Women's multidimensional empowerment index and essential newborn care practice in Bangladesh: The mediating role of skilled antenatal care follow-ups.

INTRODUCTION: The World Health Organization recommended a set of five neonatal care practices that are most essential for good health of a newborn. As good essential newborn care (ENC) practice reduces the risk of neonatal morbidity and mortality, this paper focuses how women's multidimensional empowerment index is associated with this practice through the skilled antenatal care. To the best of knowledge, no such study has been conducted yet. The composite index of women's multidimensional empowerments was constructed using family decision, intimate partner violence, social status, healthcare access and economic status of women; and skilled antenatal care was defined if a pregnant woman received eight or more checkups during pregnancy from skilled health professionals. MATERIALS AND METHODS: Data extracted from Bangladesh Demographic and Health Survey, 2017-18 have been utilized in the study. A total of 2441 mothers have been considered who delivered their last live birth at home within three years preceding the survey. A mediation analysis was performed considering the structural equation modeling to find out the adjusted association of women's empowerment on both skilled antenatal care and good ENC practice, but the unadjusted associations were also checked using a chi-square test. To test the indirect as well as total effect of women's empowerment through skilled antenatal care on good ENC practice, bias-corrected standard errors were estimated using a bootstrapping sampling. RESULTS: Good ENC practice was considerably low in Bangladesh with 7.6% of newborns receiving the practice. Both adjusted and unadjusted analyses showed the significant association of women's empowerment with both skilled antenatal care and good ENC practice. The study revealed that the indirect effect of high empowerment through skilled antenatal care was greater than its direct effect on good ENC practice. CONCLUSION: This study explored that the prevalence of good ENC practice can be accelerated through women's empowerment, where skilled antenatal care plays an important mediating role in improving good ENC practice among highly empowered mothers. The study suggests that a woman should follow the latest guidelines recommended by WHO for antenatal care follow-up. Policymakers can modify some of the maternal and child health care interventions based on the research findings.

Examining the influence of correlates on different quantile survival times: infant mortality in Bangladesh.

BACKGROUND: Several studies have identified factors influencing infant mortality, but, to the best of knowledge, no studies assessed the factors considering unequal effects on different survival times of infant mortality in Bangladesh. In this study, it was examined how a set of covariates behaves on different quantile survival times related with the infant mortality. METHODS: Data obtained from Bangladesh multiple indicator cluster survey (BMICS), 2019 have been used for purpose of the study. A total of 9,183 reproductive women were included in the study who gave their most recent live births within two years preceding the survey. Kaplan-Meier product limit approach has been applied to find the survival probabilities for the infant mortality, and the log-rank test has also been used to observe the unadjusted association between infant mortality and selected covariates. To examine the unequal effects of the covariates on different quantile survival time of infant mortality, the Laplace survival regression model has been fitted. The results obtained from this model have also been compared with the results obtained from the classical accelerated failure time (AFT) and Cox proportional hazard (Cox PH) models. RESULTS: The infant mortality in Bangladesh is still high which is around 28 per 1000 live births. In all the selected survival regression models, the directions of regression coefficients were similar, but the heterogenous effects of covariates on survival time were observed in quantile survival model. Several correlates such as maternal age, education, gender of index child, previous birth interval, skilled antenatal care provider, immediate breastfeeding etc. were identified as potential factors having higher impact on initial survival times. CONCLUSION: Infant mortality was significantly influenced by the factors more in the beginning of the infant's life period than at later stages, suggesting that receiving proper care at an early age will raise the likelihood of survival. Policy-making interventions are required to reduce the infant deaths, and the study findings may assist policy makers to revise the programs so that the sustainable development goal 3.2 can be achieved in Bangladesh.

Risk assessment and evaluation of heavy metals concentrations in blood samples of plastic industry workers in Dhaka, Bangladesh.

To assess the potential health risk caused by heavy metals twenty-six blood samples were collected from plastic industry workers based on ages and smoking status in Dhaka, Bangladesh. Heavy metals were analyzed with an atomic absorption spectrometer. The mean concentrations of Lead (Pb), Cadmium (Cd), Nickel (Ni), and Zinc (Zn) found in blood samples of the exposed workers were 32.78 ± 9.47, 1.08 ± 0.47, 1.42 ± 1.01, and 9.08 ± 1.95 µgL-1, respectively. The average heavy metal concentrations in blood samples of smoking workers show a narrow range of fluctuation than that of non-smoking workers. A review of different age groups of industry workers shows the workers between the ages of 26 and 40 are more likely to contaminated with Pb (35.90 ± 8.06 µgL-1) and Ni (1.61 ± 1.31 µgL-1). The higher level of Cd (1.26 ± 0.46 µgL-1) and Zn (9.91 ± 2.80 µgL-1) was found in >40 years old workers. The mean concentration in indoor dust samples of different industrial subsections reported as 40.27 ± 10.33, 3.24 ± 0.83, 18.08 ± 3.61, and 103.64 ± 8.16 mg kg-1 for Pb, Cd, Ni, and Zn, respectively. Exposed workers have relatively less critical health implications concluded from the average daily intake (ADI), hazard quotient (HQs), and hazard index (HI) values. The HI values of Pb, Cd, Ni, and Zn were reported as 2.0 × 10-2, 4.64 × 10-4, 1.62 × 10-3, and 5.49 × 10-4, respectively, which have imparted minimal risks (as HI < 1) to the health of the workers. The cancer risks of Pb, Cd, and Ni were reported as 1.46 × 10-10, 1.77 × 10-9, and 1.31 × 10-9, respectively lower than the threshold values. Therefore, the result divulged a potentially lower cancer risk compared to EPA limit value of 1 × 10-6 to 1 × 10-4 for exposed industrial workers.