COVID-19 vaccine barriers and perception among rural adults: a qualitative study in Bangladesh.

OBJECTIVE: The COVID-19 pandemic continues to pose challenges for global public healthcare, even with the authorisation of several vaccines worldwide. To better understand rural communities' knowledge, attitudes, perceptions and barriers towards these vaccines, we conducted a qualitative cross-sectional study with adults in rural Bangladesh. SETTING: This cross-sectional study was conducted in the rural areas of Sylhet and Natore in Bangladesh from August 2021 to February 2022. PARTICIPANTS: Our study involved 15 in-depth interviews with rural adults and 2 key informant interviews with health workers. RESULTS: We analysed data thematically, resulting in four main themes: (1) knowledge and perception aspects, (2) myths and misconceptions, (3) practice and attitude and (4) barriers and challenges of COVID-19 vaccines. CONCLUSIONS: The findings indicate that rural populations lack sufficient knowledge about COVID-19 vaccines but have a more favourable attitude towards them. Misconceptions, beliefs and personal experiences were found to be the main reasons for vaccine avoidance. To address these challenges and dispel the spread of misinformation, health education programmes play a pivotal role in improving vaccine management. Policy-makers should initiate these programmes without delay to create a well-informed and enlightened community, given that the COVID-19 is still spreading.

What Makes Bangladeshi Pregnant Women More Compliant to Iron-Folic Acid Supplementation: A Nationally Representative Cross-Sectional Survey Result.

BACKGROUND: Iron-Folic Acid Supplementation (IFAS) is an effective strategy to prevent iron deficiency anemia during pregnancy. We aimed to explore the key factors associated with compliance to IFA tablets in Bangladesh. METHODS: This study analyzed the 2017-2018 Bangladesh Demographic and Health Survey data of 3828 pregnant women aged 15-49 years. We categorized compliance into two categories; at least 90 days and full 180 days of consumption. We performed multivariable logistic regression to identify the association between key factors and IFAS compliance. RESULTS: The prevalence of consumption of IFA tablets for at least 90 days was 60.64%, and only 21.72% of women consumed the IFA for the full 180 days. About three-quarters of the women (73.36%) having at least four antenatal care visits (ANC) consumed IFA for at least 90 days, whereas only three in ten women (30.37%) consumed IFA for a minimum of 180 days. For compliance with IFA for at least 90 days, respondent's age of 20-34 years (aOR 1.26, 95% CI 1.03-1.54), respondent's educational qualification of secondary (aOR 1.77, 95% CI 1.16-2.70) or higher (aOR 2.73, 95% CI 1.65-4.53), husband's educational qualification of secondary (aOR 1.33, 95% CI 1.00-1.77) or higher (aOR 1.75, 95% CI 1.22-2.52), and having received at least four antenatal care (ANC) visits from medically skilled providers (aOR 2.53, 95% CI 2.14-3.00) were significantly associated with higher odds of compliance. For compliance with IFA for at least 180 days, respondent's educational qualification of higher (aOR 2.45, 95% CI 1.34-4.48), and having received at least four ANC visits from medically skilled providers (aOR 2.43, 95% CI 1.97-3.00) were significantly associated with higher odds of compliance. Intimate partner violence was negatively associated with compliance with IFA for at least 180 days (aOR 0.62, 95% CI 0.48-0.81). CONCLUSIONS: The full compliance to IFAS is still sub-optimal in Bangladesh. Further precise context-specific intervention strategies must be developed and implemented with fidelity.

Common factors influencing childhood undernutrition and their comparison between Sylhet, the most vulnerable region, and other parts of Bangladesh: Evidence from BDHS 2007-18 rounds.

Introduction: Undernourishment is disproportionately spread within Bangladesh, making some regions like Sylhet more vulnerable than the rest of the country. We aimed to assess the trend of diverse associated factors related to childhood stunting, wasting, and being underweight. Furthermore, we have compared the estimated factors between Sylhet, the most vulnerable region, and other parts of Bangladesh. Methods: We performed a secondary data analysis where data were derived from the nationally representative cross-sectional surveys: Bangladesh demographic and health survey (BDHS) 2007, 2011, 2014, and 2017-18 rounds. The outcome variables were childhood undernutrition, including stunting, wasting, and being underweight. Descriptive statistics such as mean, standard deviation, frequency, and proportion were used to summarize the data. All variables were summarized by BDHS survey time points. We used multiple logistic regression models to measure the associated factors with childhood stunting, wasting, and being underweight. Results: The percentage of children under the age of 5 years who were stunted declined from 40% in 2007 to 31% in 2018. Similar trends are observed in the decrease in the percentage of underweight children, dropping from 39% in 2007 to 22% in 2018. Wasting dropped to 8% in 2018 after years of critically high levels (17%). According to the results of the regression analyses, urban residence, child's age and gender, morbidity, maternal BMI, maternal and paternal education, decision-making ability, use of contraceptives, the occurrence of domestic violence, antenatal care, c-section, and birth interval, as well as geographic region, were all linked to childhood malnutrition. Conclusion: The Sylhet division falls short in several critical associated indicators, including parental education, maternal BMI, obtaining at least four ANC, women empowerment, and usage of contraceptives. Policymakers must concentrate on region-specific planning and proper intervention to achieve a more uniform improvement across the country.

Underweight, Overweight and Obesity among Reproductive Bangladeshi Women: A Nationwide Survey.

The double burden of malnutrition is becoming more prevalent among Bangladeshi women. Underweight, overweight, and obesity were examined among women aged 15-49 years using the 2017-2018 Bangladesh Demographic and Health Survey (BDHS). A dataset of 20,127 women aged 15-49 years with complete Body Mass Index (BMI) measurements were extracted and categorized as underweight, normal weight, overweight, and obesity. A multiple logistic regression that adjusts for clustering and sampling weights was used to examine underweight, overweight, and obesity among reproductive age Bangladeshi women. Our analyses revealed that the odds of being overweight and obese were higher among women who completed primary and secondary or more levels of education, rich households, breastfeeding women, and women exposed to media (newspapers and television (TV). Women from the poorest households were significantly more likely to be underweight (AOR = 3.86, 95%CI: 2.94-5.07) than women from richer households. The likelihood of being underweight was higher among women with no schooling, adolescent women, and women not using contraceptives. Conclusions: Overweight and obesity was higher among educated and affluent women while underweight was higher among women from low socioeconomic status, indicating that tailored messages to combat overweight and obesity should target educated and affluent Bangladeshi women while improving nutrition among women from low socioeconomic status.