1.69). Women having 4+ antenatal care visits were more likely to utilize SBA (AOR: 1.81; 95% CI: 1.71-1.92). Women belonging to the Hindu religion were 1.12 times more likely to utilize SBA (AOR: 1.12; 95% CI: 1.07-1.18). Women with 1 to 3 birth orders were 1.40 times more likely to utilize skilled birth attendance during home delivery (AOR: 1.40; 95% CI: 1.30-1.51). CONCLUSION: The percentage of women utilizing skilled birth attendance during home delivery is still very low which is a matter of serious concern. Several factors have been found to be associated with the utilization of SBA during home delivery in India. As skilled birth attendance has significant positive health outcomes for pregnant women and newborns, efforts to increase the rate of SBA utilization during home delivery should be undertaken.

Knowledge, attitude, and practice of university students towards monkeypox in Bangladesh.

The recent outbreak of viral zoonotic disease-monkeypox-caused by the monkeypox virus, has infected many people worldwide. This study aims to explore the knowledge, attitudes, and practices (KAP) concerning monkeypox among university students in Bangladesh. Data were collected using purposive snowball sampling from 887 university students through an online survey using Google Form. The participants were mostly in their twenties (M = 22.33 [SD 2.01] years), and they spent, on average, 2.59 [SD 1.91] hours/day on electronic and social media. The participants generally showed moderate knowledge (39.5%), low attitude (25.1%), and moderate practice (48.6%) toward monkeypox, with 47.6% having had a moderate KAP score. Findings further showed that personal attributes of university students, i.e., age, sex, year of schooling, residence, living status, geographical distribution, e.g., division, were statistically and significantly associated with knowledge, attitudes, and practices regarding monkeypox and overall KAP score. It is also apparent that health status, susceptibility to monkeypox, and exposure to social media were the most common factors significantly associated with knowledge, attitudes, and practices regarding monkeypox and overall KAP score. The current study's findings underscore the need for developing appropriate information, education, and communication (IEC) materials and their dissemination, which could play an important role in reducing the risk of monkeypox and similar other infectious diseases, particularly among students in Bangladesh.

Mental Health Status of Teachers During the Second Wave of the COVID-19 Pandemic: A Web-Based Study in Bangladesh.

Background: Following the outbreak of the COVID-19 pandemic, the government of Bangladesh implemented strict non-therapeutic measures, i.e., "social distancing," "lockdown," "work from home," in the first quarter of 2020. Like other professionals, teachers at schools, colleges and universities were confined within households. However, the introduction of online education imposed an additional burden on teachers along with growing household responsibilities, thus, affecting their psychological state. Aims: This study was aimed to explore the prevalence of mental health problems among teachers in Bangladesh and to identify the associated risk factors. Methods: This web-based cross-sectional study was conducted during the second wave of COVID-19 pandemic in Bangladesh. Data were collected from 381 teachers working at schools, colleges, and universities between 01 August and 29 August 2021 by administering a self-reported e-questionnaire using Google Form, where the mental health of teachers was assessed by depression, anxiety, and stress scale. Data were analyzed using IBM SPSS Statistics (Version 26) and STATA Version 16, and multiple linear regression was executed to predict mental health problems among teachers. Results: The findings indicate that the overall prevalence of depression, anxiety, and stress among teachers was 35.4%, 43.7%, and 6.6%, respectively. The prevalence was higher among male and older teachers than among their female and younger colleagues. The findings further showed that place of residence, institution, self-reported health, usage of social and electronic media, and fear of COVID-19 significantly influenced the mental health status of teachers. Conclusion: It is strongly recommended that the government and policymakers provide proper mental health services to teachers in order to reduce mental health problems and thus sustain the quality of education during and after the pandemic.

Changes in dietary patterns among Bangladeshi adult population during the COVID-19 pandemic: A web-based cross-sectional study.

Background: The home confinement induced by the COVID-19 pandemic affects individuals' mental wellbeing and increases unhealthy behaviors, such as minimum to no physical activity, overeating, and substance use. Objective: This study aimed to assess the changes in dietary patterns among the Bangladeshi adult population during the COVID-19 pandemic and identify their determinants. Methods: This web-based cross-sectional survey was carried out from 10-17 December 2020 using an e-questionnaire based on Google Forms. A semi-structured e-questionnaire was forwarded to the participants - Bangladesh citizens aged above 18 years - through social media platforms and email in order to collect information about socio-demographic issues and multidimensional dietary patterns. From the initial 817 responses gathered through snowball sampling, 748 responses were retained. Bivariate and multivariate analyses were executed. Results: The findings suggest that 50% of the participants reported a reduction in weight and physical activities, while approximately 52% experienced increased sleep time. One in three participants (31.4%) experienced a decrease in food buying capacity. The findings further indicate that women were 1.65 times more likely to reduce food consumption than men. Meanwhile, employed people were about 34% less likely to increase food consumption than their unemployed counterparts. People who were getting more than 6 h of sleep per day were nearly 61% less likely to increase food consumption than people who slept for less than 6 h per day. People struggling to buy food items were 2.31 times more likely to reduce food intake than people with no such limitations. Conclusions: The study shows that COVID-19 has substantially affected Bangladeshi people's common food consumption patterns. Being confined within the household, primarily due to countrywide lockdowns and 'general holidays', has affected both the dietary patterns and the financial wellbeing of people. Therefore, the concerned authorities should promote effective nutrition education and healthy dietary behaviors; meanwhile, financial support or incentives for people in need are also strongly advocated.

Knowledge, Attitudes, and Practices concerning Black Fungus during COVID-19 Pandemic among Students of Bangladesh: An Online-Based Cross-Sectional Survey.

BACKGROUND: Infection with COVID-19 and its control entailing steroids and immunomodulatory medications disrupted normal immune function. The ensuing immunological disorder led to the rise of another infection-Black Fungus (Mucormycosis). However, the spread of Black Fungus can be minimized through proper knowledge, informed attitude, and conscious preventive practice. This study aimed to assess students' knowledge, attitude, and practice (KAP) regarding Black Fungus amid the COVID-19 pandemic in Bangladesh. METHODS: This cross-sectional study was carried out among Bangladeshi students from June to July 2021. Using Google Forms, an e-questionnaire was developed for this web-based survey, and the participants were selected through a snowball sampling approach. RESULTS: Out of the 2009 participants, more than half were female (53.5%), and the majority were at an age between 18 and 25 years (31.5%) and had received higher secondary (HSC) schooling (77.8%), while around 61% resided in urban areas. Findings revealed that most of the students (63.8%) spent around 2 h on electronic and social media to become informed about COVID-19 and Black Fungus. Approximately 33% of the students showed low KAP scores (32.9%), whereas around 26% had high KAP scores. Our results show a significant association between KAP and sex, schooling, living status, residence, and media exposure. CONCLUSION: The knowledge of Black Fungus considerably varies among Bangladeshi students considering the place of residence, age, sex, living arrangement, and media exposure. Policymakers should emphasize awareness among people focusing on the results of this study to increase deterrent attitudes and protective practices to minimize the risks of being infected.

Prevalence and Triggering Factors of Childhood Anemia: An Application of Ordinal Logistic Regression Model.

Introduction: Anemia is indeed a significant risk factor for children's health as it affects growth retardation and has severe short and prolonged effects that follow in morbidity and death. Notwithstanding such ways to tackle anemia, the prevalence remains high in India and poses a severe public health concern. Objectives: The primary focus of this study was to find the prevalence and to determine the factors associated with the anemia of children under five years of age in India. Problem Statement. The increasing prevalence of childhood anemia and the life-threatening consequences for millions of children in India are a major concern. Knowing the relevant associated factors with childhood anemia is essential to reduce the frequency and severity level. Study design. For analysis purposes, this study utilized a cross-sectional study design. Methodology. Using the Indian Demographic and Health Survey 2015-16 data, we used chi-squared and gamma tests to find the association. Then, we utilized multinomial logistic regression and ordinal logistic regression to find the better model and the influencing factors of anemia in India. Results: In our study, we have found that children with highly educated mothers were 36.7% less likely (OR = 0.633, P ≤ 0.001, 95% CI: 0.608, 0.658) to be higher anemic than the children with not educated mother. Children with moderate and severe anemic mothers were 163.3% (OR = 2.633, P ≤ 0.001, 95% CI: 2.565, 7.704) more likely to be higher anemic than the children with not anemic mother. Not stunting children were 21.9% (OR = 0.781, P ≤ 0.001, 95% CI: 0 .764, 0.797) less likely to be higher anemic than the stunting children. Children aged 36-59 months were 73.9% (OR = 0.361, P ≤ 0.001, 95% CI: 0.353, 0.369) less likely to be higher anemic than the children aged 6-24 months. Again, the ACI value revealed that ordinal logistic regression was a better-fitted model for these data. Conclusion: and contribution. The variables such as stunting, underweight, wasting, child age, size of the child, and source of drinking water were the most critical indicators for child anemia in India. In summary, our study result indicated the major socioeconomic and demographic factors associated with childhood anemia in India, which can help the policymaker to take quick decision to reduce the severity level.

Individual and community-level factors associated with skilled birth attendants during delivery in Bangladesh: A multilevel analysis of demographic and health surveys.

BACKGROUND: Skilled birth attendants (SBAs) play a crucial role in reducing infant and maternal mortality. Although the ratio of skilled assistance at birth has increased in Bangladesh, factors associated with SBA use are unknown. The main goal of our study was to reveal the individual- and community-level factors associated with SBA use during childbirth in Bangladesh. We also showed the prevalence and trend of SBA use and related independent variables in Bangladesh over the past decade. METHODS: This study utilized the Bangladesh Health and Demographic Survey (BDHS) 2017-2018, a cross-sectional study. We used binary logistic regression to examine the extent of variation in SBA use attributable to the individual- and community-level variables. RESULTS: Overall, 53.35% of women received assistance from SBAs during childbirth. The average annual rate of increase (AARI) in the number of SBA-assisted births over the past 10 years was 8.88%. Respondents who gave birth at or above 19 years had 1.40 times (AOR = 1.40; 95% CI: 1.21-1.62) greater odds of having skilled delivery assistance than respondents aged 18 years old or less. Women and their husband's education levels were significantly associated with using skilled assistance during delivery, with odds of 1.60 (AOR = 1.60; 95% CI: 1.45-2.01) and 1.41 (AOR = 1.41; 95% CI: 1.21-1.66), respectively compared to those with education up to primary level. Women from rich families and those receiving better antenatal care (ANC) visits were more likely to have professional delivery assistance. Community-level factors also showed significance towards having professional assistance while giving birth. Women from urban communities and those who utilized more than four ANC visits and had completed secondary or higher education showed a greater tendency to use an SBA during childbirth than their counterparts. CONCLUSION: The use of SBAs during delivery was significantly associated with some individual- and community-level factors. To reduce maternal and child mortality, there is a need to focus on rural and uneducated people who are less likely to access these facilities. Special programs could increase awareness and help the poor community obtain the minimum facility in maternal care.