Journal Articles (2021)

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    Knowledge and practice regarding menstrual hygiene management among the Rohingya refugee adolescent girls in Cox’s Bazar, Bangladesh: A mixed method study
    (Emerald Publishing, 5/15/2021) Rakhshanda, Shagoofa; Ahmed, Sahlil; Saidu, Samuel; Nderitu, Christine; Thapa, Basanta; Awal, Abdul; Farnaz, Nadia; Rahman, Atiya; Aktar, Bachera; Faruque, A.S.G.
    Purpose About half of the 16% adolescents in the world experience menstruation. Menstrual hygiene management (MHM) is a health concern and challenge especially in humanitarian situations as experienced by Myanmar Rohingya refugees living in Cox’s Bazar, Bangladesh. This study aims to assess knowledge, practice and influencing factors for MHM among Rohingya refugee adolescent girls of 14–18 years. Design/methodology/approach The study used both quantitative (a cross-sectional survey with 340 adolescent girls through a structured questionnaire) and qualitative (7 in-depth interviews with adolescent girls and 2 focus group discussions with the mothers) approaches. Quantitative data, analyzed using STATA version 13.0, were supported by qualitative data, grouped into themes and presented as matrix. Findings Around 51% adolescent girls learned about menstruation after menarche, at the mean age of 12 years, from their mothers and older sisters. About 75% used sanitary pads as absorbents which they got mostly as relief material or bought from local stores (83%); the rest used cloths and other materials (25%). About 57% of the respondents disposed of their absorbent by burying. Those who used reusable absorbents washed them with soap and water (40%) and mostly dried them indoors (17%). Factors influencing healthy MHM practice included the use of absorbent, privacy, disposal, washing and drying of clothes, physical activities, hygiene and pain management. Adolescents with secondary or higher education were four times more likely to have better MHM practice (odds ratio = 4.27; confidence interval = 1.19–15.31) than those with no formal schooling.
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    Association of household wealth and education level with hypertension and diabetes among adults in Bangladesh: A propensity score-based analysis
    (Wiley Online Library, 5/15/2021) Gupta, Rajat Das; Chakraborty, Promit Ananyo; Hossain, Md. Belal
    Objective: To determine the association of household wealth and education level with hypertension and diabetes in Bangladesh using propensity score (PS) analyses. Methods: A nationally representative sample of the Bangladesh Demographic and Health Survey 2017-18 was analysed to explore the research question. A weighted sample of 11 320 individuals was considered. Hypertension and diabetes were the outcomes of interest, and household wealth status (non-poor and poor) and education level (secondary/higher education and no secondary/higher education) were the exposure variables of interest. A person was defined as hypertensive if their average blood pressure was ≥140/90 mmHg or self-reported history of taking antihypertensive medications. Individuals were classified as diabetic if they had a Fasting Blood Glucose level of ≥7 mmol/l or reported taking prescribed medication for reducing high blood glucose or diabetes. We used the 1:1 nearest neighbour PS matching without replacement and PS weighting approaches to assess the association between the exposures and the outcome variables. Results: Wealth status was significantly associated with diabetes but not with hypertension, while education status was significantly associated with neither diabetes nor hypertension. We also observed a significant interaction effect between household wealth status and education level with diabetes. The odds of diabetes were approximately 60% higher among adults from non-poor households and those without secondary/higher education. Conclusion: Diabetes prevention and control programs should focus on non-poor individuals, while hypertension prevention programs should target populations irrespective of educational attainment and wealth status.
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    Knotted realities: Understanding what delays early and child marriage for girls in urban slums of Bangladesh
    (Bangladesh Development Initiative, 2021-04) Ahsan, Sairana; Karim, Shuchi; Biswas, Subas; Rashid, Sabina Faiz
    Bangladesh has the fourth-highest prevalence of early and child marriage in the world. This trend has declined slightly over the years, but there is a dearth of research regarding underlying reasons. This article explores the phenomenon of delayed marriage for women in the context of understudied urban slums, and seeks to understand both why it happens and its consequences. The article uses data from 14 in-depth interviews (IDI) of girls who delayed their marriage beyond their 18th year, and two focus group discussions (FGD) with adolescent girls and young women aged between 13-24 years from a larger mixed-methods study conducted in two slums of the cities of Dhaka and Chattogram. Findings reveal that the key reasons for delaying marriage are poverty, inability to pay dowry for girls perceived as older, and the pressing obligations faced by young girls in having to take care of their families. It was also found that positive family support, mostly among better-off families, allows some girls pursue education rather than be married off at an early age. Link to journal: https://www.bdiusa.org/journal-bangladesh-studies
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    Bangla hate speech detection on social media using attention-based recurrent neural network
    (De Gruyter, 4/9/2021) Das, Amit Kumar; Al Asif, Abdullah; Paul, Anik; Hossain, Md. Nur
    Hate speech has spread more rapidly through the daily use of technology and, most notably, by sharing your opinions or feelings on social media in a negative aspect. Although numerous works have been carried out in detecting hate speeches in English, German, and other languages, very few works have been carried out in the context of the Bengali language. In contrast, millions of people communicate on social media in Bengali. The few existing works that have been carried out need improvements in both accuracy and interpretability. This article proposed encoder–decoder-based machine learning model, a popular tool in NLP, to classify user’s Bengali comments from Facebook pages. A dataset of 7,425 Bengali comments, consisting of seven distinct categories of hate speeches, was used to train and evaluate our model. For extracting and encoding local features from the comments, 1D convolutional layers were used. Finally, the attention mechanism, LSTM, and GRU-based decoders have been used for predicting hate speech categories. Among the three encoder–decoder algorithms, attention-based decoder obtained the best accuracy (77%).
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    The effects of polio eradication efforts on health systems: A cross-country analysis using the Develop–Distort Dilemma
    (Oxford Academic, 4/21/2021) Rodriguez, Daniela C; Neel, Abigail H; Mahendradhata, Yodi; Deressa, Wakgari; Owoaje, Eme; Akinyemi, Oluwaseun; Sarker, Malabika; Mafuta, Eric; Gupta, Shiv D; Salehi, Ahmad Shah; Jain, Anika; Alonge, Olakunle
    Vertical disease control programmes have enormous potential to benefit or weaken health systems, and it is critical to understand how programmes’ design and implementation impact the health systems and communities in which they operate. We use the Develop–Distort Dilemma (DDD) framework to understand how the Global Polio Eradication Initiative (GPEI) distorted or developed local health systems. We include document review and 176 interviews with respondents at the global level and across seven focus countries (Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, India, Indonesia and Nigeria). We use DDD domains, contextual factors and transition planning to analyse interactions between the broader context, local health systems and the GPEI to identify changes. Our analysis confirms earlier research including improved health worker, laboratory and surveillance capacity, monitoring and accountability, and efforts to reach vulnerable populations, whereas distortions include shifting attention from routine health services and distorting local payment and incentives structures. New findings highlight how global-level governance structures evolved and affected national actors; issues of country ownership, including for data systems, where the polio programme is not indigenously financed; how expectations of success have affected implementation at programme and community level; and unresolved tensions around transition planning. The decoupling of polio eradication from routine immunization, in particular, plays an outsize role in these issues as it removed attention from system strengthening. In addition to drawing lessons from the GPEI experience for other efforts, we also reflect on the use of the DDD framework for assessing programmes and their system-level impacts. Future eradication efforts should be approached carefully, and new initiatives of any kind should leverage the existing health system while considering equity, inclusion and transition from the start.
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    Prevalence and associated factors of underweight, overweight, and obesity Among Bangladeshi adults: An analysis of demographic and health survey 2017-18
    (Science Direct, 4/16/2021) Gupta, Rajat Das; Al Kibria, Gulam Muhammed
    This study aimed to determine the prevalence and associated factors of underweight, overweight, and obesity among Bangladeshi adults (≥18 years) using the nationally representative Bangladesh Demographic and Health Survey 2017-18 data. An Asian-specific body mass index cut-off was used to define underweight, overweight, and obesity. Multivariable multilevel logistic regression was conducted to investigate associated factors and was reported with adjusted odds ratio [AOR] with 95% confidence interval (CI). The overall prevalence of underweight, overweight, and obesity was 17.1% (95% CI: 16.2%, 18.0%), 29.4% (95% CI: 28.4%, 30.4%), and 10.8% (95% CI: 10.1%, 11.5%), respectively. Compared to 18-29-year old people, the odds of underweight and overweight/obesity was lower among people with 30–49 years of age, respectively. Males had also lower odds of overweight/obesity than females (AOR: 0.47; 95% CI: 0.42,0.51). The odds of underweight declined with increasing education level and wealth quintile. However, the odds of overweight/obesity increased with increasing education level and wealth quintile. Work status or place of residence did not have any significant association. Multisectoral interventions should be launched by targeting the at-risk population for the underweight and overweight/obesity prevention programs irrespective of work status or place of residence.
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    Adolescents’ experiences of covid-19 in Chittagong and Sylhet divisions, Bangladesh
    (GAGE, 2021-04) Alam, Farhana; Rana, Md Sajib; Raha, Samira Ahmed; Al Mamun, Saklain; Guglielmi, Silvia
    This study is part of a cross-country series designed to share emerging findings in real time from qualitative interviews with adolescents and school teachers in the context of covid-19. The young people involved are part of the Gender and Adolescence: Global Evidence (GAGE) programme, which is conducting longitudinal research in the Middle East, East Africa and South Asia. Our sample for this study was purposefully selected from an ongoing baseline GAGE impact evaluation study, and includes two cohorts: younger adolescents (10–14 years) and older adolescents (15–19 years), all of whom are in-school (grades 7 and 8). Adolescent respondents were drawn from both urban and rural schools in Chittagong and Sylhet divisions of Bangladesh (see Annex 1 for further details). The objectives of the research are as follows: • To understand adolescents’ experiences of transition from childhood to adulthood, and to identify differences in their experiences by age, gender, disability and geographic location. • To identify adolescents’ knowledge of covid-19, and how the pandemic response has affected adolescent lives across the following domains: Young adolescent girls in Chittagong, Bangladesh © Nathalie Bertrams / GAGE 2 » education and remote learning » incomes and livelihoods » nutrition, health and hygiene » psychosocial well-being and coping » voice and agency related to adolescents’ mobility. To inform the pandemic response, this study aims to understand adolescents’ knowledge, perceptions and practices during the covid-19 pandemic, their challenges and worries, and the coping mechanisms they are using to deal with the evolving situation. We explore the impact of covid-19 on the realities and experiences of in-school adolescents in Chittagong and Sylhet who have found themselves out of school since March 2020 until the present, to prevent the spread of the virus. The report also explores the impacts on adolescents in terms of gender and the vulnerability status of the household.
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    Implications of Birth-Dose Vaccination against Hepatitis B Virus in Southeast Asia
    (MDPI, 4/12/2021) Fazle Akbar, Sheikh Mohammad; Al Mahtab, Mamun; Begum, Ferdousi; Hossain, Shaikh A. Shahed; Sarker, Sukumar; Shrestha, Ananta; Khan, Md. Sakirul Islam; Yoshida, Osamu; Hiasa, Yoichi
    The World Health Organization (WHO) South-East Asia Regional Office (SEARO) covers 11 countries with a combined population of about 2 billion people, making it the most populous of the six WHO regions. In 1992, the WHO advocated including the hepatitis B vaccine in the Expanded Program of Immunization (EPI) and vaccinating all infants and children three times within 1 year of birth (HepB3). Recently, the WHO advocate birth-dose hepatitis B vaccination (HepB-BD) as soon as possible after birth, preferably within 24 hours. In 2016, the SEARO endorsed a regional hepatitis B control goal with a target of hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020. Of the 11 SEARO countries, four achieved this target on schedule. Out of these four countries, two countries (Bangladesh and Nepal) have not adopted HepB-BD in EPI program. On the other hand, the coverage of HepB3 is not satisfactory in some SEARO countries, including India which adopted HepB-BD but could not achieve the overall target of SEARO. Thus, it is a point of debate whether emphasis should be placed on proper implementation of HepB3 or whether a new agenda of HepB-BD should be incorporated in developing countries of SEARO. The article discusses strengthening and expanding the Hepatitis B vaccination program in SEARO countries with an emphasis on HepB and HepB-BD programs.
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    Public health education post-COVID-19: A proposal for critical revisions
    (BMJ Journals, 4/1/2021) Ghaffar, Abdul; Rashid, Sabina Faiz; Wanyenze, Rhoda Kitti; Hyder, Adnan A
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    Association of leisure-time physical activity with perceived general health status among hypertensive people: An analysis of NHANES 2015–18
    (Nature, 3/23/2021) Al Kibria, Gulam Muhammed; Gupta, Rajat Das; Crispen, Reese
    Although leisure-time physical activity (LTPA) improves general health, little is known about its impacts on the health of hypertensive people within the United States. We investigated the general health of hypertensive people and the relationship between LTPA and general health within this population. This cross-sectional study analyzed National Health and Nutrition Examination Survey 2015–18 data. None, some, and high LTPA were defined as ‘0’, ‘>0 but <150’, and ‘≥150’ minutes of LTPA in each week, respectively. Hypertension was defined as the systolic/diastolic blood pressure ≥130/80 mmHg or taking BP-lowering drugs. General health status was dichotomized as whether participants reported ‘very good to excellent’ health status or not. After descriptive analysis, logistic regression was performed. Among 8504 participants (48.6% male and mean age: 48.2 years), about 47.9%, 41.4%, and 39.5% of people had hypertension, ‘very good to excellent’ health, and high LTPA, respectively. The odds of ‘very good to excellent’ health was lower among hypertensives than those without hypertension (adjusted odds ratio [AOR]: 0.7, 95% confidence interval [CI]: 0.6–0.8, p < 0.001). Among hypertensive individuals, about one-third reported ‘very good to excellent’ health (33.1%) and high LTPA (32.0%). Lastly, compared to people with no LTPA, those with some (AOR: 1.5, 95% CI: 1.0–2.0, p < 0.05) and high (AOR: 2.3, 95% CI: 1.7–3.0, p < 0.001) LTPA had greater odds of ‘very good to excellent’ health. We found positive relationships between LTPA and ‘very good to excellent’ health of hypertensive people. Therefore, improving general health could be an added advantage of LTPA for hypertensive people.