Browsing by Author "Akter, Fahmida"

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A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh
(BMJ Journals, 3/16/2021) Pitchik, Helen O; Tofail, Fahmida; Rahman, Mahbubur; Akter, Fahmida; Sultana, Jesmin; Shoab, Abul Kasham; Huda, Tarique Md. Nurul; Jahir, Tania; Amin, Md Ruhul; Hossain, Md Khobair; Das, Jyoti Bhushan; Chung, Esther O; Byrd, Kendra A; Yeasmin, Farzana; Kwong, Laura H; Forsyth, Jenna E; Mridha, Malay K; Winch, Peter J; Luby, Stephen P; Fernald, Lia CH
Introduction In low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention. Methods We conducted a 9-month, parallel, multiarm, clusterrandomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers. Results In July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (ageadjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54). Conclusion Our findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.
Assessment of the status and its associated factors among lactating mothers taking services in an urban healthcare facility in Dhaka city: a cross-sectional study
(BRAC University, 1/5/2025) Delwar, Umama Binte; Ireen, Santhia; Akter, Fahmida
Our study aims to determine the nutritional status of lactating mothers attending an urban MNCH facility in Dhaka, Bangladesh, and identify the associated factors. A cross-sectional study was conducted which analyzed socio-demographic data, dietary diversity, and body mass index (BMI). Among the participants, 39.7% were aged 21–25 years, and 40% held a bachelor’s degree or higher. The majority (79.2%) were homemakers, with a median monthly income of 50,000 BDT. Nutritional assessment revealed a dual burden, with overweight and obesity prevalent in 64% of the lactating mothers and undernutrition observed in 10%. When regression analysis was done it highlighted that mothers aged more than 30 years had significantly higher the odds of being overweight or obese (AOR=9.98; p=0.001), emphasizing the impact of age on BMI. Attainment of education also influenced BMI significantly; mothers completing higher secondary education were more likely to have increased BMI (AOR=3.02; p=0.026), likely due to calorie-dense food choices, while those who had completed their education up to bachelors and above education appeared to mitigate this risk. Mothers coming from middle-income households were less likely to be overweight or obese (AOR=0.37; p=0.023), this indicated the impact of income on nutritional outcomes. Dietary factors also played a significant role; frequent consumption of sugary foods increased the likelihood of higher BMI (AOR=2.73; p=0.001), whereas sweets consumption showed an inverse association with overweight and obesity (AOR=0.40; p=0.003) which could be due to differential reporting or cultural practices. Thus interventions should focus on the enhancement of nutritional literacy particularly women of lactational phase and additionally, introduce policies that ensure access to affordable, nutrient-rich foods which could mitigate the rising burden of overweight and obesity. Future longitudinal studies are necessary to explore the long-term effects of these factors on maternal and child health in urban Bangladesh.
Exploration of attendance, active Participation, and behavior change in a group-based responsive stimulation, maternal and child health, and nutrition intervention
(ASTMH, 1/18/2021) Yeasmin, Farzana; Winch, Peter J.; Hwang, Sharon T.; Leontsini, Elli; Jahir, Tania; Das, Jyoti B.; Amin, Mohammad R.; Hossain, Md K.; Huda, Tarique Md. Nurul; Akter, Fahmida; Shoab, Abul Kashem; Tofail, Fahmida; Mridha, Malay K.; Sultana, Jesmin; Pitchik, Helen; Fernald, Lia C. H.; Luby, Stephen P.; Rahman, Mahbubur
Delivery of interventions through group sessions allows for in-depth discussions and creates opportunities for group members to work together to identify and solve common problems. However, low attendance may limit impact. We explored factors affecting attendance, active participation, and behavior change in an integrated group-based child development and maternal and child health intervention in Bangladesh. Community health workers (CHWs) facilitated two sessions a month including material on child stimulation; water, sanitation, and hygiene; nutrition, maternal depression, and lead exposure prevention. Sessions were conducted with 320 pregnant women and mothers with children younger than 24 months, in 16 villages in Kishoreganj district. After 4 and 9 months of intervention, we conducted focus group discussions and in-depth interviews with mothers (n = 55 and n = 48) to identify determinants of attendance and behavior change, and to examine potential for intervention scale-up. Recruiting family members to assist with childcare resulted in improved attention during sessions. Adopting a storytelling format for presentation of session materials resulted in more engaged participation during courtyard sessions. Session attendance and behavior change, especially purchasing decisions, were difficult for participants without the support of male heads of the household. Selecting a rotating leader from among the group members to remind group members to attend sessions and support CHWs in organizing the sessions was not successful. Facilitating self-appraisals and planning for water and sanitation allowed participants to identify areas for improvement and track their progress. Key determinants of a participant’s attendance were identified, and the resulting intervention shows promise for future implementation at scale.
Exploring Factors Associated With Women’s Willingness To Provide Digital Fingerprints in Accessing Healthcare Services
(MDPI, 2021-12-21) Mistry, Sabuj Kanti; Akter, Fahmida; Hossain, Md. Belal; Huda, Md. Nazmul; Irfan, Nafis Md.; Yadav, Uday Narayan; Storisteanu, Daniel M. L.; Arora, Amit
Digital fingerprints are increasingly used for patient care and treatment delivery, health system monitoring and evaluation, and maintaining data integrity during health research. Yet, no evidence exists about the use of fingerprinting technologies in maternal healthcare services in urban slum contexts, globally. The present study aimed to explore the recently delivered women’s willingness to give digital fingerprints to community health workers to access healthcare services in the urban slums of Bangladesh and identify the associated factors. Employing a two-stage cluster random sampling procedure, we chose 458 recently delivered women from eight randomly selected urban slums of Dhaka city, Bangladesh. Chi-square tests were performed for descriptive analyses, and binary logistic regression analyses were performed to explore the factors associated with willingness to provide fingerprints. Overall, 78% of the participants reported that they were willing to provide digital fingerprints if that eased access to healthcare services. After adjusting for potential confounders, the sex of the household head, family type, and household wealth status were significantly associated with the willingness to provide fingerprints to access healthcare services. The study highlighted the potentials of using fingerprints for making healthcare services accessible. Focus is needed for female-headed households, women from poor families, and engaging husbands and in-laws in mobile health programs.
Inadequate dietary diversity and Its determinants among adolescent girls and boys: Evidence from the National Nutrition surveillance study in Bangladesh
(Oxford Academic, 5/29/2020) Akter, Fahmida; Hossain, Md Mokbul; Shamim, Abu Ahmed; Hasan, Mehedi; Hanif, Abu Abdullah Mohammad; Hossaine, Moyazzam; Ullah, Mohammad Aman; Sarker, Samir Kanti; Rahman, S M Mustafizur; Mitra, Dipak Kumar; Haque, Md Emdadul; Mridha, Malay
Objectives: Bangladesh is experiencing triple burden of malnutrition among adolescents, which may be associated with inadequate dietary diversity (IDD). In the recently completed round of the national nutrition surveillance (NNS 2018–2019), we explored the prevalence of IDD and its determinants among adolescent girls and boys. Methods A total of 4808 adolescent girls and 4761 adolescent boys were interviewed. We used minimum dietary diversity for women (MDD-W) questionnaire to collect dietary data. IDD was defined as consumption of <5 food groups out of 10 food groups in the past 24 hours. Bivariate and multivariable logistic regression were performed to identify risk factors for IDD among adolescent girls and boys. Results The prevalence of IDD was 55.5% and 50.6% among the adolescent girls and boys. Prevalence of IDD decreased with an increase of educational attainment among girls (no education 77.8% and grade 10 completed education 49.2%) and boys (no education 68.2% and grade 10 completed education 44.2%). The prevalence of IDD in slum, urban and rural areas was 66.4%, 55.6%, and 51.9% among girls and 61.4%, 50.5% and 52.6% among boys, respectively. Prevalence of IDD was lowest among the richest wealth quintile (girls: 45.4% and boys: 43.1%). Among adolescent girls education (e.g., for grade 10 completed, AOR: 3.42, P = 0.002), marital status (AOR: 1.24, P = 0.046), processed food consumption (AOR: 1.66, P < 0.001), television viewing time (e. g. for ≤60 min/day, AOR: 1.37, P < 0.001), and sex of household head (AOR: 0.81, P = 0.003) were significantly associated with IDD. Among the adolescent boys age (AOR: 0.82, P = 0.024), education (e.g., for grade 10 completed, AOR: 2.36, P < 0.001), sex of household heads (AOR: 0.80, P = 0.002), livestock ownership (AOR: 1.22, P = 0.012), fruits and vegetable consumption (AOR: 1.38, P = 0.004), processed food intake (AOR: 1.74, P < 0.001), physical activity (AOR: 0.76, P = 0.001), and television viewing time (e. g. for ≤60 min/day, AOR: 1.19, P = 0.021) were significantly associated with IDD. Conclusions About more than half of the adolescent girls and boys consume inadequately diversified diet in Bangladesh. The study identified a number of factors associated with IDD, which should be addressed through comprehensive and sustainable public health interventions.
Infant and young child feeding knowledge and practices among lactating mothers attending an urban health care facility in Dhaka, Bangladesh
(BRAC University, 1/5/2025) Tabassum, Tasbiha; Ireen, Santhia; Akter, Fahmida
Introduction: The first 1,000 days of a child’s life are critical for growth and development as proper nutrition during this period plays a significant role in health outcomes in future. In Bangladesh, though breastfeeding rates are relatively high, challenges persist in achieving optimal Infant and Young Child Feeding (IYCF) practices. Concerning stunting and wasting rates with lack of data in urban areas like Dhaka highlights the need for understanding the influencing factors of IYCF adherence. This study examines IYCF knowledge and practices among lactating mothers of children aged 0-6 months attending an urban MNCH facility in Dhaka. Method: A cross-sectional, quantitative study was conducted at two Maternal Neonatal and Child Health (MNCH) facilities in Dhaka City from November 24 to December 11, 2024. The participants included 342 lactating mothers of infants aged 0-6 months, selected through convenience sampling. Data were collected via a semi-structured questionnaire on socio-demographic factors, antenatal and postnatal care utilization, and IYCF knowledge, practices and barriers. Data analyses included descriptive statistics, chi-squared tests, and multivariable regression analysis. Findings: The study found that overall IYCF knowledge among the mothers was quite well, specifically regarding early breastfeeding initiation (90.4%) and colostrum feeding (99.1%). Knowledge gaps existed in complementary feeding, proper breastfeeding techniques and understanding broader benefits of exclusive breastfeeding. Out of 342 mothers, 100% breastfed their child at least once, 62.6% initiated breastfeeding within 1 hour, 81.6% exclusively breastfed and 17.0% practiced mixed feeding. Barriers such as low milk secretion, post-C-section complications, and cultural factors were significant challenges to optimal IYCF practices. Conclusion: The findings highlight the need for targeted interventions to improve optimal IYCF practices. Addressing barriers as well as strengthening of healthcare service are crucial for enhancing child nutrition in urban Bangladesh.
Knowledge Attitude and Practice on Dengue among Households in Rural Areas [North Dharmapur, Gaibandha Bangladesh]
(Pharmacology online, 2020-12-30) Rahman, Md. Mizanur; Farhana, Masuka Mim; Majumder, Suman; Akter, Fahmida; Rajib, Md. Ariful Hossen; Haque, Md. Anamul; Afroz, Tahmina
Dengue is the most common and essential viral arthropod-borne (arboviral) infection in humans. Throughout recent decades, the dengue rate has increased significantly. So far this year, the number of dengue-recognized patients across Bangladesh is almost double than the total diagnosed with mosquito-borne disease reported over the past 19 years. Dengue increase in rural Bangladesh stirs concerns about the cycle of outbreaks. A cross-sectional community based survey was conducted from September to October 2019 among 100 individuals belonging to the selected village in rural Gaibandha. A formal questionnaire was used to compile data on awareness, behavior, source of information, and dengue training. Adequacy of information and behavior with a confidence interval of 95 percent was summarized as a proportion. A sample of 100 people (males 42 and females 58) were interviewed at the mean age of 35.3 years. 23% were illiterate, while 32% were university graduates. 65% of respondents knew mosquito as their vector, 89% identified clear stagnant water as their dumping ground. Fever was identified as a symptom by 100%. 37% felt dengue fever may not be cured and 76%-felt dengue fever arises during the rainy seasons. 93 % had a positive attitude towards consulting a doctor for the disease. The bulk of the data was through television, social networking sites supplemented by radio and magazines, and only 3% was through health workers. The current study observed that awareness of dengue and mosquito control measures was satisfactory to a significant extent. As a consequence, large-scale information, education and communication campaigns are needed at frequent intervals for the rural population.
Noncommunicable disease risk factors among adolescent boys and girls in Bangladesh: Evidence from a National survey
(Osong public health and research perspectives, 12/11/2020) Urmy, Nushrat Jahan; Hossain, Md. Mokbul; Shamim, Abu Ahmed; Khan, Md. Showkat Ali; Hanif, Abu Abdullah Mohammad; Hasan, Mehedi; Akter, Fahmida; Mitra, Dipak Kumar; Hossaine, Moyazzam; Ullah, Mohammad Aman; Sarker, Samir Kanti; Rahman, SM Mustafizur; Bulbul, Md. Mofijul Islam; Mridha, Malay Kanti
Objectives: To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. Methods: Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed. Results: The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. Conclusion: The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.
Performance Appraisal and its Effect on Employee Motivation of Value Engineering Services Incorporation (VEnS Inc.)
(Daffodil International University, 2024-11-02) Akter, Fahmida
The most essential equipment for assessing an individual's performance is the performance appraisal. Also, it facilitates providing an overview of employees' performance. The personnel may obtain their potential and contribute their best potential to acquire their aim by receiving constant feedback. In this study, Value Engineering Services Incorporation (VEnS Inc.) provided the basis for my attempt to assemble a thorough investigation of performance assessment and its advantages on workers' motivation in this report.. Performance appraisal is a cornerstone of the HR strategy at VEnS Incorporation, a dynamic and forward-thinking company. By aligning employee performance with organizational objectives, the company's approach to evaluating employee performance hopes to foster success and creativity. Through a blend of organized evaluations, goal-setting, and routine feedback, VEnS ensures that its employees are inspired, involved, and committed to attaining greatness.
Reasons for formula feeding among rural Bangladeshi mothers: A qualitative exploration
(PLOS ONE, 2/26/2019) Rahman, Atiya; Akter, Fahmida
In Bangladesh the exclusive breastfeeding rate remains low and prelacteal, formula and bottle feeding is increasing. This study aims to explore reasons behind infant formula feeding practices from mothers, caregivers, and health care provider’s perspective. This was a qualitative study carried out in four sub-districts of Sylhet and Jessore of rural Bangladesh. Data were collected through focus group discussions (12), in-depth interviews (4) and key informant interviews (12) from January to February 2014. The qualitative data collected and were analyzed using thematic content analysis. This study clearly showed the factor behind formula feeding by Bangladeshi rural women. One of the major findings was that women could not differentiate between formula and other milk. Main differences between formula and powder milk were the type of consumer where formula only was taken by infant and children less than 2 years. Other major reasons include; poor breastfeeding practices, lack of appropriate breastfeeding practices, superficial knowledge on harmful effect on infant formula; perceived insufficient breast milk production, the influence of family and society and authoritarian power of hospital staff. Rural mothers have intension to feed infant formula to their infants due to various factors including individual, social, cultural and institutional. These identified factors can contribute to policy making and develop more specific interventions targeting expected mother and their family members that can contribute to stop formula feeding and increase breastfeeding practices in rural Bangladesh.
The Legal Regime on the Protection of Air Pollution Under the Environmental Law
(Daffodil International University, 2019-11-27) Akter, Fahmida
The essential advantages of an in-house program are that general costs will be lower, the executives can increase quick access to information, and the board can completely control changes to the checking program. The essential benefit of an in-house program is, in any event for the occasion, DOE doesn't have adequate prepared staff to set up, work, and keep up the screens and create reports from what information there is. The essential advantages of a contracted program are it tends to be ready for action with no time for readiness, nobody should be prepared by DOE for activities (in spite of the fact that staff do should be prepared to do contractual worker oversight work), and the temporary worker will have the option to contract and prepare equipped staff without being obstructed by the present compensation issues inside the administration. The essential benefits are greater expenses and constrained capacity to change the program without persevering through an adjustment in the contract. Since the present checking staff isn't completely prepared to work and keep up the vaporous instruments being made arrangements for use soon, it is prescribed that a contractual worker be enlisted to guarantee persistent activity of the instruments for the close to term. This contractual worker, or an alternate temporary worker, ought to be procured to prepare the air observing staff on the best possible use and support of the instruments with an objective for the staff to be completely free when the administration contract lapses (roughly 27 months after start up of the up and coming age of instruments).It is emphatically prescribed that once the Cell has sufficient assets all constant checking information ought to be sent consequently or on a normal premise via landline or Internet association with the observing research facility