Community perception and utilization of services for the severe wasted children aged 6-59 months in the Forcibly Displaced Myanmar Nationals and their nearest host communities in Bangladesh: a qualitative exploration.

Introduction: There is a paucity of data on community perception and utilization of services for wasted children in Forcibly Displaced Myanmar Nationals (FDMN) and their nearest host communities. Methods: We conducted a qualitative study to explore community perceptions and understand the utilization of services for severely wasted children among the FDMN and their nearest host communities in Teknaf, Cox's Bazar. We carried out 13 focus group discussions and 17 in-depth interviews with the caregivers of the children of 6-59 months, and 8 key informant interviews. Results: Caregivers' perceived causes of severe wasting of their children included caregivers' inattention, unhygienic practices, and inappropriate feeding practices. However, the context and settings of the FDMN camps shaped perceptions of the FDMN communities. Caregivers in both the FDMN and host communities sought care from healthcare providers for their children with severe acute malnutrition (SAM) when they were noticed and encouraged by their neighbors or community outreach workers, and when their SAM children suffered from diseases such as diarrhea and fever. Some caregivers perceived ready-to-use therapeutic food (RUTF) as a food to be shared and so they fed it to their non-SAM children. Discussion: Caregivers of the children having SAM with complications, in the FDMN and host communities, were reluctant to stay in stabilization centers or complex respectively, due to their households' chores and husbands' unwillingness to grant them to stay. The findings of this study are expected to be used to design interventions using locally produced RUTF for the management of SAM children in the FDMN, as well as to inform the health sector working on SAM child management in the host communities.

Caregivers' socio-cultural influences on health-seeking behavior for their wasted children among forcibly displaced Myanmar Nationals and their nearest host communities.

Introduction: A total of 19% of forcibly displaced Myanmar Nationals (FDMNs) Bangladesh fall within the age range of under five years old, while an average of 1% exhibit severe malnutrition. Cox's Bazar is the closest host community for FDMNs, with similar traditional culture and religion and shared linguistic, ethnic, and cultural ties. Methods: A qualitative study was conducted to investigate the impact of socio-cultural factors on the healthcare-seeking behavior of caregivers of critically malnourished children in FDMN camps and neighboring host communities. Results: The utilization of informal healthcare by caregivers in both populations can be attributed to cultural attitudes, taboos, and peer pressure. The healthcare by practices in the FDMN camps and host towns were primarily affected by household responsibilities, familial assistance in accessing medical services, decisions made by husbands or mothers-in-law, and the availability and accessibility of healthcare facilities. Certain features were identified that prompt caregivers to seek formal treatment in both groups. The efficacy of the treatment was a primary consideration. In instances where conventional remedies and informal treatments proved ineffective in restoring the health of children, others who were invested in their well-being, such as family members and neighbors, advised caretakers to pursue professional medical care. Discussion: Enhanced caregiver awareness of severe wasting, enhanced healthcare accessibility, and increased community volunteer engagement have the potential to facilitate early identification of severely wasted children and mitigate delays in treatment.

Geographical variations of food insecurity and its associated factors in Bangladesh: Evidence from pooled data of seven cross-sectional surveys.

Food insecurity has multiple negative effects on maternal and child health and nutritional outcomes. There is a dearth of up-to-date evidence on the prevalence of food insecurity in Bangladesh based on geographical variations. We investigated the prevalence of food insecurity based on geographical variations and its associated factors. We pooled data from seven cross-sectional surveys conducted in 15,009 households from March 2015 to May 2018. This study was a part of the evaluation of the Maternal Infant Young Child Nutrition Phase 2 programme implemented by BRAC, one of the largest international non-governmental organizations located in Bangladesh that covered rural areas in 26 districts and two urban slums in Dhaka, Bangladesh. We used Household Food Insecurity Access Scale (a widely used scale to measure household food insecurity) to estimate the food insecurity status from the data collected through a face-to-face interview using a structured questionnaire. Hot spot analysis was conducted using the Getis-Ord Gi* statistic. The multiple logistic regression model was applied to explore the associated factors of food insecurity. The food insecurity hotspots were in the northwestern, central-southwestern, and coastal districts of Bangladesh. The overall prevalence of mild, moderate, and severe food insecurity were 12.7%, 13.8%, and 3.5%, respectively. In the adjusted model, household heads and caregivers of children with five or more years of schooling had respectively 42% (adjusted odds ratio (AOR): 0.58, 95% confidence interval (CI): 0.52, 0.64) and 46% (AOR: 0.54; 95% CI: 0.49, 0.61) less likelihood to suffer from food insecurity. Households in the middle (AOR: 0.58, 95% CI: 0.52, 0.65) and rich (AOR: 0.32, 95% CI: 0.28, 0.36) wealth status had lower odds of food insecurity. Food insecurity is widely spread in rural districts of Bangladesh and the degree of vulnerability is higher among the households of the northwestern, central-southwestern, and coastal areas of Bangladesh. Comprehensive interventions including strategies for poverty reduction and education for all might be effective to reduce food insecurity at rural households in Bangladesh.

Household food insecurity and unimproved toilet facilities associate with child morbidity: evidence from a cross-sectional study in Bangladesh.

BACKGROUND: Despite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Evidence regarding the consequencs of household FI and poor sanitation on child morbidity is scarce. This study aimed to understand the association of FI and unimproved toilet facility with morbidity status of under-5 children in Bangladesh. METHODS: We used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in 9 districts of Bangladesh. The study population included children aged 6-59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders. RESULTS: A total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95). CONCLUSIONS: Our study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is recommended to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.

A Short Review on Polymeric Biomaterials as Additives for Lubricants.

With increasing environmental concerns and the depletion of petroleum resources, the development of lubricant additives from bioresources has attracted much attention recently. In this review, we reported a few polymers and polymer composites that are synthesized from vegetable oils (soybean oil, sunflower oil, rice bran oil, and castor oil) and used as multifunctional additives in the formulation of eco-friendly lubricant compositions. We mentioned the preparation of vegetable oil-based homo- and copolymers and their characterization by different spectral techniques (FTIR/NMR). The average molecular weights of the polymers are determined by gel permeation chromatography (GPC). Performance evaluations of the polymeric materials mainly as a viscosity index improver (VII), pour point depressant (PPD), and most importantly antifriction additives when blended with lubricating base oils are indicated. Standard ASTM methods have been applied to evaluate their performances. The findings have shown that all the additives discussed are non-toxic, biodegradable, and showed excellent performances compared to commercial petroleum-based additives.

Unintended consequences of programmatic changes to infant and young child feeding practices in Bangladesh.

BRAC, an international development organization, implemented a home-fortification programme from 2014 to 2018 in Bangladesh. This study aimed to understand the unintended consequences of programmatic changes that occurred during the implementation of the programme on the prevalence of good infant and young child feeding (IYCF) practices and other associated factors. We used pooled data from eight cross-sectional surveys and data from a series of qualitative investigations carried out as part of a mixed-methods evaluation approach. A total of 6,479 caregivers of children aged 6 to 23 months participated in the surveys. The prevalence of good IYCF practices increased from baseline (42.1%) to midline (45.3%), but it decreased at the endline survey (31.9%). Qualitative investigations identified several reasons for low IYCF practices at the programme level, such as the withdrawal of community health worker (CHW) incentives for promoting IYCF, providing incentives for the home-fortification of micronutrient powder (MNP) and changing the focus from IYCF promotion to MNP promotion. A multivariable generalized estimating equation model for pooled data revealed that caregivers were 28% (adjusted risk ratio [ARR]: 0.72, 95% CI [0.67, 0.78]) less likely to maintain good IYCF practices during the period when CHWs were not incentivized to promote IYCF compared to the period when CHWs were incentivized to promote it. The prevalence of good IYCF practices decreased from both baseline and midline to the endline survey due to the unintended consequences of the programmatic changes. An integrated intervention strategy to promote the home-fortification of MNP and IYCF could be helpful to avoid unintended negative consequences of programmatic changes.

Polyacrylate-magnetite nanocomposite as a potential multifunctional additive for lube oil.

The application of polymer nanocomposites (PNCs) in lubricant industry has attracted considerable interest due to their much enhanced properties compared to neat polymers. In this study, magnetite (Fe3O4) nanoparticles (NPs) were synthesized. Then PNCs were prepared by reinforcing these NPs in the homopolymer of dodecyl acrylate in different percentages. The characterization of the prepared NPs and PNCs was done by different analytical techniques. Thermal stability is determined through thermogravimetric analysis (TGA). Performance evaluation of the PNCs as viscosity index improver, pour point depressant and antiwear additive was carried out by blending them with a mineral base stock at different percentage ratios. Standard ASTM methods are followed to carry out the evaluations. It is found that with increasing the percentage of nanocomposites in the base stock, the overall performance of the furnished lubricant is enhanced.