Special Issue, 2012

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    Use of contraceptive methods among married women of Bagnibari village: perceptions, preferences and behaviors
    (BRAC University, 2012-12) Parvin, Kausar; Thaemert, K.; Turkmani, Sabera
    Introduction: Understanding the cultural and socioeconomic factors influencing the choice of contraceptives among women are essential to having a successful family planning program. Objectives: To identify the cultural and socioeconomic factors influencing the individual use of contraception among married women of reproductive age in Bagnibari village Methods: A qualitative grounded theory approach collected data from In-Depth Interviews (IDI), a Focus Group Discussion (FGD), Participatory Rural Appraisals (PRA), and informal discussions and observations in peri-urban Bagnibari village from married women of reproductive age and key informants. Results: The most popular contraceptive method is the pill followed by the injection. Decision-making regarding contraceptive use is directly and indirectly affected by the relationship of three dimensions – individual, cultural, and socioeconomic. All are heavily influenced by Muslim religious beliefs and male and female power dynamics. Women are responsible for use of contraceptives and often do not have proper knowledge regarding the methods and side effects. Knowledge is further limited by the cultural context placing women primarily in the home without access to non-governmental family planning options. Women perceive government family planning as inadequate. There was a lack of trust in government services. Women prefer temporary methods rather than permanent methods owing to their religious beliefs. Conclusion: Cultural and socioeconomic factors have a significant impact on contraceptive use. The relationship among the three dimensions influencing contraceptive use has to be addressed when delivering family planning services.
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    Traditional healing beliefs and practices in Bagnibari and Samair villages: implications for public health in rural Bangladesh
    (BRAC University, 2012-12) Camp, Lauren Ashley; Pervin, Jesmin; Raza, Farrukh
    Introduction: Traditional medicine plays a vital part in the health care systems of many developing countries. Healers’ knowledge and background, commonly treated illnesses, methods, and the factors leading to communities’ utilization of traditional services are important areas of research to understand how the informal health sector contributes to the health outcomes in these countries. Methods: A short exploratory, qualitative study in two villages of Savar, Bangladesh focused on traditional healers and community members. We completed six in-depth interviews, one focus group discussion, four informal discussions and three PRA techniques to investigate the issue. Data were translated, transcribed, coded and analyzed to develop themes that emerged from the specific research questions. Results: The study found that there were common illness experiences among our participants, including fever, headache, body pain, jaundice, diarrhea and illness caused by evil spirits, as well as commonalities among healers in terms of training, social status and treatment practices. Conclusion: We found that perceived causes of disease and severity led to the use of traditional healers. There was a need for increased training among the healers to improve their ability to contribute to the broader health care system.
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    Tobacco and substance use: perceptions and practices among men in Bagnibari, Bangladesh
    (BRAC University, 2012-12) Morris, Kathryn A.; Aftab, Afzal
    Tobacco and substance abuse are associated with several serious diseases and despite understanding their negative health consequences, men in Bangladesh still smoke at a rate higher than elsewhere in South Asia. There is little information concerning substance use in men in rural or urbanizing areas of Bangladesh. This study was a qualitative, exploratory study of the practices and emic perspective of men’s tobacco and substance use in order to more fully understand why men choose to use and their associations with use. The research team sampled men in Bagnibari village, Bangladesh, and questioned them on theirs as well as the community’s perceptions and use of tobacco and substances conducting a series of qualitative methods. Men within the study associated smoking at first as a social behavior but as their habits grew, they smoked on their own. Substance use on the other hand started in social situations and remained social. Participating men showed components of individual will and assertion of independence which were made more convenient through the perceived acceptance of men smoking among the community.
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    Utilization of a local government health center: community and provider perceptions from a Bangladeshi village
    (BRAC University, 2012-12) Zahan, Sharmin Akhter; Gyawali, Min Raj; Vernon, Christina
    Objective: To explore the contributing factors for the utilization or underutilization of a local government health center from the community member and health provider perspectives in a rural village of Bangladesh. Methods: In-depth interviews, focus group discussions, participatory rural appraisals, informal discussions, and observations were conducted among lower socio-economic community members and health providers. Findings: The main contributing factors for the utilization of the local government health center from community members and providers were free service, accessibility, and availability ofservice. The main contributing factors for the underutilization of the center were lack of health personnel and medicines, as well as staff behavior towards patients. Conclusion: Numerous factors affect the underutilization of the health service in rural Bangladesh. These critical factors must be explored further and considered in the design and implementation of health programs to meet the needs of communities in order to improve utilization and the health status of the population.
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    Pharmaceutical use for common cough and cold inunder-five children
    (BRAC University, 2012-12) Purser, Jessica A.; Sanin, Kazi Istiaque
    Introduction: There is a burgeoning epidemic of antibiotic resistance in low-income countries, and pharmaceutical use is on the rise even in rural areas. It is important to understand how caregivers and drug sellers use pharmaceutical medicines in treating the common cold and cough in under-five children. Methods: The researchers interviewed caregivers and drug sellers, observed drug sellers’ practices, and conducted social mapping with caregivers in Bagnibari, a village transitioning to a peri-urban area in Savar, Bangladesh. Results: Researchers found that caregivers use pharmaceutical medicines extensively in treating the common cold and cough and that drug sellers recommend the use of pharmaceutical medicines. However extensive antibiotic use was not found. Drug sellers gave instructions on the use of the pharmaceutical medicines that caregivers followed, and caregivers considered drug sellers their main source of information. Drug sellers said they had completed a governmental training course. Conclusion: Because some caregivers perceived drug sellers as uneducated and there is no follow-up training, visible knowledge dissemination should be started with drug sellers. Medicalization and urbanization are impacting the treatment of the common cough and cold of under-five children.
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    Perceptions and practices of food consumption of adult women in Bagnibari village, Bangladesh
    (BRAC University, 2012-12) Chaudhury, Sumangala; Yeasmin, Sultana
    Introduction: An understanding of working and non-working women’s perceptions and practices of food consumption is crucial for success of nutrition intervention programs by incorporating their emic perspective. Methods: An exploratory qualitative study was carried out among 7 adult working women (aged 15 years to 35 years) and 11 adult non-working women (aged 17 years to 60 years) using in-depth interviews, focus group and informal discussions, participatory rural appraisal tools and observations in households, roadside tea-shops and restaurants. Results: Rice and potato are commonly consumed by people. Rice symbolizes food as it reduces hunger and provides energy. Three meals with rice are usually consumed by the family. Home-cooked food is perceived as healthy. Although market food are perceived as unhealthy, it is often consumed, particularly by working women. Cognitive and socio-economic factors influence its consumption. Stale food is considered unhealthy and is perceived to be a cause of diarrhea but is nevertheless eaten by poor households. Elderly women perceive food as adulterated and they consume less. Conclusion: Consumption of food is not determined by the perception of its nutrient value alone, but is influenced by cultural, social and economic factors. Understanding of perceptions of adult women is crucial for the success of nutrition intervention programs.
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    Perceptions of occupational health risks, illnesses and coping strategies among workers in a factory in Savar, Bangladesh
    (BRAC University, 2012-12) Iacobelli, M.; Chowdhury, Morseda; Nagbe, Thomas Knue
    Introduction: Occupational health risks are emerging topics of interest and concern in Bangladesh. It is important to understand worker perceptions of risks, illnesses and their coping strategies in order to develop interventions relevant to their environment and concerns. Methods: We interviewed 28 factory workers in Savar, Bangladesh identifying their perceptions of illness, risk and coping strategies for illnesses occurred in the factory. Results: All workers identified repeated exposure to dust and industrial chemicals as the main risks within the factory. Additionally, workers reported unsafe conditions from cutting machinery with mechanical injury being the common outcome. Among all workers in the factory, common illnesses attributed to the work environment included respiratory disorders, anorexia and skin infections. It emerged from data collection that socioeconomic conditions and lack of rights added to the burden of illness. Some workers also resorted to self-inflicted injuries in order to receive compensation. Conclusion: Societal factors and perceived hierarchy within the factory has led to an added burden among factory workers. The already dangerous work environment adds to the job insecurity and psychological stress imposed on a worker. Factories should include compulsory safety training and mandatory safety equipment use in order to curb the growing risks of occupational health.
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    Perceptions of mental illness among adolescents in Bagnibari village
    (BRAC University, 2012-12) Noykhovich, Ekaterinovla Yakevna; Bulage, Patience; Hossain, Mohammad Didar
    Introduction: Mental illnesses have a large impact on a society, affecting economic productivity and bearing potential for destabilization of a society. About 16% of the population in Bangladesh suffers from mental illness. Previous studies in Bangladesh have focused primarily on mental illness in young children and adults in urban and rural populations, but not on adolescents. Methodology:The research team conducted a short exploratory qualitative study utilizing grounded theory approach in Bagnibari village, Bangladesh. The study consisted of in-depth and semi-formal interviews, focus group discussions, and observations with adolescents, parents, traditional healers, and caretakers of adolescents. Findings:The research team identified local terms and symptoms for the conditions of adolescents who had a mental illness. These terms were used to find an English equivalent for each condition. Community members had mixed responses to the use of traditional medicine and home remedies. Use of hospital and professional doctors was similar for complicated cases, especially after the failure of traditional medicine in relieving the condition. The behaviors of adolescents with mental illness included emotional changes and isolation. Conclusion:The research teams categorized the common mental illnesses among adolescents into convulsions, supernatural, and worry illnesses. The perceived causes of mental illnesses varied from mother’s fault to evil spirits. Social interactions of adolescents with a perceived mental illness varied throughout the community.
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    Feeding practices of under-5 children in a semi-urban village in Bangladesh
    (BRAC University, 2012-12) Moe, A.Z.; Sharmin, Farhana; Zaman, Saima
    Objective: To explore the reported feeding practices of under-five (U-5) children in a rapidly urbanizing village in Bangladesh. Methodology: This was a study with qualitative exploratory design based on grounded theory. Researchers identified caregivers of U-5 children and shopkeepers in proximity to the village through purposive sampling. The researchers conducted five in-depth interviews, two focus group discussions, participatory rapid appraisal exercises and three informal interviews were done. For the purpose of triangulation, informal observations took place in households, nearby shops and with children on the streets. Results: The study identified five main themes: family influences, caregiver’s educational level, overall changes in time, the perception of “good” or “bad” food for health and preferences. Conclusion: Exploring these themes regarding the feeding practices of U-5 children will be helpful in understanding the health and nutritional changes of nearby semi-urban areas going through rapid development. Keywords: under-5 children, feeding practices, urbanization, Bangladesh