Browsing by Author "Barua, Mrittika"

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A qualitative exploration of motivations and barriers in the decision-making regarding the uptake of HPV vaccine among caregivers of adolescent girls in Dhaka Korail slums
(BRAC University, 2025) Yudhianto, Kristian; Anwar, Humayra Binte; Barua, Mrittika
Introduction: Cervical cancer, primarily caused by the human papillomavirus (HPV), remains a health concern globally, particularly in low- and middle-income countries like Bangladesh. HPV vaccination is a proven preventive measure, yet the implementation of HPV vaccination in urban slums such as Dhaka’s Korail slum is challenging. This study aims to explore the motivations and barriers influencing caregivers’ decision-making regarding HPV vaccination for their adolescent daughters aged 10–14 years. Method: The study population is caregivers of adolescent girls aged 10-14 years living in Korail slum Dhaka, Bangladesh. A qualitative study was conducted by using the Behavioral and Social Drivers (BeSD) framework developed by WHO to guide data collection and analysis. In-depth interviews were carried out with eight caregivers, selected through purposive and snowball sampling methods. Data were analyzed thematically to identify interactional factors shaping vaccination decisions. Findings: Caregivers demonstrated low awareness of cervical cancer and HPV vaccination. Motivators for vaccination included trust in school authorities, influence from family and peers, and perceived health benefits for their daughters. Barriers included misinformation, concerns about vaccine side effects, inadequate communication from implementers, and cultural perceptions. Mothers were often the primary decision-makers, with HPV vaccination viewed as a “feminine matter”. Conclusion: The research highlights the urgency for targeted communication strategies to improve caregivers’ understanding of HPV vaccination. Engaging trusted figures such as schoolteachers and community health workers is important to address misconceptions and build trust with caregivers. Specific interventions should focus on enhancing the understanding of HPV vaccination and cervical cancer in urban slum communities, to increase HPV vaccination uptake and prevent cervical cancer in future generations.
A qualitative research on knowledge, attitude, and practice of hand washing among BRAC volunteers and their experience on message dissemination in Cox’s Bazar, Bangladesh
(Brac University, 2023) Rajan, N Ganesh; Sarker, Malabika; Barua, Mrittika
Introduction: Covid-19 Volunteers played a vital role in absorbing the shock on the healthcare system to some extent during the pandemic by task shifting. They played a multifaceted role where healthcare students assisted in medical activities, and non-medical volunteers helped with surveillance, quarantine, providing psychological support, and preventive measure campaigns. On contrary, disseminating healthcare knowledge by a non-medical person to the community in this infodemic scenario is challenging. The practice of handwashing is considered to be one of the best ways to prevent covid-19 infection. The current study focused on knowledge, attitude, and practice of handwashing among BRAC volunteer and their experience in message dissemination and implementation of handwashing stations. Method: This study was conducted in the Sadar and Ramu Upazila of cox’s Bazar of Bangladesh. We used an exploratory qualitative study to conduct this research and purposive sampling was done to select the volunteer. 8 in-depth interview was conducted using semi-structured in-depth interview guidelines. Findings: we found that volunteers were from different educational backgrounds and ages but they have good knowledge about covid-19 and handwashing. Induction training post-recruitment helped to attain this uniform knowledge among them. All-volunteer believed that covid-19 can be controlled by embracing proper covid-19 preventive measures, and handwashing. Various factors like financial allowance, security, power play, misconceptions, power play, inadequate logistical supply, and the design of the handwashing station acted as barriers and the BRAC brand, support from the local government and religious leader, and response from the community were the facilitator’s factors for message dissemination. Conclusion: From this study, we can say that volunteers have the proper knowledge to disseminate correct information to the community. During emergency periods volunteers can be trained to perform appropriate tasks. So as to absorb the shocks in the health system. In addition, involving key community stockholders in planning can make the message context-specific and easy to implement. Lately providing a human-centric designed handwashing station can promote hand washing in the community.
A qualitative study on implementer’s perspective of success and challenges: Interactive Popular Theatre (IPT) component of BRAC CST
(Brac University, 2023) Nawaz, Shahpara; Barua, Mrittika
Interactive popular theater (IPT) has been used as a public health education tool for decades in different countries of the world. Bangladesh Rural Advancement Committee (BRAC) conducted IPTs in the Cox’s bazar districts of Bangladesh to build awareness about COVID-19 and cervical cancer prevention. This study aimed to explore the experience of the IPT implementers and understand their perspective on the success and challenges of BRAC IPT implementation at Cox’s Bazar. A qualitative approach with exploratory research design was employed and in-depth interviews were done to with the managerial level and field level implementers of IPT to conduct the study. The study finding indicated that the IPT implementers had overall positive experience about the implementation and they considered the IPTs successful due to the positive feedback they received from beneficiaries and positive behavior change they observed in the community after conducting IPTs. However, this study also discovered that the implementers faced certain challenges during the IPT implementation. The challenges found were lack of acceptance of IPT among Muslim conservative people and Muslim religious leaders, difficulty of conducting IPTs in hard-to-reach areas, no sitting arrangement done for the audience in the IPT conducting site, difficulty in crowd management and short duration of training for the actors. These challenges can be overcome by involving the Muslim religious leaders in the consultation meetings prior to conducting IPTs, developing specific plan focusing on timing and transportation process to conduct IPTs in hard-to-reach areas, provide logistic support for the sitting arrangement of audience and trainers assessing the need of extending the training period through close supervision and discussion with the actors.
An exploratory qualitative study on the enabling factors of volunteerism: the perspective of BRAC volunteers and their family members in Cox’s Bazar District, Bangladesh
(Brac University, 2023) Lastima, Jorina; Barua, Mrittika
Introduction: Volunteers have a vital role in the community. Their motivation to volunteer can influence other people to change their behavior. Especially in the time of the COVID-19 pandemic, volunteers assisted institutions to help deliver service. Similarly, the BRAC CST project is dealing with COVID-19 in 6 project sites in Cox’s Bazar, Bangladesh with the aid of volunteers. BRAC volunteers are disseminating COVID-19 messages and distributing masks in the community. The volunteers and their families have the relevant information to determine their perception, motivation, and experiences on volunteerism. This study aimed to understand enabling factors of volunteerism from BRAC volunteers and their family members' perspectives in Cox’s Bazar, Bangladesh. Method: The study design used is a qualitative study. An in-depth interview was conducted with 10 BRAC volunteers and 4 family members in 3 BRAC CST project sites located in Cox’s Bazar, Bangladesh. The purposive sampling method was used to select the samples. A semi-structured IDI guideline was developed along with a consent form. IDIs were recorded, transcribed, translated, coded, and analyzed thematically. Clustering and comparing were done by using a data matrix and the results were summarized. Data triangulation was done to verify the responses from the volunteers and family members. Ethical approval from BRAC University James P Grant School of Public Health Institutional Review Board was obtained. The study purpose, risks, benefits, and right to refuse and withdraw from the study were explained to the participants. Anonymity and confidentiality were maintained during the entire time of the study. o Findings: The study discovered that enabling factors on volunteerism contribute to volunteers’ positive experience in volunteer work. The volunteers' and family members’ perception of volunteerism was that it is noble work to do. Volunteers serve the people willing to improve their health which people find respectable. Representing a respectable institution such as BRAC gave the volunteers a sense of pride. Volunteers along with their family members enjoy volunteering activities as they experienced good interactions with the people. Gaining knowledge on COVID-19 prevention benefited the volunteers as well as their families as it enhanced their health practices. Volunteers also developed their communication skills in dealing with many people. The family supported and encouraged volunteers in joining and doing volunteer work. They are proud of their family member as the volunteer is doing a good deed for others. The supervisors were also supportive of the volunteer’s time in taking leaves for their schoolwork. Recognition in the community is also experienced by the volunteers. People’s participation facilitated the discussion that helped the volunteer convey COVID-19 messages in the community. Conclusion: This study concluded that there were different factors of volunteerism. Each one was interconnected with the other that making volunteers motivated to do volunteering. Factors discovered where volunteer work is perceived as an honorable act, being proud to be part of a respectable institution, enjoying volunteering, experiencing benefits, acceptability, and support from the family, institution, and the community. These enabling factors identified made volunteer work on COVID-19 awareness feasible in Cox’s Bazar, Bangladesh.
Assessing the feasibility and acceptability of a wearable device for early detection and monitoring of pediatric sepsis among healthcare workers and health facility managers in a peri-urban hospital in Dhaka, Bangladesh: a scenario-based exploration
(BRAC University, 1/5/2025) Levi, Fiona Pauru; Barua, Mrittika; Anwar, Humayra Binte
Background: Sepsis remains a leading cause of morbidity and mortality in under-five children globally, particularly in low-resource settings, with early detection playing a critical role in improving outcomes. This study explores the feasibility and acceptability of a wearable device designed for early sepsis detection and monitoring in a peri-urban hospital setting in Bangladesh, where such technology is not yet widely used. Methods: A qualitative approach was used involving key informant interviews (KII) with nurses and doctors working in the pediatric department and the health facility managers at Sajida Foundation Hospital. Participants were asked about their perceptions of the wearable device, its usability, and potential barriers to its acceptance. The study applied the Theoretical Framework of Acceptability (TFA) and the data was analyzed thematically to identify key themes. Results: Participants highlighted the device's ease of use, remote monitoring capabilities, ability to provide real-time updates, and potential to improve workflow efficiency and neonatal sepsis management. Concerns include infection control, cost, and the need for comprehensive training. The device was perceived as a valuable tool, particularly in resource-limited settings, provided that these challenges were addressed. Suggestions for integration with existing hospital systems and pilot testing were emphasized. Conclusion: The findings demonstrate that wearable device technology for under five children sepsis monitoring is feasible and acceptable. Recommendations include pilot testing, healthcare provider training, and public awareness efforts. With careful implementation and ongoing evaluation, this technology has the potential to significantly improve early sepsis detection and outcomes in pediatric care settings in low-resource environments.
Barriers and facilitators in implementing human papillomavirus vaccination for adolescent girls: qualitative insights from healthcare implementers in the Korail slum, Dhaka, Bangladesh
(BRAC University, 2025) Powjithan, Natkunarajah; Anwar, Humayra Binte; Barua, Mrittika
Introduction: Cervical cancer remains as a significant global health issue, ranking fourth among cancers among women. Low- and middle-income countries (LMICs) account for over 90% of related deaths due to limited access to prevention and treatment. The Human Papilloma (Virus) vaccine offers up to 97% protection against cervical cancer when given to women during adolescence, yet the uptake remains alarmingly low in disadvantaged communities. This study explores the qualitative insights from the implementors to identify the barriers and facilitators to HPV vaccination in the urban Korail slum in Dhaka, Bangladesh. Method: A qualitative exploratory design was employed, involving Key Informant Interviews (KIIs) with nine healthcare implementers, including vaccinators, school principals, and field-level supervisors. Data were analyzed using thematic analysis framed by the Consolidated Framework for Implementation Research (CFIR), highlighting contextual and systemic challenges in the Korail slum setting. Findings: The study identified significant facilitators, including high awareness among healthcare workers involved in HPV vaccination, parents and school teachers about cervical cancer prevention, free vaccine provision, and trust in schools as vaccination sites. Training programs boosted implementers' confidence, while stakeholder engagement involving local leaders, parents, and school teachers enhanced vaccine uptake. However, barriers such as misinformation among community members, the sociocultural stigma among adolescent girls and their parents, logistical constraints, and financial challenges faced by the healthcare workers impeded widespread coverage. Logistical hurdles, including the lack of male assistants and transportation support for healthcare workers, added operational inefficiencies. Conclusion: The study highlights the need to address sociocultural barriers through tailored, community-driven strategies. Enhancing implementers' capacity, combating misinformation with culturally sensitive campaigns, and ensuring sustained logistical support are pivotal to improving vaccine uptake. These insights contribute to refining HPV vaccination programs in resource-constrained settings, aligning with global goals to reduce cervical cancer-related morbidity and mortality. Future interventions should focus on sustainable models and scaling successful practices to similar LMIC contexts.
Double trouble: prevalence and factors associated with tuberculosis and diabetes comorbidity in Bangladesh
(BRAC Univeristy, 10/31/2016) Sarker, Malabika; Barua, Mrittika; Guerra, Fiona; Saha, Avijit; Aftab, Afzal; Latif, A. H. M. Mahbub; Islam, Shayla; Islam, Akramul
Background Diabetes among tuberculosis patients increases the risk of tuberculosis treatment failure, death, and development of multidrug-resistant tuberculosis. Yet, there is no data is available in Bangladesh on the prevalence of diabetes among tuberculosis patients. The objective of the current study was to estimate prevalence and identify factors associated with tuberculosis-diabetes co-morbidity among TB patients enrolled in the Directly Observed Treatment, Short course program. Methods A community based cross-sectional quantitative study was conducted among 1910 tuberculosis patients living in six urban and eleven rural areas among whom Oral Glucose Tolerance Test (those who fasted) and Random Blood Sugar test (those who did not fast) were performed. Besides glucose levels, data on socio-demographic information, family history of diabetes and anthropometric measurements (height and weight) were also collected. Result Among the 1910 TB patients who participated in screening for diabetes, 245 (12.8%) were found to have diabetes and 296 (15.5%) to have pre-diabetes. Out of those who had diabetes, 34.7% were newly diagnosed through the current study and 65.3% already knew their status. Among those who were found to have prediabetes, 27 (9.1%) had impaired Fasting Blood Glucose (FBG), 230 (77.7%) had Impaired Glucose Tolerance (IGT), and 39 (13.2%) had both Impaired FBG and IGT. Older age, higher BMI, higher education (secondary level and above), being married, participation in less active work, and family history of diabetes are associated with higher prevalence of diabetes. Conclusion We observed a higher prevalence of diabetes and pre-diabetes in TB patients than reported previously in Bangladesh among the general population which may challenge TB and diabetes control in Bangladesh. Diabetes diagnosis, treatment and care should be integrated in the National TB Program.
Experiences of the beneficiaries of Interactive Popular Theatre (IPT): a qualitative study on the experiences of the beneficiaries of IPT as a part of BRAC CST program on COVID-19 prevention at Cox’s Bazar Sadar, Ramu & Chakoria upazila in Bangladesh
(Brac University, 2023) Rahman, Md. Mizanur; Sarker, Malabika; Barua, Mrittika
The COVID-19 pandemic is still ongoing across the globe as well in Bangladesh which spreads very fast in human contact. To prevent this disease from spreading, we need to follow certain guidelines and some behavioral modifications which need a conscious effort from all of us. Aiming to that, BRAC is conducting a community-based CST program in six sub-districts of Cox’s Bazar. Interactive Popular Theater (IPT) is one of the components among other interventions of the CST program like handwashing stations, mask-wearing, social distancing and miking. IPT incorporates awareness messages regarding COVID-19, cervical cancer and other social issues into it. The focus was COVID-19 preventive messages while cervical cancer also bears great importance as well. IPT transfers knowledge to its audience through entertainment like singing, dancing and acting. This study looked into the experiences of the beneficiaries, from their perspective. Our study investigated their feeling about IPT. This study wanted to know whether the IPT was entertaining, the reason for liking or disliking it, they got benefitted or learned new things. Knowledge gained from the IPT and their application in real life was also a topic of interest. All the respondents reported an overall good experience with IPT. The reason for expressing satisfaction with the IPT is learning new knowledge. The study also found out the daily applications of these messages in their life which mean, there are positive behavioral changes have been noticed like adopting wearing masks and handwashing as habits. As this kind of intervention is very new in our country, we need more research in this field from different perspectives. The use of IPT also has a great impact on building people’s awareness and understanding. It could be a great tool and might be used to educate the common people in Bangladesh on a larger scale.
Experiences of volunteers as change agents for prevention of COVID-19 in Cox’s Bazaar, Bangladesh: an exploratory qualitative study
(Brac University, 2023) Mariam, Warisha; Sarker, Malabika; Barua, Mrittika
Background: Community volunteers are an important backbone for engaging communities to bring about health related behaviour change among the people of the communities. In recent years the pandemic due to Coronavirus 2019 has gained all the momentum and most of the preventive strategies have been shifted in reducing the further transmission of this virus and curbing the pandemic. This study examines the volunteering experience of the volunteers working in the BRAC Community Support Team intervention as change agents in the Cox Bazaar community. The area has been chosen for its high urban and peri urban type of population density. Methods: This was an exploratory qualitative study done among ten volunteers involved in BRAC CST project in Ramu, Sadar and Kutubdia upazilas of Cox’s Bazaar. In depth interviews were conducted and data was organised, coded and analysed using manual coding and web-based software Dedoose. Thematic analysis has been done and results has been interpreted using the Social Cognitive Theory. Results: Ten volunteers were interviewed, out of which 1 is female and 9 males. The age ranges from 21 to 38 years. All volunteers perceived their desire to work as a volunteer a noble cause for the community. They were also recognised and respected in the society for their work done. Social recognition, job satisfaction for working in public welfare and support from their families and communities helped them to perform their job better. However, social, cultural and language barrier and shaming of their work by abusing and harassing played an important role in hindrance to performing their activities as change agents. There were also some power distribution roles in community which hampered the volunteering activity. Lack of refresher training and limited resources and absence of mobility support are some of the identified factors that also hampered their activity as a change agent. Conclusion: In general volunteers were able to perform their assigned tasks. However, ensuring continuous organisational support, refresher trainings can lead to a greater motivation for acting as a change agent and performing their tasks better. Future research directed towards exploring the gender differences in experiences will also add to the knowledge gap.
Exploring caregivers’ perception of wearable technology for sepsis management for children aged under 5: a scenario-based qualitative study in Dhaka, Bangladesh
(BRAC University, 1/5/2025) Ankon, Sabrina Kamal; Anwar, Humayra Binte; Barua, Mrittika
Background: Sepsis is a condition when the body's extreme immunological reaction to an infection can harm organs, resulting in shock, organ failure, or even death if treatment is not received. People all across the world are affected by sepsis, although lower-middle-income nations (LMICs) have far higher incidence and fatality rates. Notably, neonatal sepsis is a major cause of death in these areas, accounting for 99% of infant deaths worldwide. Bangladesh continues to have a serious problem with pediatric sepsis mortality, especially in areas with low resources. Before a specific sepsis treatment management was implemented, the death rate for high-risk children with sepsis at Dhaka Hospital was startlingly high, approaching 60% which demonstrates the need for urgent standardized treatments for vulnerable pediatric populations. Objective: This study aims to explore caregivers' perceptions of children under five about wearable technology for sepsis control. Methods: An exploratory design using a qualitative method was followed to conduct this study. The study population was the caregivers of children under five hospitalized for any illness including sepsis from Sajida Foundation Hospital at Keraniganj in Dhaka. A purposive sampling technique was finalized to make the sample size. To find out how caregivers felt about the wearable device for sepsis management, 10 IDIs (In-depth Interviews) were done until the data was saturated. Data collection was done following the Theoretical Framework of acceptability. For analyzing data framework analysis was followed. Results: This study observed the possibilities and difficulties of using a wearable device to monitor children's health in settings with limited resources. Its noninvasive, user-friendly design and efficient vital sign monitoring, capacity to lower hospital visits, and conformed to Islamic principles helped caregivers build confidence and trust to use the device in the future. Caregivers were concerned about the hospital stay due to their work, household chores, and caring for other children as well as the device’s signal sound. Despite recognizing its benefits, some remained hesitant due to conservative views. Conclusion: The wearable device's non-invasive, user-friendly design demonstrated potential in enhancing children's health monitoring; nevertheless, greater acceptance and implementation require addressing caregivers' concerns and practical challenges.
Exploring the experience of human papillomavirus vaccine uptake among adolescent girls in an urban slum of Dhaka
(BRAC University, 2025) Lhamo, Sherab; Anwar, Humayra Binte; Barua, Mrittika
Introduction: Cervical cancer is one of the most common causes of morbidity and mortality among women in low- and middle-income countries, including Bangladesh, where it is the second most common cancer among women. Human papillomavirus vaccination represents a transformative solution, yet uptake remains hindered in marginalized settings such as urban slums. The current study investigates in detail the experience of adolescent girls in reaching vaccination within the Korail slum in Dhaka, facilitated and barred factors that have influenced such a journey. Method: A qualitative study design was used, involving semi-structured in-depth interviews with eight adolescent girls who received the HPV vaccine aged 10–14 years. The Behavioral and Social Drivers framework guided exploration of emotional, social, and logistical experiences. Thematic analysis was conducted, incorporating both deductive and inductive approaches in order to identify meaningful insights from the data. Findings: Teachers and mothers emerged as strong influencers, helping reduce fears and misconceptions engendering trust. Reassurance legitimized vaccination as a normal and thus empowering experience by peers. The appreciation for free access to vaccines underscored values that the country places on health. Nevertheless, misinformation across social media, logistical difficulties in regard to mandatory online registration, and last-minute notifications on vaccination schedules thwarted processes. Despite these barriers, participants also reflected a very strong sense of agency and optimism with respect to taking the vaccine against cervical cancer. Conclusion: The study highlights the importance of trust, community engagement, and culturally sensitive communication in improving vaccination uptake. By addressing logistical barriers and misinformation, and leveraging trusted peer networks, we can create a supportive environment for vaccination. These insights can enhance HPV vaccination campaigns and reduce cervical cancer rates among underserved populations, ensuring no girl is left behind in the fight against preventable diseases.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh
(© 2015 BioMed Central Ltd., 2015) Paul, Sukanta; Akter, Rahima; Aftab, Afzal; M Khan, Antora; Barua, Mrittika; Islam, Shayla; Islam, Akramul; Husain, Ashaque; Sarker, Malabika
Background: Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas. Methods: This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part. Results: Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB. Conclusions: This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
Knowledge, perceptions and practices regarding human papillomavirus (HPV) vaccination among 10 to 14 years school going adolescent girls and parents of Korail slum in Dhaka, Bangladesh
(BRAC University, 2025) Akash, Sheikh Mohammad Rafi; Anwar, Humayra Binte; Barua, Mrittika
Cervical cancer remains a leading cause of mortality among women in low- and middle-income countries (LMICs), including Bangladesh. However, the Human Papillomavirus (HPV) vaccine provides up to 97% protection against cervical cancer when given to women during adolescence. Barriers such as limited healthcare access, misinformation and cultural norms hinder HPV vaccination efforts. This study aimed to explore the knowledge, perceptions and practices regarding HPV vaccination among adolescent girls aged 10 to14 years and their parents in Korail slum, Dhaka by using the Behavioral and Social Drivers (BeSD) framework. A mixed-method approach was adopted. Quantitative data were collected through a census survey of 161 school-going adolescent girls aged 10 to 14 years. On the other hand, qualitative insights were derived from three focus group discussions (FGDs), two with mothers and one with fathers. Challenges in conducting FGDs with fathers arose due to their work schedules and heightened political tensions in the area, limiting their participation. Data analysis combined descriptive statistics for the quantitative findings and thematic analysis for the qualitative data. Quantitative results revealed that while 99.38% of participants had heard about the HPV vaccine, primarily through schools, only 62.73% understood its purpose. Schools (95.71%) and the perceived health benefits of vaccination (96.43%) were key motivators for uptake. However, barriers like fear of side effects (20%), lack of parental approval (13.33%) and misinformation (71.43%) persisted. Qualitative findings emphasized the role of trusted figures, such as teachers and healthcare workers, in addressing misconceptions. Community members valued the vaccine’s preventive benefits and it's free availability but stressed the need for clearer communication and community outreach. In conclusion, high awareness of HPV vaccination was observed. Yet detailed knowledge and acceptance were limited among the residents by misinformation and logistical challenges. Effective interventions must focus on targeted health education campaigns, community engagement and strategies to overcome socio-political barriers to improve vaccine uptake and reduce cervical cancer prevalence in underserved communities.
Tuberculosis and the sexual and reproductive lives of women in Bangladesh
(PLOS ONE, 7/19/2018) Barua, Mrittika; Driel, Francien Van; Jansen, Willy
When they do not meet norms related to sexuality and reproduction, Bangladeshi women often face abandonment and are thus deprived of an active sexual life, a marital relationship, and motherhood. Little is known about how a stigmatised disease such as tuberculosis (TB) may constrain the reproductive health and sexual lives of women. This article, derived from a larger study on the impact of TB on women’s sexual and reproductive health and rights in Narsingdi district and Dhaka, Bangladesh, aims to fill this gap. Based on interviews with nine married women who have or had TB, four husbands, and two mothers-in-law, this article highlights that the ways in which TB impedes on the sexual and reproductive lives of women depends on the stigma within their family and community, their relationships with their husbands, motherhood, their living arrangements, their economic contribution to the family and/or their disclosure of their TB diagnosis. Women with children and supportive husbands retain a stronger position among their in-laws and are less likely to be isolated or rejected. The patients’ narratives revealed that the instructions of health workers influenced their decisions about intercourse or abstinence. Future studies should examine the instructions patients receive from health workers regarding their living and sleeping arrangements, sexual intercourse, and pregnancy, as well as policy documents on TB treatment and prevention.