Knowledge and involvement of husbands in maternal and newborn health in rural Bangladesh

Abstract Background Access to skilled health services during pregnancy, childbirth and postnatal period for obstetric care is one of the strongest determinants of maternal and newborn health (MNH) outcomes. In many countries, husbands are key decision-makers in households, effectively determining women’s access to health services. We examined husbands’ knowledge and involvement regarding MNH issues in rural Bangladesh, and how their involvement is related to women receiving MNH services from trained providers. Methods We conducted a cross-sectional survey in two rural sub-districts of Bangladesh in 2014 adopting a stratified cluster sampling technique. Women with a recent birth history and their husbands were interviewed separately with a structured questionnaire. A total of 317 wife-husband dyads were interviewed. The associations between husbands accompanying their wives as explanatory variables and utilization of skilled services as outcome variables were assessed using multiple logistic regression analyses. Results In terms of MNH knowledge, two-thirds of husbands were aware that women have special rights related to pregnancy and childbirth and one-quarter could mention three or more pregnancy-, birth- and postpartum-related danger signs. With regard to MNH practice, approximately three-quarters of husbands discussed birth preparedness and complication readiness with their wives. Only 12% and 21% were involved in identifying a potential blood donor and arranging transportation, respectively. Among women who attended antenatal care (ANC), 47% were accompanied by their husbands. Around half of the husbands were present at the birthplace during birth. Of the 22% women who received postpartum care (PNC), 67% were accompanied by their husbands. Husbands accompanying their wives was positively associated with women receiving ANC from a medically trained provider (AOR 4.5, p < .01), birth at a health facility (AOR 1.5, p < .05), receiving PNC from a medically trained provider (AOR 48.8, p < .01) and seeking care from medically trained providers for obstetric complications (AOR 3.0, p < 0.5). Conclusion Husbands accompanying women when receiving health services is positively correlated with women’s use of skilled MNH services. Special initiatives should be taken for encouraging husbands to accompany their wives while availing MNH services. These initiatives should aim to increase men’s awareness regarding MNH issues, but should not be limited to this

Legislative Documents

Also, variously referred to as: House bills; House documents; House legislative documents; legislative documents; General Court documents

A community-based cluster randomized controlled trial (cRCT) to evaluate the impact and operational assessment of “safe motherhood and newborn health promotion package”: study protocol

Abstract Background Despite considerable progress in reduction of both under-five and maternal mortality in recent decades, Bangladesh is still one of the low and middle income countries with high burden of maternal and neonatal mortality. The primary objective of the current study is to measure the impact of a comprehensive package of interventions on maternal and neonatal mortality. In addition, changes in coverage, quality and utilization of maternal and newborn health (MNH) services, social capital, and cost effectiveness of the interventions will be measured. Methods A community-based, cluster randomized controlled trial design will be adopted and implemented in 30 unions of three sub-districts of Chandpur district of Bangladesh. Every union, the lowest administrative unit of the local government with population of around 20,000–30,000, will be considered a cluster. Based on the baseline estimates, 15 clusters will be paired for random assignment as intervention and comparison clusters. The primary outcome measure is neonatal mortality, and secondary outcomes are coverage of key interventions like ANC, PNC, facility and skilled provider delivery. Baseline, midterm and endline household survey will be conducted to assess the key coverage of interventions. Health facility assessment surveys will be conducted periodically to assess facility readiness and utilization of MNH services in the participating health facilities. Discussion The current study is expected to provide essential strong evidences on the impact of a comprehensive package of interventions to the Bangladesh government, and other developmental partners. The study results may help in prioritizing, planning, and scaling-up of Safe Motherhood Promotional interventions in other geographical areas of Bangladesh as well as to inform other developing countries of similar settings. Trial registration NCT03032276

Birth preparedness and complication readiness among women and couples and its association with skilled birth attendance in rural Bangladesh

<div><p>Introduction</p><p>Despite remarkable progress in maternal and neonatal health over past two decades, maternal and neonatal mortality in Bangladesh remain high, which is partially attributable to low use of skilled maternal and newborn health (MNH) services. Birth preparedness and complications readiness (BCPR) is recommended by the World Health Organization and by the Government of Bangladesh as a key intervention to increasing appropriate MNH services. This study aims to explore the status of BPCR in a hard-to-reach area of rural Bangladesh and to demonstrate how BPCR practices is associated with birth in the presence of a skilled birth attendant.</p><p>Methods</p><p>Data was collected using multistage cluster sampling-based household survey in two sub-districts of Netrokona, Bangladesh in 2014. Interviews were conducted among women with a recent birth history in 12-months and their husbands. Univariate, bivariate, and multivariable analysis using Stata 14.0 were performed from 317 couples.</p><p>Results</p><p>Mean age of respondents was 26.1 (SD ± 5.3) years. There was a significant difference in BPCR practice between women and couples for identification of the place of birth (84% vs. 75%), identification of a birth attendant (89% vs.72%), arranging transport for birth or emergencies (20% vs. 13%), and identification of a blood donor (15% vs. 8%). In multivariable analysis, odds of giving birth in presence of a skilled birth attendant consistently increased with higher completeness of preparedness (OR 3.3 for 3–5 BPCR components, OR 5.5 for 4–5 BPCR components, OR 10.4 for all 5 BPCR components). For different levels of completeness of BPCR practice, the adjusted odds ratios were higher for couple preparedness comparatively.</p><p>Conclusions</p><p>BPCR is associated with birth in the presence of a skilled attendant and this effect is magnified when planning is carried out by the couple. Interventions aiming to increase BPCR practices should not focus on women only, as involving the couple is most likely lead to positive care-seeking practices.</p></div

Evaluation of 130 Eggplant (Solanum melongena L.) Genotypes for Future Breeding Program Based on Qualitative and Quantitative Traits, and Various Genetic Parameters

Eggplant is an essential widespread year-round fruit vegetable. This study was conducted using 130 local germplasm of brinjal to select diverse parents based on the multiple traits selection index for the future breeding program. This selection was performed focusing on 14 qualitative and 10 quantitative traits variation and genetic parameters namely, phenotypic and genotypic variance (PV and GV) and genotypic and phenotypic coefficients of variation (GCV and PCV), broad-sense heritability (hBS), genetic advance, traits association, genotype by trait biplot (G × T), heatmap analysis and multi-trait index based on factor analysis and genotype-ideotype distance (MGIDI). Descriptive statistics and analysis of variance revealed a wide range of variability for morpho-physiological traits. Estimated hBS for all the measured traits ranged from 10.6% to 93%, indicating that all the traits were highly inheritable. Genetic variances were low to high for most morpho-physiological traits, indicating complex genetic architecture. Yield per plant was significantly correlated with fruit diameter, fruits per plant, percent fruits infestation by brinjal shoot and fruit borer, and fruit weight traits indicating that direct selection based on fruit number and fruit weight might be sufficient for improvement of other traits. The first two principal components (PCs) explained about 81.27% of the total variation among lines for 38 brinjal morpho-physiological traits. Genotype by trait (G × T) biplot revealed superior genotypes with combinations of favorable traits. The average genetic distance was 3.53, ranging from 0.25 to 20.01, indicating high levels of variability among the germplasm. The heat map was also used to know the relationship matrix among all the brinjal genotypes. MGIDI is an appropriate method of selection based on multiple trait information. Based on the fourteen qualitative and ten quantitative traits and evaluation of various genetic parameters, the germplasm G80, G54, G66, and G120 might be considered as best parents for the future breeding program for eggplant improvement

Associations (adjusted odds ratio with 95% CI) between completeness of BPCR and birth in the presence of a skilled birth attendant, by women and couples.

<p>Associations (adjusted odds ratio with 95% CI) between completeness of BPCR and birth in the presence of a skilled birth attendant, by women and couples.</p

Completeness of BPCR practices among women (n = 317) and couples (n = 317).

<p>Completeness of BPCR practices among women (n = 317) and couples (n = 317).</p

BPCR good practices, by women and couples.

<p>BPCR good practices, by women and couples.</p

The percentage of different financing mechanisms adopted to meet OOP of care seeking for illnesses of under five children by type of illnesses, type of provider and background characteristics, in Bangladesh 2014.

<p>The percentage of different financing mechanisms adopted to meet OOP of care seeking for illnesses of under five children by type of illnesses, type of provider and background characteristics, in Bangladesh 2014.</p

Dhaka Food Agenda 2041 Foresight and Scenario development : Workshop Report Dhaka Food Systems project

This report is a compilation of a workshop sessions held with stakeholders engaged in a foresight and scenario develop process to develop a Dhaka Food Agenda 2041. The report describes the rationale and the different steps undertaken in the process as well as its outputs. Stakeholders have interacted and explored the Dhaka Metropolitan food system and discussed the linkages between issues in the domain of food and nutrition security, food safety, food loss and waste, fresh markets and value chains. In terms of output they have deliberated that one of the major uncertainties is the shift in diets of citizens related to the uncertainty of having thriving small and sustainable businesses versus big- companies (supermarketisation). The participants developed different scenarios and their narratives that are varying from least to most desirable situation. The workshops have led to evidence and dialogue on the needs and opportunities to aim for a sustainable and inclusive food system in Dhaka in 2041. In conclusion, the report presents the steps that will follow the scoping, mapping, analysis of drivers and trends and the scenario development feeding into the further development of the Dhaka Food Agenda 2041