Thesis/ Project Report, Master of Public Health (James P. Grant School of Public Health)

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    Assessment of the status and its associated factors among lactating mothers taking services in an urban healthcare facility in Dhaka city: a cross-sectional study
    (BRAC University, 1/5/2025) Delwar, Umama Binte; Ireen, Santhia; Akter, Fahmida
    Our study aims to determine the nutritional status of lactating mothers attending an urban MNCH facility in Dhaka, Bangladesh, and identify the associated factors. A cross-sectional study was conducted which analyzed socio-demographic data, dietary diversity, and body mass index (BMI). Among the participants, 39.7% were aged 21–25 years, and 40% held a bachelor’s degree or higher. The majority (79.2%) were homemakers, with a median monthly income of 50,000 BDT. Nutritional assessment revealed a dual burden, with overweight and obesity prevalent in 64% of the lactating mothers and undernutrition observed in 10%. When regression analysis was done it highlighted that mothers aged more than 30 years had significantly higher the odds of being overweight or obese (AOR=9.98; p=0.001), emphasizing the impact of age on BMI. Attainment of education also influenced BMI significantly; mothers completing higher secondary education were more likely to have increased BMI (AOR=3.02; p=0.026), likely due to calorie-dense food choices, while those who had completed their education up to bachelors and above education appeared to mitigate this risk. Mothers coming from middle-income households were less likely to be overweight or obese (AOR=0.37; p=0.023), this indicated the impact of income on nutritional outcomes. Dietary factors also played a significant role; frequent consumption of sugary foods increased the likelihood of higher BMI (AOR=2.73; p=0.001), whereas sweets consumption showed an inverse association with overweight and obesity (AOR=0.40; p=0.003) which could be due to differential reporting or cultural practices. Thus interventions should focus on the enhancement of nutritional literacy particularly women of lactational phase and additionally, introduce policies that ensure access to affordable, nutrient-rich foods which could mitigate the rising burden of overweight and obesity. Future longitudinal studies are necessary to explore the long-term effects of these factors on maternal and child health in urban Bangladesh.
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    Infant and young child feeding knowledge and practices among lactating mothers attending an urban health care facility in Dhaka, Bangladesh
    (BRAC University, 1/5/2025) Tabassum, Tasbiha; Ireen, Santhia; Akter, Fahmida
    Introduction: The first 1,000 days of a child’s life are critical for growth and development as proper nutrition during this period plays a significant role in health outcomes in future. In Bangladesh, though breastfeeding rates are relatively high, challenges persist in achieving optimal Infant and Young Child Feeding (IYCF) practices. Concerning stunting and wasting rates with lack of data in urban areas like Dhaka highlights the need for understanding the influencing factors of IYCF adherence. This study examines IYCF knowledge and practices among lactating mothers of children aged 0-6 months attending an urban MNCH facility in Dhaka. Method: A cross-sectional, quantitative study was conducted at two Maternal Neonatal and Child Health (MNCH) facilities in Dhaka City from November 24 to December 11, 2024. The participants included 342 lactating mothers of infants aged 0-6 months, selected through convenience sampling. Data were collected via a semi-structured questionnaire on socio-demographic factors, antenatal and postnatal care utilization, and IYCF knowledge, practices and barriers. Data analyses included descriptive statistics, chi-squared tests, and multivariable regression analysis. Findings: The study found that overall IYCF knowledge among the mothers was quite well, specifically regarding early breastfeeding initiation (90.4%) and colostrum feeding (99.1%). Knowledge gaps existed in complementary feeding, proper breastfeeding techniques and understanding broader benefits of exclusive breastfeeding. Out of 342 mothers, 100% breastfed their child at least once, 62.6% initiated breastfeeding within 1 hour, 81.6% exclusively breastfed and 17.0% practiced mixed feeding. Barriers such as low milk secretion, post-C-section complications, and cultural factors were significant challenges to optimal IYCF practices. Conclusion: The findings highlight the need for targeted interventions to improve optimal IYCF practices. Addressing barriers as well as strengthening of healthcare service are crucial for enhancing child nutrition in urban Bangladesh.