Parental decisions, child health and valuation of avoiding arsenic in drinking water in rural Bangladesh.

Arsenic contamination of groundwater in Bangladesh is a widespread public health hazard. Water sources without high arsenic levels are scarce, affecting people's availability for work and other activities when they have to seek safe water to drink. While children are particularly susceptible to chronic arsenic exposure, limited information and heavy constraints on resources may preclude people in developing countries from taking protective actions. Since parents are primary decision-makers for children, a model of stochastic decision-making analytically linking parent health and child health is used to frame the valuation of avoiding arsenic exposure using an averting behavior model. The results show that safe drinking water programs do work and that people do take protective actions. The results can help guide public health mitigation policies, and examine whether factors such as child health and time required for remediation have an effect on mitigation measures.

Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh.

As the world's longest running pandemic, cholera poses a substantial public health burden in Bangladesh, where human vulnerability intersects with climatic variability. Barriers to safe water and sanitation place the health of millions of Bangladeshis in jeopardy - especially those who have highly constrained choices in preventing and responding to cholera. In this paper we investigate demand for cholera prevention among residents in the Mirpur and Karail slum areas of urban Dhaka. Using survey data from 2023 households in two slum areas, we analyze responses from a contingent valuation questionnaire that elicited willingness to pay (WTP) for cholera vaccines across household members and under varying disease risk scenarios, finding higher valuation for cholera prevention for children and under scenarios of greater epidemic risk. We estimate the average WTP for a cholera vaccine for a child ranges from TK 134-167 (US$ 1.58-1.96). Consistently, respondents with prior knowledge of the cholera vaccine reported lower WTP valuations, providing suggestive evidence of concerns about vaccine effectiveness and preferences for cholera treatment over prevention. We supplement the contingent valuation analysis with cost of illness estimates from both our household sample as well as from administrative hospital records of over 34,000 cholera patients. We estimate that a household incurs costs of TK 801-922 (US$ 9.43-10.50) per episode of cholera that requires medical treatment. Taken together, these findings indicate higher WTP for cholera treatment compared to prevention, but increased interest in prevention under early warning system scenarios of high disease risk.

Thalassemias in South Asia: clinical lessons learnt from Bangladesh.

Thalassemias are emerging as a global public health concern. Due to remarkable success in the reduction of childhood mortality by controlling infectious diseases in developing countries, thalassemias are likely to be a major public health concern in the coming decades in South Asia. Despite the fact that Bangladesh lies in the world's thalassemia belt, the information on different aspects (epidemiology, clinical course, mortality, complications and treatment outcomes) of thalassemias is lacking. In this comprehensive review, the aim is to to depict the epidemiological aspects of thalassemias, mutation profile and current treatment and management practices in the country by sharing the experience of dealing with 1178 cases over 2009-2014 time periods in a specialized thalassemia treatment centre. We have also discussed the preventative strategies of thalassemias from the context of Bangladesh which could be effective for other developing countries.

Knowledge of arsenic in drinking-water: risks and avoidance in Matlab, Bangladesh.

Widespread contamination of arsenic in Bangladesh has been jeopardizing the health of millions of people. Residents of Matlab, Bangladesh, are among the millions at risk. Using bivariate models in the analysis of survey data, knowledge of health risks and avoidance of arsenic exposure in response to widespread contamination of arsenic for residents of Matlab were estimated. The models examined individuals' knowledge of an arsenic problem in the household and knowledge of specific illnesses caused by arsenic exposure. The likelihood of avoiding exposure to arsenic contamination was further examined. Results of the estimation showed that individual's knowledge of arsenic problems in the household was gathered through awareness campaigns and by word of mouth and that knowledge of illnesses was predicated on education, health, presence of children, elderly and young women. Adoption of avoidance measures was not affected by exposure to arsenic-information sources, but level of education had a statistically significant positive effect on the decision to avoid arsenic exposure. Lack of convenience of safe drinking-water practices lead people to persist in drinking arsenic-contaminated water.

Arsenic in drinking water in bangladesh: factors affecting child health.

The focus of this paper is to present an empirical model of factors affecting child health by observing actions households take to avoid exposure to arsenic in drinking water. Millions of Bangladeshis face multiple health hazards from high levels of arsenic in drinking water. Safe water sources are either expensive or difficult to access, affecting people's individuals' time available for work and ultimately affecting the health of household members. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, parental actions linking child health outcomes is used in the empirical model. Empirical results suggest that child health is significantly affected by the age and gender of the household water procurer. Adults with a high degree of concern for children's health risk from arsenic contamination, and who actively mitigate their arsenic contaminated water have a positive effect on child health.

Averting Behavior Framework for Perceived Risk of Yersinia enterocolitica Infections.

The focus of this research is to present a theoretical model of averting actions that households take to avoid exposure to Yersinia enterocolitica in contaminated food. The cost of illness approach only takes into account the value of a cure, while the averting behavior approach can estimate the value of preventing the illness. The household, rather than the individual, is the unit of analysis in this model, where one household member is primarily responsible for procuring uncontaminated food for their family. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, the designated household head makes the choices that are investigated in this paper. This model uses constrained optimization to characterize activities that may offer protection from exposure to Yersinia enterocolitica contaminated food. A representative household decision maker is assumed to allocate family resources to maximize utility of an altruistic parent, an assumption used in most research involving economics of the family.