Exploring knowledge and practices regarding menstrual hygiene management among Bihari women in the Geneva Camp in Bangladesh

Background: Research into menstrual hygiene management (MHM) has been mainly based on menstruation-related knowledge and practices of women and girls in the mainstream Bangladeshi society; socially disadvantaged groups, such as the Bihari refugee women, have largely been ignored. Purpose: This study aims to assess knowledge and practices about MHM among Bihari women in the Mohammadpur Geneva Camp in Dhaka, Bangladesh. Methods: In 2017, a cross-sectional survey was conducted among Bihari women and girls by the trained interviewers using a structured questionnaire. The purposive sampling was applied to select 160 Bihari women aged between 15 and 49. Data were entered, cleaned, and analysed using SPSS software. Both univariate and bivariate analyses were undertaken to examine knowledge and MHM-related practices with a significance level of p<0.01. Results: Overall, most women (59.4%) had low knowledge about menstruation. More than one-quarter (27.0%) used disposable sanitary napkins. The Bihari women who did not use sanitary pads (73%) reported that they used old disposable clothes (59.83%), reusable cloths (25.64%), cotton (9.40%), or toilet tissue paper (4.27%). Around two-thirds of the women (68.0%) performed special baths and 36.9% followed socio-cultural taboos during menstruation. The bivariate analyses revealed that higher menstruation knowledge was associated with higher use of disposable sanitary napkins (low knowledge: 18.9%, high knowledge: 38.5%; p<0.01). Conclusions: The findings suggest that it is imperative for Bihari women to have adequate and appropriate menstruation knowledge so that they can maintain good menstrual hygiene practices. The findings highlight challenges experienced by the refugee women in maintaining MHM and can be used to improve women’s reproductive health and well-being and reduce the risk of reproductive tract infections (RTI) among socially disadvantaged women

Rumours and social stigma as barriers to the prevention of coronavirus disease (COVID-19) : what solutions to consider?

Globally, multiple factors have elevated the risk and contributed to the fast spread of COVID-19. Alongside this, unsolicited rumours and social stigma are believed to be two possible barriers to the effective prevention of the disease. Despite measures taken, rumours and social stigma related to COVID-19 tend to increase globally. Several studies document that rumours and social stigma may fuel the risk and rapid spread of COVID-19. However, how these rumours and social stigma act as barriers to the prevention of the COVID-19 outbreak remain unclear. This article aims to discuss how rumours and social stigma can undermine the preventive and clinical efforts to fight against the spread of COVID-19 and suggest potential policy implications for addressing rumours and social stigma and optimising preventive efforts. A narrative review of secondary sources of data, including published studies, grey literature and authentic press reports was conducted. The analysis indicates that unverified rumours associated with COVID-19 may weaken people’s preparedness for a new infectious disease by driving them to wrong treatment and preventing them from adhering to evidence-based medical suggestions and treatment. Findings also suggest that social stigma may reduce healthcare workers’ agency and self-respect to provide support, treatment and care for those with COVID-19. Social stigma may also constrain participation in screening, testing, quarantine, isolation, and treatment of the disease. This article offers six potential policy pathways and emphasises the national and international coordination of all stakeholders for addressing rumours and social stigma associated with COVID-19

Migrant and refugee youth perspectives on sexual and reproductive health and rights in Australia : a systematic review

Migrant and refugee youth (MRY) in Australia face specific experiences that inform their sexual and reproductive health and rights (SRHR). Migrant and refugee communities experience poor health outcomes and low service uptake. Additionally, youth are vulnerable to poor sexual health. This review examines the understandings and perspectives of MRY. A systematic review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol is registered with PROSPERO: CRD42021241213. Nine databases were systematically searched. Inclusion criteria specified literature reporting on migrant and/or refugee youth perspectives and attitudes towards sexual and reproductive health; peer-reviewed qualitative, mixed-methods and/or quantitative studies or grey literature reports; records using Australian research; literature published in English between January 2000 and March 2021. Records that did not report on MRY and did not examine participant views or perspectives; were abstract-only, reviews, pamphlets, protocols, opinion pieces or letters; did not include Australian research; were published before 2000 and/or in a language other than English were excluded. Two reviewers screened titles, abstracts and full-text articles. The Mixed Method Appraisal Tool was used to assess studies' methodological quality. Thematic synthesis methods guided data extraction and analysis. Twenty-eight papers were included in the final review. Three themes were identified in MRY constructions of SRHR: (1) experiences of silence and shame; (2) understandings of and responses to SRHR risks; (3) navigation of relationships and sexual activity. Socioecological factors shaped MRY perspectives at individual, interpersonal, institutional and societal levels. Societal factors and interpersonal relationships significantly influenced decision making

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Stigma and discrimination related to HIV/AIDS: a study of the Iranian community in the Sydney metropolitan area

Abstract presented at the XVI International AIDS Conference, 13-18 August 2006, Toronto, Canad

Stigma and discrimination related to HIV/AIDS

Abstract presented at the Fifth Health Research Conference 2006, 9-10 November 2006, Leura, Australi

Functional analysis of HIV/AIDS stigma: Consensus or divergence?

Functional theory proposes that attitudes may serve a variety of purposes for individuals. This study aimed to determine whether stigmatized attitudes toward HIV/AIDS serve the same function for all (consensus function) or serve different functions for different individuals (divergence function) by assessing various aspects of HIV/AIDS stigma using a sample of 236 adults aged 20 to 65 years from the Iranian community living in Sydney, Australia in 2007. Respondents were classified as evaluatives or expressives based on their responses to attitude function inventory scale. HIV/AIDS-related attitudes in the study group were found to have more of an expressive (58.5%) than an evaluative function (32.2%). Multiple regression analyses revealed that various aspects of HIV/AIDS stigma were functionally divergent within the study group and could serve evaluative and expressive function. The study\u27s findings suggest that different messages should be presented to different audiences depending on whether the stigma performs an expressive or evaluative function

Levels and functions of HIV/AIDS stigma within the Iranian community living in the Sydney metropolitan area

Objective: This study examines the levels of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) related stigma among the Iranian population and the factors that contribute to the formation of stigma within the study population. Design: A quantitative research design was used in this research whereby participants completed a self-administrated questionnaire. A sample of 236 adults aged 20-65 were collected using non-probability sampling techniques. Setting: The study was carried out in the Sydney (Australia) metropolitan area and data were collected in 2007. Method: To obtain a desirable sample size, multivariate techniques including snowball were used. Herek\u27s (1986) functional approach to attitudes was used to analyze HIV/AIDS stigma in the study population. Results: The findings illustrate that HIV/AIDS-related stigma was dominant among the study population. Overall, participants had negative feelings toward people with HIV/AIDS (PWHA); they were in favour of punitive policies against them and were more likely to avoid having contact with people who had contracted HIV/AIDS. Multiple regression analysis revealed that both instrumental (fear of contamination) and symbolic factors (attitudes towards homosexuals and injecting drug user) independently contributed to HIV/AIDS stigma. Conclusion: The findings suggest that HIV/AIDS stigma has instrumental and symbolic function, and concentrating solely on instrumental (HIV/AIDS transmission routes) factors is less likely to address it properly. Therefore, educational campaigns to reduce HIV/AIDS stigma should also focus on symbolic factors. The findings contribute to the knowledge area of better understanding of HIV/AIDS stigma among ethnic minorities of similar characteristics. The results are valuable for the Iranian community, health service providers, health educators and policy makers

Perceived stigma and social risk of HIV testing and disclosure among Iranian-Australians living in the Sydney metropolitan area

Background: Fear of being stigmatised is a major social risk for seeking help in the HIV/AIDS arena. However, little is known about the social perceptions that people hold about the disease. This study explores the level of perceived stigma and its effect on the social risk of HIV testing and disclosure among Iranian-Australians immigrants living in the Sydney metropolitan area. Methods: A total of 236 Iranian-Australians immigrants aged 20–65 years participated in this cross-sectional study. Results: The majority of respondents (73.3%) perceived that HIV-infected people face a great deal of or some stigma. Participants were concerned about being stigmatised if they tested positive or were known to be HIV-positive in the future. A significant majority expressed that such concerns would affect their decision-making related to HIV testing and disclosure. Females were more likely to perceive HIV/AIDS stigma. Multiple regression analyses showed that perceived HIV/AIDS stigma could explain 28.6% of the variance in social risk of HIV testing and disclosure (B = 0.89, β = 0.53, P \u3c 0.0001) and 24.6% of the variance in decision-making related to HIV testing and disclosure (B = 0.62, β = 0.49, P \u3c 0.0001) after controlling for sociodemographic factors. Time since migration (predictive power of 4.8–6.78%) strongly influenced the associations. Conclusions: If social stigma is left unaddressed, individuals would be reluctant to undertake HIV testing or disclose their HIV status if tested positive. Further attempts are needed to change the current social construction of HIV/AIDS among Iranians-Australians living in Sydney