Browsing by Author "Ali, ARM Mehrab"

Now showing 1 - 10 of 10

Changes in Prevalence and Determinants of Self-Reported Hypertension Among Bangladeshi Older Adults During the COVID-19 Pandemic
(Scopus, 22-10-18) Mistry, Sabuj Kanti; Ali, ARM Mehrab; Yadav, Uday Narayan; Khanam, Fouzia; Huda, Md. Nazmul; Lim, David; Chowdhury, ABM Alauddin; Sarma, Haribondhu
The present study aimed to assess the changes in the prevalence and determinants of self-reported hypertension among older adults during the COVID-19 pandemic in Bangladesh. This repeated cross-sectional study was conducted on two successive occasions (October 2020 and September 2021), overlapping the first and second waves of the COVID-19 pandemic in Bangladesh. The survey was conducted through telephone interviews among Bangladeshi older adults aged 60 years and above. The prevalence of hypertension was measured by asking a question about whether a doctor or health professional told the participants that they have hypertension or high blood pressure and/or whether they are currently using medication to control it. We also collected information on the socio-economic characteristics of the participants, their cognitive ability, and their COVID-19-related attributes. A total of 2077 older adults with a mean age of 66.7 ± 6.4 years participated in the study. The samples were randomly selected on two successive occasions from a pre-established registry developed by the ARCED Foundation. Thus, the sample in the 2021-survey (round two; n = 1045) was not the same as that in the 2020-survey (round one; n = 1031) but both were drawn from the same population. The findings revealed that the prevalence of hypertension significantly increased across the two periods (43.7% versus 56.3%; p = 0.006). The odds of hypertension were 1.34 times more likely in round two than in the round one cohort (AOR 1.34, 95% CI 1.06-1.70). We also found that having formal schooling, poorer memory or concentration, and having had received COVID-19 information were all associated with an increased risk of hypertension in both rounds (p < 0.05). The findings of the present study suggest providing immediate support to ensure proper screening, control, and treatment of hypertension among older adults in Bangladesh.
Changes in the use of safe water and water safety measures in water, sanitation and hygiene intervention areas of Bangladesh: a midline assessment
(BRAC Research and Evaluation Division (RED), 2010-12) Dey, Nepal C; Ali, ARM Mehrab
The BRAC Water, Sanitation and Hygiene (WASH) programme reached 150 upazilas (sub-districts) in collaboration with the Government of Bangladesh since 2006. This study assessed the changes in the use of tubewell water and water safety measures in the households in the 11 upazilas of Bangladesh after BRAC WASH inteNentions. Data were collected from 6,600 households where 3,812 tubewells were traced in baseline (2006-7) and 3,591 tubewells in midline (2009) . Most of the households (98-99%) used tubewell water for drinking, 70-73% for cooking, 62-66% for washing utensils, 70-73% for cleaning after defecation, and 24 -36% for bathing in midline both in the dry and rainy seasons. The numbers were significantly larger in midline than in baseline (p<0.01) except for drinking in the rainy season. Overall arsenic-free tubewells increased from 58% in baseline to 60% in midline and most households (83%) drank arsenic-free tubewell water in midline. The study revealed that water safety measures including awareness of cleaning/purifying water and hygienic management of water increased significantly (p<0.01 ). The concrete-built platform increased from 63% in baline to 69% in midline. Tubewell platforms were cleaned (32%) in baseline, which increased to 46% in midline. However, there still remained impediments to 100% safe water use by the households include arsenic contamination of tubewell water, financial inabilities of the ultra poor and poor households for installing tubewells for arsenic-free water. unmarked tubewell (whether contaminated by arsenic or not). The study concluded that WASH inteNention has succeeded in increasing access to safe water use. hygienic management of water, and cleanliness of water collecting point in the study areas. It is encouraging to note that ultra poor households had interest to get new tubewells and preferred to pay the costs in monthly instalments, which indicates that these households were aware of the benefits of safe water. Thus, BRAC WASH programe needs to pay further attention to these impediments at the household level in order to further improve the current situation.
Changes in the use of safe water and water safety measures in water, sanitation and hygiene intervention areas of Bangladesh: a midline assessment
(BRAC Research and Evaluation Division (RED), 2011-11) Dey, Nepal C; Ali, ARM Mehrab
The BRAC Water, Sanitation and Hygiene (WASH) programme reached 150 upazilas (sub-districts) in collaboration with the Government of Bangladesh since 2006. This study assessed the changes in the use of tubewell water and water safety measures in the households in the 11 upazilas of Bangladesh after BRAC WASH intentions. Data were collected from 6,600 households where 3,812 tubewells were traced in baseline (2006-7) and 3,591 tubewells in midline (2009) . Most of the households (98-99%) used tubewell water for drinking, 70-73% for cooking, 62-66% for washing utensils, 70-73% for cleaning after defecation, and 24 -36% for bathing in midline both in the dry and rainy seasons. The numbers were significantly larger in midline than in baseline (p<0.01) except for drinking in the rainy season. Overall arsenic-free tubewells increased from 58% in baseline to 60% in midline and most households (83%) drank arsenic-free tubewell water in midline. The study revealed that water safety measures including awareness of cleaning/purifying water and hygienic management of water increased significantly (p<0.01 ). The concrete-built platform increased from 63% in baline to 69% in midline. Tubewell platforms were cleaned (32%) in baseline, which increased to 46% in midline. However, there still remained impediments to 100% safe water use by the households include arsenic contamination of tubewell water, financial inabilities of the ultra poor and poor households for installing tubewells for arsenic-free water. unmarked tubewell (whether contaminated by arsenic or not). The study concluded that WASH inteNention has succeeded in increasing access to safe water use. hygienic management of water, and cleanliness of water collecting point in the study areas. It is encouraging to note that ultra poor households had interest to get new tubewells and preferred to pay the costs in monthly installments, which indicates that these households were aware of the benefits of safe water. Thus, BRAC WASH programme needs to pay further attention to these impediments at the household level in order to further improve the current situation.
Comparative status of safe water use and hygiene practices in areas with and without NGO-Ied Water, Sanitation and Hygiene (WASH) Programme
(BRAC Research and Evaluation Division (RED), 2011-01) Ghosh, Shyamal C; Ali, ARM Mehrab; Arif, Tahmid
More than 90% people in Bangladesh have access to improved water supply system, but arsenic is posing a threat to this achievement. Additionally, hygiene is considered as one of the challenging areas to deal in the development sector. A number of organizations (both government and non-goverment) are working to improve the water supply, sanitation and hygiene practices through various water, sanitation and hygiene programmes. OBJECTIVE The overall objective of this study is to reveal the role of non-government organizations (NGOs) in improving safe water use and hygiene practices by the rural people of Bangladesh. METHODS Ten upazi/as with both NGO-Ied sanitation programme intervention and without any such activity (Comparison group) were selected for the study. Among the study upazilas, four were comparison upazilas, three were with BRAC facilitated WASH programme intervention areas and the rest three were with other NGO-Ied intervention areas. A multistage 30-cluster sampling method was adopted and 420 households were selected randomly from every upazila for the survey. In selecting 30 villages from every upazila, interval-sampling method was used. KEY FINDINGS 1. Tubewell water was used predominantly for drinking in the study areas. Significantly higher proportion of households in the BRAC WASH areas used tubewell water for drinking than the comparison and other NGO intervention areas (p<0.001). 2. The expenditure for tubewell drilling was mostly covered by self arrangement (95.1 %) in the study areas. However, in BRAC WASH intervention areas 1.2% and in other NGO-covered areas 1.1 % tubewells were financed by NGOs. Households not having their own tubewell mentioned financial problem (90.8%) as the major reason for not being able to install tubewell. 3. Overall knowledge about the demerits of using arsenic-contaminated water in the comparison areas was found less than the NGO-Ied WASH intervention areas. Regardless of the NGO-facilitated WASH programme prevalence, social institutions (54%), NGOs (23.5%) and mass media (26.6%) were the most common sources of information for knowing the demerits of using arseniccontaminated water. 4. Significantly higher proportion of people in NGO intervention areas (either BRAe or other NGOs) mentioned to wash hands during critical times than the comparison areas. The overall hygiene practice among the households in the other NGO intervention areas with regard to all relevant issues was found higher than the BRAe WASH and comparison areas, since less proportion of respondents mentioned not to know about the hygiene issues (p
Effects of BRAC Water, Sanitation and Hygiene (WASH) Programme in improved sanitation: changes from baseline to midline survey
(BRAC Research and Evaluation Division (RED), 2010-10) Ghosh, Shyamal C; Rana, AKM Masud; Ali, ARM Mehrab; Arif, Tahmid
To facilitate achieving national target of 1 00 percent sanitation in Bangladesh by the year 2013, BRAC Water. Sanitation and Hygiene (WASH) programme has been working in 150 upazilas for improving water supply, sanitation and hygiene practices. This study investigated the effect of BRAC WASH programme on sanitation in the intervention areas after two years of implementation, by comparing the data of baseline and midline surveys. Data of 30,000 households from 50 upazilas were used to measure the improvement in sanitation at household level. The sanitation situation in the same upazilas at institutional level was studied by surveying educational institutions (2 ,395 during baseline and 1,487 during midline), which were financed by the BRAC WASH programme for arranging improved sanitation facilities. Use of sanitary latrines increased significantly (p<0.001) both at household (7.1 %) and institutional level (2.4%). Additionally, the quality of sanitary latrines improved significantly (p<0.001 ). During midline survey higher percentage of latrines were found clean (17.2% at the households, 23.7% at the educational institutes) and with available water nearby the latrines (5.5% at the households, 11.4% at the institutes). There were also reduced percentage of latrines with stink (14 .8% at the households. 22.4% at the institutes) and residual fecal left (12 .8% at the households, 21 .6% at the institutes). The improvements of sanitation status could be attributed to the BRAC WASH activities implemented in the study areas for 2 years. However, there were some impediments revealed from the study, i.e., shifting of households using sanitary latrines to unsanitary practices, poverty, illiteracy etc .. which were slowing down the sanitation improvements. Thus, the BRAC WASH programme needs strengthening of ongoing activities addressing the key impediments at household level together with extended support for educational institutions to achieve the set goals.
Knowledge and practice of hygiene in BRAC's WASH Programme areas
(BRAC Research and Evaluation Division (RED), 2011-12) Akter, Tahera; Ali, ARM Mehrab
Improved hygiene behaviour is one of the most effective means of reducing disease occurrence. However, question may arise, which factors did contribute to such improvement? Past studies seldom addressed these issues systematically nor explained the influencing factors that facilitate or impede hygiene knowledge and practice from the perspectives of successful and unsuccessful households. This study, combining qualitative and quantitative methods, measured the changes in knowledge and practice of hygiene and explored factors that facilitate or impede hygiene behaviours in water, sanitation and hygiene (WASH) intervention areas of BRAC. Indepth interviews were conducted with 144 purposively selected women. Some of their practices were physically verified to get the proof of their claims. Besides, 30,000 systematically chosen households studied in the baseline were revisited in the midline survey for collecting quantitative data. Results on common variables investigated through both quantitative and qualitative approaches were triangulated. Findings show that respondent's hygiene behaviours were mainly facilitated by improved knowledge and awareness about health and environment-related issues. BRAC's financial assistance had positive impact on latrine ownership resulting in increased privacy and dignity of the households. Latrine or tubewell ownership also increased their social prestige and sense of responsibility. In this regard, maintaining hygiene behaviours for healthy life was perceived as everybody's responsibility. On the other hand, lack of interest in attending cluster meeting, traditional knowledge, poverty, difficulties in carrying water, location of latrine, lack of will to practice, and complex mind-set were the impeding factors to hygiene knowledge and practice. Mainly the psychosocial aspects made the difference between successful and unsuccessful households, as successful households followed hygiene behaviours irrespective of poverty and other barriers. To increase awareness to a further extent and to transform knowledge into practice and practice into habit, more cluster meetings ensuring participation of all including children and home visits by the programme organizers are imperative.
Knowledge, attitudes and practice about sanitation and hygiene: a midline evaluation in WASH areas of BRAC
(BRAC Research and Evaluation Division (RED), 2010-09) Sifat-E-Rabbi; Ali, ARM Mehrab
This study aimed to evaluate the impact of BRAC WASH (Water, Sanitation and Hygiene) programme on hygiene knowledge and practice of the people in intervention areas compared to baseline status. A population-based cross-sectional study with a pre-test and post-test design was conducted in 50 sub-districts of rural Bangladesh where BRAC WASH programme exists. A two-stage systematic sampling design was followed in drawing the sample. Data collection took place during November 2006- June 2007 at baseline and April-June 2009 at midline using a pre-tested structured questionnaire and physical verification. Findings reveal that knowledge and practice of hand washing at critical times (such as after contact with feaces and waste, before eating, cooking and serving food) significantly increased at midline compared to baseline. Knowledge about water contamination and water-borne diseases, water purification procedure, sanitation hygiene, rules of maintaining good health, and waste disposal at fixed place increased at midline. Availability of slippers, soap and water nearby latrine increased in intervention areas. However, there still exists room for improvement because practice of hygiene behaviour was not universal although they had knowledge of its importance. To achieve the targets of Millennium Development Goal, the WASH programme needs to pay more attention in providing knowledge related to personal hygiene.
Older Adults With Pre-Existing Noncommunicable Conditions and Their Healthcare Access Amid COVID-19 Pandemic
(Daffodil International University, 2022-01-19) Ghimire, Saruna; Shrestha, Aman; Yadav, Uday Narayan; Mistry, Sabuj Kanti; Chapadia, Bunsi; Yadav, Om Prakash; Ali, ARM Mehrab; Rawal, Lal B; Yadav, Priyanka; Mehata, Suresh; Harris, Mark
Background: COVID-19 has greatly impacted older adults with pre-existing noncommunicable conditions (hereafter called pre-existing conditions) in terms of their access to essential healthcare services. Based on the theory of vertical health equity, this study investigated access to healthcare by Nepali older adults with pre-existing conditions during the COVID-19 pandemic. Methods: A cross-sectional study surveyed 847 randomly selected older adults (≥60 years) in three districts of eastern Nepal. Survey questionnaires, administered by trained community health workers, collected information on participants reported difficulty obtaining routine care and medications during the pandemic, in addition to questions on demographics, socioeconomic factors and pre-existing conditions. Cumulative scores for pre-existing conditions were recoded as no pre-existing condition, single condition and multimorbidity for the analyses. χ2 tests and binary logistic regressions determined inferences. Results: Nearly two-thirds of the participants had a pre-existing condition (43.8% single condition and 22.8% multimorbid) and reported experiencing difficulty obtaining routine care (52.8%) and medications (13.5%). Participants with single (OR 3.06, 95% CI 2.17 to 4.32) and multimorbid (OR 5.62, 95% CI 3.63 to 8.71) conditions had threefold and fivefold increased odds of experiencing difficulty accessing routine care. Findings were similar for difficulty obtaining medication (OR single: 3.12, 95% CI 1.71 to 5.69; OR multimorbid: 3.98, 95% CI 2.01 to 7.87) where odds were greater than threefolds. Conclusions: Older adults with pre-existing conditions in Nepal, who require routine medical care and medication, faced significant difficulties obtaining them during the pandemic, which may lead to deterioration in their pre-existing conditions. Public health emergency preparedness should incorporate plans for both managing the emergency and providing continuing care.
Prevalence and Determinants of Self-Reported Functional Status Among Older Adults Residing in the Largest Refugee Camp of the World
(Springer Nature, 2023-06-01) Anwar, Afsana; Yadav, Uday Narayan; Huda, Md. Nazmul; Rifat, M. A.; Ali, ARM Mehrab; Mondal, Probal Kumar; Rizwan, Abu Ansar Md.; Shuvo, Suvasish Das; Mistry, Sabuj Kanti
Background The older adults of refugee camps might be vulnerable to exhibiting limited functional abilities because of the limited resources available to create a supportive environment for older population in the camps. This study aims to explore the prevalence and determinants of self-reported functional status among the older adults residing in the Rohingya refugee camp in Bangladesh. Methods This cross-sectional study was conducted on 864 older adults aged 60 years and above living in five selected sub-camps of Rohingya refugee camp in Cox’s Bazar, Bangladesh. Data were collected through face-to-face interviews of the participants between November-December 2021. Functional status was measured using the Barthel Index. Information on participants’ sociodemographic characteristics, self-reported chronic diseases and lifestyle characteristics were also collected. A multiple logistic regression model was used to assess the factors associated with self-reported functional abilities among the participants. Results The overall percentage of people having limited self-reported functional ability was 26.5% (male: 22.6% and female: 31.5%) with inability most found in grooming (33.2%), bathing (31.8%), stair using (13.2%) and mobility (10.7%). In the final adjusted model, having age of 80 years or more (aOR = 2.01,95% CI: 1.08,3.75), being female (aOR = 1.44, 95% CI: 1.04,2.0), having low memory or concentration (aOR = 1.83, 95% CI: 1.30,2.56), loneliness (aOR = 2.89, 95% CI:1.74,4.80) and living with aid alone (aOR = 2.89, 95% CI: 1.74,4.80) were found to be associated with self-reported limited functional ability. Conclusion The findings of this study highlight the need for attention from policymakers and public health practitioners on addressing functional limitations among older adults residing in the Rohingya refugee camp. Our findings emphasize the need for the development of comprehensive interventions that can address the wider unmet needs (e.g., ensuring family/caregiver support, engaging in social and physical activities, providing nutritional support packages, etc.) to improve the health and well-being of older Rohingya adults.
Promotion of improved cookstove in rural Bangladesh
(BRAC, 2011-05) Arif, Tahmid; Ashraf, Anik; Miller, Grant; Mobarak, Ahmed Mushflq; Akter, Nasima; Ali, ARM Mehrab; Sarkar, MA Quaiyum; Hildemann, Lynn; Dey, Nepal C; Rahman, Mizanur; Dwivedi, Puneet; Wise, Paul
This study aimed to explore the factors affecting the promotion of improved cookstove (ICS) to replace traditional stove and hence to combat indoor air pollution (lAP). The study was conducted in 58 randomly selected villages of Jamalpur sadar and Hatia upazilas (29 villages in each) in 2008. Both qualitative and quantitative methods were used. Focus group discussions were performed in each village to divide the villages in three equal clusters as well as Paras and listed the opinion leader of the villages. Fifty randomly selected households and nine households of the opinion leaders were surveyed in each village. Thus, a total of 3,080 households were selected for quantitative survey with pre-designed questionnaire. These households were also offered two types of ICSs - portable and with-chimney under different experimental conditions. Among those who adopted ICS as was offered usually chose portable res since they believed this would reduce fuel consumption while they chose 1es with chimney to reduce pollution. We found that households were usually aware of lAP but not so much so of the existence of res. But once they came to know about it through this survey, they would expect ICS to be better than traditional stoves in producing better tasting food, less smoke emissions, less cooking and fuel collection time, etc. When compared with those who did not know about ICS before, prior knowledge on ICS was found to be associated with greater share of people thinking res was better than traditional in terms of taste of food and smoke emission. In most cases financial constraints was stated as a reason for not to adopt an res. The adoption decision was also found to be highly responsive to price. On the other hand, opinion leaders appeared to have a stronger impact on households' decisions when the leaders decided against 1es as opposed to when they decided in its favour. Although this is a very product specific study the results can provide a guideline to understand similar constraints for many other improved technologies that exist but are not generally adopted.