The impact of HIV/AIDS education through formal curriculum and texts in Bangladesh : a study on secondary and higher secondary students

Background: The education sector in Bangladesh provides students with information about HIV/ AIDS which may emerge as a major public health and socioeconomic problem affecting students. Objective: The purpose of this study was to assess the impact of HIV/AIDS education through Formal Curriculum and Texts (FCT) on secondary and higher secondary students in Bangladesh. Methods: Using multistage cluster sampling technique, a total of 384 students aged between 11- 19 years were chosen from four secondary and higher secondary institutions in Bangladesh and interviewed through a predesigned structured questionnaire. For triangulation of the quantitative findings, the study employed Key Informant Interview (KII) technique to collect qualitative data from the teachers. Results: The findings of the study show that a little more than half of the students (53.1 percent) reported that HIV/AIDS education prevented students from having unprotected intercourse while 52.60 percent of them stated that it helped to increase self-efficacy. Again, a significant proportion of the students (70.1 percent) said that HIV/AIDS education removed their misconceptions. It can be said that the textbooks of secondary and higher secondary students lack sufficient information about HIV/AIDS. Conclusion: Therefore, the Government of Bangladesh may take an initiative to include more information about HIV/AIDS in the textbooks of secondary and higher secondary students

Factors influencing COVID-19 vaccine acceptance and hesitancy among rural community in Bangladesh : a cross-sectional survey based study

Although more than one hundred million beneficiaries were administered COVID-19 vaccine until 20th February, 2022 in Bangladesh; however, proportionally a low turnout has been recorded in rural places and a substantial gap exist among the people living in rural and urban areas concerning the ratio of receiving vaccine. This study aims to investigate COVID-19 vaccine acceptance intention and to identify the potential factors influencing vaccine acceptance and hesitancy among the rural community in Bangladesh. A bilingual, self-administered anonymous questionnaire was developed, and data were collected between 10th June 2021 and 14th August 2021 through face-to-face interview. 655 rural people participated in this cross-sectional study, and sampling was done randomly. Descriptive statistics and binary logistic regressions were used to explore and rationalize study objectives. Out of 655 rural participants, 552 (84.3%, 95% CI 81.2─86.8) responded to accept COVID-19 vaccine; however, minor fractions (n = 5, n% = 0.8, 95% CI 0.12–1.4) of rural community had willingness to pay (WTP) for a COVID-19 vaccine. The result of binary regression showed that “safety,” “side effects,” “effectiveness,” and “trust” had highly significant (p <.01) and positive correlation with vaccine acceptance intention. “Rumor” had moderately significant (p <.05) and negative association while “gender” had insignificant correlation with vaccine acceptance intention. Easy and constant access to evidence-based and trustworthy information on vaccination consequences is imperative for resource-less remote people. Health communication regarding safety, side effect, and effectiveness of vaccines were identified as the most important predictor to convert vaccines to vaccinations and for ensuring mass immunization against COVID-19 in Bangladesh

A population-level data linkage study to explore the association between health facility level factors and unintended pregnancy in Bangladesh

The objective of this study was to investigate the effects of health facility-level factors, including the availability of long-acting modern contraceptives (LAMC) at the nearest health facility and its distance from women’s homes, on the occurrence of unintended pregnancy that resulted in a live birth. We analysed the 2017/18 Bangladesh Demographic and Health Survey data linked with the 2017 Bangladesh Health Facility Survey. The weighted sample comprised 5051 women of reproductive age, who had at least one live birth within 3 years of the survey. The outcome variable was women’s intention to conceive at their most recent pregnancy that ended with a live birth. The major explanatory variables were the health facility level factors. A multi-level multinomial logistic regression model was used to assess the association of the outcome variable with explanatory variables adjusting for individual, household, and community-level factors. Nearly 21% of the total respondents reported that their most recent live birth was unintended at conception. Better health facility management systems and health facility infrastructure were found to be 14–30% protective of unintended pregnancy that resulted in a live birth. LAMC availability at the nearest health facility was associated with a 31% reduction (95% CI 0.50–0.92) in the likelihood of an unwanted pregnancy that resulted in a live birth. Health facility readiness to provide LAMC was also associated with a 14–16% reduction in unintended pregnancies that ended with a birth. The likelihood of unintended pregnancy that resulted in a live birth increased around 20–22% with the increased distance of the nearest health facility providing LAMC from the women’s homes.The availability of health facilities near women’s homes and access to LAMC can significantly reduce unintended pregnancy. Policies and programs to ensure access and affordability of LAMC across current health facilities and to increase the number of health facilities are recommended

Access to mass media and awareness of sexually transmitted diseases (STDs) among the truck drivers in Dhaka City : do mass media make them aware?

The major objective of the study is to determine the association between access to mass media such as television, newspaper, radio and internet and level of STDs awareness among the truck drivers in Dhaka city. This research utilized purposive sampling technique to select 250 respondents from the study areas. The results of the study demonstrate that a significant number of respondents (88%) had heard of STDs. However, most of them (70%) did not have the awareness of STDs. It again reveals that radio, newspaper and internet did not play significant role in making them aware of STDs. Bivariate results of the study indicate that respondents with higher degree of exposure to television were more likely to be aware of STD like HIV. This study concludes that mass media may play vibrant role in disseminating information about not only HIV but also other STDs such as Chlamydia, Herpes, Hepatitis B and Human Papilloma Virus (HPV)

Socio-demographic and economic correlates of climate change coping and adaptation strategies : a study on the farmer communities in Barisal District, Bangladesh

The major objective of the study is to apply Conservation of Resource (COR) theory for examining the influence of farmers’ socio-demographic and economic correlates upon their adoption of agricultural, economic and emotion-focused coping and adaptation strategies of climate change. An interview schedule developed from the COR theory was utilized for data collection. Using multistage cluster sampling technique, a total of 384 farmers were chosen from Agailjhara Upazila of Barisal District and interviewed through a predesigned structured questionnaire. For triangulation of the quantitative findings, the study employed case study technique to collect qualitative data from the respondents. The findings of the study demonstrate that the most common emotion-focused, agricultural and economic coping and adaptation strategies of climate change were social support seeking (79.69%), planting trees (71.35%), homestead gardening (52.08%), hydroponic farming/floating garden (46.88%), duck rearing (30.73%), saving (20.83%), self-insurance (18.75%), etc. Bivariate results indicate that age, ownership of land, income and ownership of television or mobile phone were found significantly correlated with the three variables, including economic, agricultural and emotion-focused coping and adaptation strategies of COR theory. Again, access to microcredit has relationship with economic and agricultural adaptation strategies. Furthermore, education has significant relationship with agricultural adaptation strategies. The study suggests that continuous researches by policy makers, researchers, GOs and NGOs are very essential to exploring and enhancing farmers’ coping and adaptation strategies which may relegate the adverse impacts and vulnerabilities of climate change in the study area

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

Associations between family social circumstances and psychological distress among the university students of Bangladesh : to what extent do the lifestyle factors mediate?

Background: While there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress. Methods: A total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students’ socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI). Results: The multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress. Conclusion: The social and lifestyle factors operated independently to increase students’ risk of psychological distress. Accordingly, while promoting students’ healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life

Examining Bangladesh’s responses to COVID-19 in light of Vietnam : lessons learned

This review aimed to examine the extent of Bangladesh’s COVID-19 preparedness and control measures up to 20 January 2021, and to draw some lessons for informing the current and future pandemic responses in Bangladesh in light of Vietnam’s responses, which had successfully controlled the pandemic. We performed a content analysis of data to identify similarities and critical discrepancies in epidemiological features and COVID-19 responses between the two countries. Findings indicated that Vietnam reported lower COVID-19 incidence (15 cases per million) and death rate (0.4 cases per million) than Bangladesh, with 3,129 cases per million and a death rate of 46 cases per million. Vietnam reported only 35 deaths, with 22 older individuals (>60 years) compared with 7,950 deaths in Bangladesh, with the highest death rate in older people (45%). An integrated approach combined with widespread contact tracing, better health investment, vaccine development, and strong political commitment enabled Vietnam to control the disease and mitigate its impacts. In contrast, Bangladesh seemed to adopt inadequate and untimely measures in the same domains, potentially contributing to relatively high COVID-19 infections and death rates. To control COVID-19 or inform responses to future pandemics, Bangladesh and similar countries can learn eight lessons from Vietnam. Such transferable responses could prepare health systems and populations for an appropriate global response to the next potential pandemic

Changes in loneliness prevalence and its associated factors among Bangladeshi older adults during the COVID-19 pandemic

Aims Worldwide, loneliness is one of the most common psychological phenomena among older adults, adversely affecting their physical and mental health conditions during the COVID-19 pandemic. This study aims to assess changes in the prevalence of loneliness in the two timeframes (first and second waves of COVID-19 in Bangladesh) and identify its correlates in pooled data. Methods This repeated cross-sectional study was conducted on two successive occasions (October 2020 and September 2021), overlapping with the first and second waves of the COVID-19 pandemic in Bangladesh. The survey was conducted remotely through telephone interviews among 2077 (1032 in the 2020-survey and 1045 in the 2021-survey) older Bangladeshi adults aged 60 years and above. Loneliness was measured using the 3-item UCLA Loneliness scale. The binary logistic regression model was used to identify the factors associated with loneliness in pooled data. Results We found a decline in the loneliness prevalence among the participants in two survey rounds (51.5% in 2021 versus 45.7% in 2020; P = 0.008), corresponding to 33% lower odds in the 2021-survey (AOR 0.67, 95% CI 0.54-0.84). Still, nearly half of the participants were found to be lonely in the latest survey. We also found that, compared to their respective counterparts, the odds of loneliness were significantly higher among the participants without a partner (AOR 1.58, 95% CI 1.20-2.08), with a monthly family income less than 5000 BDT (AOR 2.34, 95% CI 1.58-3.47), who lived alone (AOR 2.17, 95% CI 1.34-3.51), with poor memory or concentration (AOR 1.58, 95% CI 1.23-2.03), and suffering from non-communicable chronic conditions (AOR 1.55, 95% CI 1.23-1.95). Various COVID-19-related characteristics, such as concern about COVID-19 (AOR 1.28, 95% CI 0.94-1.73), overwhelm by COVID-19 (AOR 1.53, 95% CI 1.14-2.06), difficulty earning (AOR 2.00, 95% CI 1.54-2.59), and receiving routine medical care during COVID-19 (AOR 2.08, 95% CI 1.61-2.68), and perception that the participants required additional care during the pandemic (AOR 2.93, 95% CI 2.27-3.79) were also associated with significantly higher odds of loneliness. However, the odds of loneliness were significantly lower among the participants with formal schooling (AOR 0.71, 95% CI 0.57-0.89) and with a family of more than four members (AOR 0.76, 95% CI 0.60-0.96). Conclusions The current study found a decreased prevalence of loneliness among Bangladeshi older adults during the ongoing pandemic. However, the prevalence is still very high. The findings suggest the need for mental health interventions that may include improving social interactions increasing opportunities for meaningful social connections with family and community members and providing psychosocial support to the vulnerable population including older adults during the pandemic. It also suggests that policymakers and public health practitioners should emphasise providing mental health services at the peripheral level where the majority of older adults reside

Child marriage in South Asia : a systematic review

Background: Child marriage is a serious public health issue with dire implications at the individual and societal level. Almost half of all child marriages globally originate from South Asia. The aim of this study is to identify consistent factors associated with and resulting from child marriage in South Asia through a review of available evidence. Methods: This systematic review adhered to the 2015 Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, namely PsycINFO, CINAHL, EMBASE, Ovid Medline, PUBMED, and Scopus were searched. Retrieved studies were exported to EndNote and screened for eligibility using pre-determined criteria. The quality of the included studies was rated using 14 quality appraisal criteria derived from the National Institutes of Health (NIH) Tool. Results: A total of 520 articles were retrieved from six databases. Of these, 13 articles met the eligibility criteria and were included in this study. Factors consistently associated with child marriage in South Asia were rural residence, low level of education, poor economic background, low exposure to mass media and religion (Hindu and Muslim in particular countries). Maternal health care factors resulting from child marriage included: low utilization of antenatal care services, low institutional delivery, and low delivery assistance by a skilled birth attendant. Conclusions: Child marriage results from an interplay of economic and social forces. Therefore, to address the complex nature of child marriage, efforts targeting improvement in education, employment, exposure to health information via mass media, and gender egalitarianism are required