Age and sex-specific disability-free life expectancy in urban and rural settings of Bangladesh.

BACKGROUND: Disability-free life expectancy (DFLE) has been used to gain a better understanding of the population's quality of life. OBJECTIVES: The authors aimed to estimate age and sex-specific disability-free life expectancy (DFLE) for urban and rural areas of Bangladesh, as well as to investigate the differences in DFLE between males and females of urban and rural areas. METHODS: Data from the Bangladesh Sample Vital Statistics-2016 and the Bangladesh Household Income and Expenditure Survey (HIES)-2016 were used to calculate the disability-free life expectancy (DFLE) of urban and rural males and females in Bangladesh in 2016. The DFLE was calculated using the Sullivan method. RESULTS: With only a few exceptions, rural areas have higher mortality and disability rates than urban areas. For both males and females, statistically significant differences in DFLE were reported between urban and rural areas between the ages of birth and 39 years. In comparison to rural males and females, urban males and females had a longer life expectancy (LE), a longer disability-free life expectancy, and a higher share of life without disability. CONCLUSION: This study illuminates stark urban-rural disparities in LE and DFLE, especially among individuals aged < 1-39 years. Gender dynamics reveal longer life expectancy but shorter disability-free life expectancy for Bangladeshi women compared to men, emphasizing the need for targeted interventions to address these pronounced health inequalities.

Knowledge, attitudes, and practices regarding antibiotic use in Bangladesh: Findings from a cross-sectional study.

BACKGROUND: Escalating antibiotic resistance presents a notable worldwide dilemma, pointing a large involvement of general population. The objective of this study was to assess knowledge, attitudes, and practices regarding the utilization of antibiotics among Bangladeshi residents. METHODS: A cross-sectional study, conducted from January 01 to April 25, 2022, included 1,947 Bangladeshi adults with a history of antibiotic use, via online surveys and face-to-face interviews using a pretested semi-structured questionnaire. Descriptive statistics, Chi-square tests, and multivariate linear regression models were employed. RESULTS: Mean scores for knowledge, attitudes, and practices were 6.59±1.20, 8.34±1.19, and 12.74±2.59, with correct rates of 73.22%, 92.67%, and 57.91%. Positive predictors for knowledge included being unmarried (ß = 0.10, p = 0.001), higher education (College: ß = 0.09, p = 0.025; Bachelor: ß = 0.22, p<0.001; Master or above: ß = 0.14, p<0.001), various professions (student: ß = 0.57, p<0.001; housewife: ß = 0.33, p<0.001; employee: ß = 0.53, p<0.001; businessman: ß = 0.31, p<0.001; unemployed: ß = 0.15, p<0.001), and residing in semi-urban (ß = 0.32, p<0.001) or urban areas (ß = 0.15, p<0.001). Positive predictors for attitudes included being married (ß = 0.18, p<0.001), specific professions (student: ß = 1.06, p<0.001; housewife: ß = 0.33, p<0.001; employee: ß = 0.86, p<0.001; businessman: ß = 0.37, p<0.001; unemployed: ß = 0.47, p<0.001), higher SES (Lower-middle: ß = 0.22, p<0.001; Middle: ß = 0.26, p<0.001), and residing in semi-urban areas (ß = 0.18, p<0.001); negative predictors included higher education (College: ß = -0.12, p = 0.001; Master or above: ß = -0.09, p = 0.008) and being rich (ß = -0.13, p<0.001). Positive predictors for practices included being married (ß = 0.18, p<0.001), specific professions (student: ß = 0.32, p<0.001; employee: ß = 0.43, p<0.001; businessman: ß = 10, p = 0.034; unemployed: ß = 0.11, p = 0.009), and higher SES (Lower-middle: ß = 0.14, p = 0.009; Middle: ß = 0.38, p<0.001; Higher-middle: ß = 0.15, p = 0.008); negative predictors included higher education (College: ß = -0.21, p<0.001), being rich (ß = -0.12, p<0.001), residing in semi-urban (ß = -0.14, p<0.001) or urban areas (ß = -0.16, p<0.001). CONCLUSIONS: Participants exhibited adequate knowledge and positive attitudes but lagged behind in proper practice of antibiotic use. Proper initiatives should be tailored to enhance prudent antibiotic use and mitigate the risk of antimicrobial resistance.

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.

Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996-2018.

OBJECTIVE: To examine the height-for-age z-score (HAZ) of 0-35 months' children along with stunting prevalence to identify trends, changes and available nutrition-sensitive and specific determinants that could help explain the long-term variation in child linear growth using successive Bangladesh Demographic and Health Surveys (BDHS) data from 1996 to 2018. DESIGN: The BDHS pooled data are used for determining the key outcome variables HAZ, stunting and severe stunting. Trends, kernel-weighted local polynomial smoothing illustrations, pooled multivariable linear probability model (LPM), ordinary least squares method (OLS) and regression decomposition were used. PARTICIPANTS: Mothers having 0-35 months' children, the most critical age range for growth faltering. RESULTS: The mean HAZ increased by 0·91(±1·53) with 0·041 annual average change, while the percentages of stunting (-26·63 ± 0·54) and severe stunting (-21·12 ± 0·48) showed a reduction with 1·21 and 0·96 average annual changes, respectively. The average HAZ improvement (0·42 ± 1·56) in urban areas was less than the rural areas (1·16 ± 1·44). Similar patterns followed for stunting and severe stunting. The prenatal doctor visits (3064·65 %), birth in a medical facility (1054·32 %), breastfeeding initiation (153·18 %) and asset index (144·73 %) demonstrated a huge change. The findings of OLS, LPM and regression decomposition identified asset index, birth order, paternal and maternal education, bottle-fed, prenatal doctor visit, birth in a medical facility, vaccination, maternal BMI and ever-breastfed as influencing factors to predict the long-term changes of stunting and severe stunting. CONCLUSION: The nutrition-sensitive and specific factors identified through regression decomposition describing long-term variation in child linear growth should be focused further to attain the sustainable development goals.

Positive impacts of COVID-19 Lock down in Bangladesh: An online investigation.

Background: This research focuses on the positive impacts of the COVID-19 lockdown on society and the environment, despite acknowledging the widespread negative effects of the pandemic and lockdown measures. The research was aimed at pinpointing and evaluating the beneficial results stemming from these measures. Method: Data for the study was collected through an online survey distributed via Google forms to adults over the age of 18 across the country. A total of 1230 participants completed the survey, mostly from rural areas (61.7%), providing valuable insights for analysis. The questionnaire encompassed personal, family, and cohesive social data, along with information on the environment and biodiversity. The study utilized structural equation modeling (SEM) and confirmatory factor analysis (CFA) to analyze the data and examine correlations between variables. Results: The findings indicated that the COVID-19 lockdown had positive implications for individuals and society, leading to increased health consciousness, improved family relationships, and constructive social attitudes. Moreover, restrictions on access to natural tourist destinations and parks during the lockdown contributed to positive changes in biodiversity. These results highlight the importance of adopting appropriate measures during pandemics to foster personal and social well-being, as well as the preservation of natural environments and biodiversity. Conclusion: This study emphasizes the need for further research to promote sustainable living in similar situations. By understanding the data appropriately, individuals can play a constructive role in future pandemics, leading to positive outcomes for both society and the environment.

Influencing factors associated with maternal delivery at home in urban areas: a cross-sectional analysis of the Bangladesh Demographic and Health Survey 2017-2018 data.

BACKGROUND: The associated factors and patterns of giving birth in home settings of rural areas have been extensively studied in Bangladeshi literature. However, urban areas still need to be explored, particularly with recent data. Therefore, the authors aimed to investigate the influential determinants of delivery at home in urban areas of Bangladesh. MATERIALS AND METHODS: In this study, 1699 urban-dwelling women who had given birth within the previous 60 months of the survey and lived in urban areas were used. The secondary data were extracted from the latest Bangladesh Demographic and Health Survey 2017-2018. Descriptive statistics and logistic regression were applied along with the association among selected variables were examined by the Chi-square test. RESULTS: Findings depict that 36.49% of women who lived in urban areas of Bangladesh delivered at home, whereas, 63.51% delivered at different govt. and private health care facilities. Women who lived in Chittagong [adjusted odds ratio (AOR) = 2.11, 95% CI 1.24-3.60], Barisal [AOR = 2.05, 95% CI 1.16-3.64] and Sylhet [AOR = 1.92, 95% CI 1.08-3.43] divisions have more likelihood to deliver at home (36.85%). Urban women following Christian religion [AOR = 10.71, 95% CI 1.32-86.68] have higher odds of delivering child at home (0.47%). Urban women having three or more children before her latest delivery (22.37%) and who are employed (29.37%) have more likelihood to deliver at home. However, women aged between 25 and 34 years (43.50%), who have higher education (25.90%), play the role of household head (9.06%), have parity of more than two births (2.24%), and read daily newspapers (68.69%) had a lower chance of delivery at home. Furthermore, women from wealthier families (89.12%) and more antenatal care (ANC) visits (94.93%) were less likely to have a delivery at home. CONCLUSION: Despite significant progress in women and reproductive health in Bangladesh, the proportion of delivery in the home in urban areas is alarming and should be emphasized more. The authors believe the identified factors will help design interventions and policy development on this issue.