41 research outputs found
‘‘I can’t stop worrying about everything’’-experiences of rural Bangladeshi women during the first postpartum months
Over recent years, researchers have found evidence which indicates that the prevalence of postpartum depressive symptoms
crosses cultural boundaries and is reported to be at least as high in non-Western countries as inWestern countries. However,
qualitative studies about new mothers’ experiences from non-Western countries, such as Bangladesh, are rare, particularly
in rural areas. This study aims to describe the experiences and concerns of rural Bangladeshi mothers with postpartum
depressive symptoms. Open narrative interviews were conducted with 21 mothers with depressive symptoms 2-3 months
postpartum, consecutively selected from a longitudinal study about prevalence and risk factors of perinatal depressive
symptoms. Inductive content analysis was used to analyse data and three themes emerged: family dynamics, living at the
limits of survival, and role of the cultural context after childbirth. These themes were based on six categories and 15
subcategories. The findings show that troublesome family relationships, including intimate partner violence and violence in
the family, influenced the mothers’ mental well-being. They and their families lived at the limit of survival and the mothers
expressed fear and worries about their insecure situation regarding economic difficulties and health problems. They felt
sorry for being unable to give their infants a good start in life and sad because they could not always follow the traditional
norms related to childbirth. Thus, it is important to focus on the depressive symptoms among new mothers and offer
counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the
changing Bangladeshi society today
Prevalence and Patterns of Multimorbidity among Elderly People in Rural Bangladesh: A Cross-sectional Study
Data on multimorbidity among the elderly people in Bangladesh are lacking. This paper reports the prevalence and distribution patterns of multimorbidity among the elderly people in rural Bangladesh. This cross-sectional study was conducted among persons aged ≥60 years in Matlab, Bangladesh. Information on their demographics and literacy was collected through interview in the home. Information about their assets was obtained from a surveillance database. Physicians conducted clinical examinations at a local health centre. Two physicians diagnosed medical conditions, and two senior geriatricians then evaluated the same separately. Multimorbidity was defined as suffering from two or more of nine chronic medical conditions, such as arthritis, stroke, obesity, signs of thyroid hypofunction, obstructive pulmonary symptoms, symptoms of heart failure, impaired vision, hearing impairment, and high blood pressure. The overall prevalence of multimorbidity among the study population was 53.8%, and it was significantly higher among women, illiterates, persons who were single, and persons in the non-poorest quintile. In multivariable logistic regression analyses, female sex and belonging to the non-poorest quintile were independently associated with an increased odds ratio of multimorbidity. The results suggest that the prevalence of multimorbidity is high among the elderly people in rural Bangladesh. Women and the non-poorest group of the elderly people are more likely than men and the poorest people to be affected by multimorbidity. The study sheds new light on the need of primary care for the elderly people with multimorbidity in rural Bangladesh
Prevalence and Patterns of Multimorbidity among Elderly People in Rural Bangladesh: A Cross-sectional Study
Data on multimorbidity among the elderly people in Bangladesh are
lacking. This paper reports the prevalence and distribution patterns of
multimorbidity among the elderly people in rural Bangladesh. This
crosssectional study was conducted among persons aged 6560 years
in Matlab, Bangladesh. Information on their demographics and literacy
was collected through interview in the home. Information about their
assets was obtained from a surveillance database. Physicians conducted
clinical examinations at a local health centre. Two physicians
diagnosed medical conditions, and two senior geriatricians then
evaluated the same separately. Multimorbidity was defined as suffering
from two or more of nine chronic medical conditions, such as arthritis,
stroke, obesity, signs of thyroid hypofunction, obstructive pulmonary
symptoms, symptoms of heart failure, impaired vision, hearing
impairment, and high blood pressure. The overall prevalence of
multimorbidity among the study population was 53.8%, and it was
significantly higher among women, illiterates, persons who were single,
and persons in the non-poorest quintile. In multivariable logistic
regression analyses, female sex and belonging to the non-poorest
quintile were independently associated with an increased odds ratio of
multimorbidity. The results suggest that the prevalence of
multimorbidity is high among the elderly people in rural Bangladesh.
Women and the non-poorest group of the elderly people are more likely
than men and the poorest people to be affected by multimorbidity. The
study sheds new light on the need of primary care for the elderly
people with multimorbidity in rural Bangladesh
Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: results from a population based study in Bangladesh
<p>Abstract</p> <p>Background</p> <p>There is a high prevalence of antepartum depression and low birth weight (LBW) in Bangladesh. In high- and low-income countries, prior evidence linking maternal depressive and anxiety symptoms with infant LBW is conflicting. There is no research on the association between maternal mental disorders and LBW in Bangladesh. This study aims to investigate the independent effect of maternal antepartum depressive and anxiety symptoms on infant LBW among women in a rural district of Bangladesh.</p> <p>Methods</p> <p>A population-based sample of 720 pregnant women from two rural subdistricts was assessed for symptoms of antepartum depression, using the Edinburgh Postpartum Depression Scale (EPDS), and antepartum anxiety, using the State Trait Anxiety Inventory (STAI), and followed for 6-8 months postpartum. Infant birth weight of 583 (81%) singleton live babies born at term (≥37 weeks of pregnancy) was measured within 48 hours of delivery. Baseline data provided socioeconomic, anthropometric, reproductive, obstetric, and social support information. Trained female interviewers carried out structured interviews. Chi-square, Fisher's exact, and independent-sample <it>t </it>tests were done as descriptive statistics, and a multiple logistic regression model was used to identify predictors of LBW.</p> <p>Results</p> <p>After adjusting for potential confounders, depressive (OR = 2.24; 95% CI 1.37-3.68) and anxiety (OR = 2.08; 95% CI 1.30-3.25) symptoms were significantly associated with LBW (≤2.5 kg). Poverty, maternal malnutrition, and support during pregnancy were also associated with LBW.</p> <p>Conclusions</p> <p>This study provides evidence that maternal depressive and anxiety symptoms during pregnancy predict the LBW of newborns and replicates results found in other South Asian countries. Policies aimed at the detection and effective management of depressive and anxiety symptoms during pregnancy may reduce the burden on mothers and also act as an important measure in the prevention of LBW among offspring in Bangladesh.</p
The emerging elderly population in Bangladesh : Aspects of their health and social situation
Background: Bangladesh is one of the twenty countries in the world with
the largest elderly populations, and by 2025, along with four other Asian
countries, will account for 44% of world's total elderly population. This
rapidly increasing population is a new and important group in terms of
social and health policy in the country.
Aim: This thesis aims to establish a knowledge base about aspects of the
health and social situation of elderly people in rural and urban
Bangladesh. It also aims to adapt existing instruments assessing health
status in terms of gender sensitivity and cultural relevance in the
cultural context of Bangladesh.
Material and methods: A multi-stage sampling method was used to select
the study sample of elderly men and women aged 60 years and older (N=786)
for a multi-dimensional survey. With a nonresponse rate of 10.8% (urban:
17.9%; rural: 2.5%), 701 elderly persons were interviewed. Information
about elderly people was collected under the broad categories: i)
Socio-demographic information; ii) Household composition; iii)
Socio-economic information and family support; iv) Contribution of
elderly person in household work; v) Use of health care facilities; vi)
Functional ability and sources of assistance for managing activities of
daily living and instrumental activities of daily living. Cognitive
function was also assessed using a modified version of Mini-Mental State
Examination (MMSE) adapted for the study.
Results: Socio-economic and demographic characteristics of elderly
persons in Bangladesh indicate: a high proportion of men (app 90%) were
married while women were widowed (67%); 98% of all elderly people
reported having children; intergenerational co-residence with sons was
common; and more than 70% of elderly men reported being in paid work
while elderly women reported unpaid work.
The Bangla Adaptation of Mini-mental State Examination, BAMSE, a modified
Mini-Mental State Examination (MMSE), adapted for the cultural context of
Bangladesh and not requiring literacy as a precondition, demonstrated
satisfactory test properties in comparison to MMSE. Association between
the two instruments was significant (r=0.57), and the test-retest
reliability was good (r=0.70). More importantly, BAMSE was found to be
less sensitive to age and education than MMSE.
Modified assessment instruments of activities of daily living (ADL) and
instrumental activities of daily living (IADL) indicated differential
performance in ADL and IADL tasks by gender and region. Socio- economic
status was found to influence IADL tasks only. Empirical data regarding
type of help used and reason for not performing a task enables
understanding of socio-cultural and structural influence on functional
ability. Based on this data, socio-cultural and structural factors are
suggested to be strong determinants of task performance.
More than 95% of the elderly people reported experiencing health problems
and most reported multiple health problems. More health problems were
reported by women compared to men and in the rural region compared to the
urban. Socio-economic factors were found to have little influence on
reporting of health problems. In terms of provision of support, support
from family members in old age was found to be strong in Bangladesh. The
role of providers of support, i.e. emotional, practical or material, was
primarily shared between spouse, daughter, son and daughter-in-law. While
elderly people reported receiving support from their family members, they
also reported providing support in the functioning of their own
households, both financially and with household activities.
Implications: The importance of adapting research methodologies according
to context is highlighted. Given the contribution of elderly people in
terms of paid and unpaid work, re-definition of indicators such as
dependency ratio is called for. Regional variation in performance of
health measures may indicate influence of social and structural factors.
Welfare of the elderly people is an issue that concerns both the elderly
persons themselves as well as their families in Bangladesh and
policymakers need to address the issue in the context of the family and
not only the individual. Differences within the elderly population, such
as regional and gender, need to be recognised in formulating social and
health policies for elderly people in Bangladesh
No place is safe: Sexual abuse of children in rural Bangladesh
During July 2007 to June 2010, BRAC, a nongovernment organization in Bangladesh, reported 713 incidents of rape and attempted rape of children (< 18 years) in rural Bangladesh. This study explores these 713 incidents to identify possible patterns related to the victims, perpetrators, and different dynamics of the incidents. Rape and attempted rape, particularly of young girls, constituted 64% of all reported incidents of violence against children. Children were found to be abused by men from all walks of life, mainly by non-family-members (83%). Similar diversity was seen in the location, time, and context of the incidents. The present study attempts to put forward an overall picture of the depth of the problem of child sexual abuse in rural Bangladesh, linking the incidents with the socially constructed gender relations of power and how it perpetuates sexual abuse of children, especially girls
Lessons learned from pandemic response to COVID-19 in Bangladesh: NGO-based emergency response framework for low- and middle-income countries
Abstract Background Response to COVID-19 pandemic in Bangladesh was led by the Government of Bangladesh aided by Non-Government Organisations (NGO) among others. The aim of the study was to explore the activities of such an NGO to understand the philosophy, aspiration and strategy to plan and implement an effective response to COVID-19 pandemic in Bangladesh. Methods A case study of a Bangladeshi NGO called SAJIDA Foundation (SF) is presented. From September to November 2021, using document review, field observation and in-depth interviews, four aspects of their COVID-19 pandemic related activities was explored – a) why and how SF initiated their COVID response; b) what adaptations were made to their usual programmes; c) how SF’s response to COVID-19 were designed and what were the anticipated challenges including overcoming measures; and d) perception of the staff about SF’s activities related to COVID-19. Fifteen in-depth interviews were conducted with three groups of SF staff: frontliners, managers and leaders. Result The impact of COVID-19 has been beyond health emergencies and posed multidimensional challenges. SF took a two-pronged approach – aid the government to respond to the emergency and adopt an all-inclusive plan to address diverse challenges related to overall well-being of the population. The underlying strategy of their response has been to: define the challenge of COVID-19 and identify required expertise and resources, ensure people’s health and social wellbeing, adjust existing organisational processes, ensure functional partnership with other organisations for effective resource and task sharing, and safeguard health and wellbeing of the organisation’s own employees. Conclusion The findings suggest a ‘4C framework’ including four components as the basis of a comprehensive response to emergencies by NGOs: 1. Capability assessment to identify who are in need and what is needed; 2. Collaboration with stakeholders to pool resources and expertise; 3. Compassionate leadership to ensure health and social safety of the employees which ensures their dedication in managing the emergency; and 4. Communication for quick and effective decision making, decentralisation, monitoring and coordination. It is expected that this ‘4C framework’ can help NGOs to embark on a comprehensive response to manage emergencies in resource constrained low- and middle-income countries
Impact of intimate partner violence on infant temperament
Intimate partner violence (IPV) during the first year postpartum is common in Bangladesh, and many infants are exposed to hostile and aggressive environment. The aim of the current study was to investigate how IPV (physical, emotional, and sexual) impacts on the mother’s perception of her infant’s temperament 6 to 8 months postpartum, and whether maternal depressive symptom at 6 to 8 months postpartum is a mediator in this association. A total of 656 rural Bangladeshi women and their children 6 to 8 months postpartum were included in this study. Data were collected by structured interviews. The women were asked about physical, sexual, and emotional IPV; depressive symptoms (Edinburgh Postnatal Depressive Symptoms [EPDS]); and their perception of infant temperament assessed by the Infant Characteristic Questionnaire (ICQ). Descriptive analyses were conducted for prevalence of IPV and maternal depressive symptoms. Mediation analysis was conducted with a series of linear regressions with types of IPV as independent variables, ICQ including its subscales as dependent variables and maternal depressive symptoms as potential mediator. All the analyses were adjusted for the woman’s and her husband’s ages and number of children of the couple. Nearly 90% of the mothers reported some kind of IPV at 6 to 8 months postpartum. All types of IPV were directly associated with the mother’s perception of her infant as unadaptable. Maternal depressive symptom was a mediating factor between physical IPV and the ICQ subscales fussy-difficult and unpredictable. In addition, depressive symptoms mediated between sexual and emotional IPV, and the mother’s perception of the infant as unpredictable. The results showed that IPV influenced how mothers perceived their infant’s temperament. It is important that health care professionals at maternal and child health services enquire about IPV with possibilities to refer the family or the mother and infant for appropriate support
Dynamics of health care seeking behaviour of elderly people in rural Bangladesh
Bangladesh is projected to experience a doubling of its elderly population from the current level of 7 million to 14 million by the end of the next decade. Drawing upon qualitative evidence from rural Bangladesh, this article focuses on coping strategies in cases of illness of elderly people and the contributing factors in determin-ing the health-seeking behaviour of elderly persons. The sample for this study consisted of elderly men and women aged 60 years or older and their caregivers. Nine focus group discussions and 30 in-depth interviews were conducted. Findings indicate that old age and ill-health are perceived to be inseparable entities. Seeking health care from a formally qualified doctor is avoided due to high costs. Familiarity and accessibility of health care providers play important roles in health-seeking behaviour of elderly persons. Flexibility of health care providers in receiving payment is a crucial deciding factor of whether or not to seek treatment, and even the type of treatment sought