A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol

PRIFPRI3; CRP4; ISIPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH

Effect of nonplastic silt content on undrained shear strength of sand–silt mixtures

Abstract To assess the behavior of sand–silt mixtures, strain-controlled monotonic triaxial tests were conducted on sand–silt mixtures of specimen size 71 mm in diameter and 142 mm in height at various relative densities but same isotropic effective confining pressure of 100 kPa. Concept of limiting fines content (LFC) was verified by these undrained monotonic triaxial tests. LFC was found to be the very important parameter to understand the behavior of sand–silt mixtures. The behavior of sand–silt mixture changes approximately at LFC. At constant relative density, increase in silt content decreases the undrained peak shear strength till LFC. After LFC the strength becomes near about same till pure silt sample. The reason of behavior could not be explained. At constant global void ratio, the peak shear strength decreases with increase in silt content till LFC and for further increment of silt content the peak shear strength increases. Sand–silt mixtures containing certain amount of silt which is near to the LFC showed flow type as well as brittle behavior. Failure of structure on this type of soil will be catastrophic during earthquake. In the case of permeability decreased with increasing silt content up to LFC. After the LFC, dry density is decreasing with increasing silt content but permeability remains constant till pure silt

Effect of salinity of water in lime-fly ash treated sand

Abstract Ensuring sustainable development of coastal areas need improvement of road embankment infrastructure. Being a byproduct of industry, fly ash may be considered as environment friendly and low cost material for this purpose. However, scarcity of fresh water in coastal areas may compel to use saline water. To investigate the effects of sodium chloride content of mixing water on fly ash and lime mixed compacted sand, a series of the unconfined compression tests have been conducted on 50 mm diameter and 100 mm high specimens. Lime content was varied over a range of 1–5% of dry sand weight and fly ash contents were 9, 15 and 30% of dry sand weight. Besides, 0, 4 and 8% of sodium chloride were mixed with tap water, which were used for preparing specimens at 10% moisture content by compaction method. The specimens were cured for 7, 15, 30 and 60 days by spraying method. Experiment results show that, the unconfined compression strength of fly ash and lime mixed compacted sand increases with the increase in sodium chloride content. However, the long term effect of using saline water in fly ash and lime mixed compacted sand should be investigated, which is out of scope of this study

Systematic review and meta-analysis of prevalence of, and risk factors for, pelvic floor disorders in community-dwelling women in low and middle-income countries:A protocol study

INTRODUCTION: Pelvic floor disorders (PFDs) including urinary incontinence, faecal incontinence and pelvic organ prolapse are common debilitating conditions among women in high-income countries. However, PFDs in women in low/middle-income countries (LMICs) have not been studied extensively. We aim to conduct a systematic review and meta-analysis of the available literature to determine the prevalence of, and/or risk factors for, PFDs in women in LMIC. METHODS AND ANALYSIS: We will search electronic databases including MEDLINE, EMBASE, PsycINFO, CINAHL, Maternity & Infant Care and Google Scholar for eligible studies. Inclusion criteria will be observational studies of healthy women, which have collected data using validated or non-validated tools, are published in English and were conducted in community women in LMICs, defined by the World Bank. A standardised data extraction form will be developed and piloted, based on the template of the Cochrane good practice data extraction form. All included studies will be assessed based on a risk-of-bias tool specifically developed for prevalence studies. Pooled prevalence estimates of PFDs will be generated using RevMan V.5.2.1 software. Forest plots will be generated to display the overall random-effects pooled estimates with CIs. A metaregression will be conducted to identify sources of between-study heterogeneity in the pooled prevalence estimates. We will quantify heterogeneity using the I2 measure and its CI. We will use funnel plots to detect potential reporting biases and small-study effects. We will also conduct a sensitivity analysis to verify the robustness of the study conclusions, assessing the impact of methodological quality, study design, sample size and the effect of missing data. ETHICS AND DISSEMINATION: Our review is entirely based on published data. Thus, an ethics committee approval or written informed consent will not be required for this study as primary data will not be collected. The results will be disseminated by publication of the manuscript in a peer-reviewed journal and/or will be presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42016043881

Bottleneck analysis of maternal and newborn health services in hard-to-reach areas of Bangladesh using 'TANAHASHI' framework': An explanatory mixed-method study.

Maternal and Newborn Health (MNH) is of paramount importance in the realm of attaining sustainable development goals that also focuses on universal health coverage (UHC). The study aimed at identifying and exploring the bottlenecks in MNH services in Hard-to-reach (HtR) areas of Bangladesh using the Tanahashi framework exploring the possible remedial approaches. The study was conducted in four different types of HtR areas (hilly, coastal, lowlands, and river islands) by utilizing a sequential explanatory mixed-method design. Overall, we collected information from 20 health facilities and 2,989 households by interviewing 2,768 recently delivered women (RDW) with a structured questionnaire and qualitative interviews (n = 55) of facility managers, local stakeholders, RDWs, and health care providers (HCP). The quantitative data were analyzed principally for descriptive statistics and the qualitative data was analyzed by utilizing the thematic approach. Antenatal care, under-5 care, and family planning services were available in almost all the facilities. However, Normal vaginal deliveries were performed in 55.6% of the union-level facilities. Only 40% of sub-district level facilities had provision for C-sections. Blood transfusion services were available in only 20.1% of facilities, whereas laboratory services were obtainable in 51.7% of facilities. Overall, the bottlenecks were identified in cases of availability of drugs, human resources, transportation, lack of knowledge regarding different essential services and health components, out of pocket expenditure etc. There have been several remedial approaches suggested from both the demand and supply side that included incentives for care providers for staying in these areas, a coordinated transport/referral system, and health education campaigns. More research works are warranted in HtR areas, especially to test the proposed interventions. Meanwhile, the government should take the necessary steps to overcome the bottlenecks identified

Prevalence and factors associated with caesarean section in four Hard-to-Reach areas of Bangladesh: Findings from a cross-sectional survey.

BackgroundCaesarean section (C-section) is a major obstetric life-saving intervention for the prevention of pregnancy and childbirth related complications. Globally C-section is increasing, as well as in Bangladesh. This study identifies the prevalence of C-section and socio-economic and health care seeking related determinants of C-section among women living in hard-to-reach (HtR) areas in Bangladesh.MethodsA cross-sectional survey was conducted using a structured questionnaire between August and December 2017 at four distinct types of HtR areas of Bangladesh, namely coastal, hilly, haor (wetland), and char areas (shallow land-mass rising out of a river). Total 2,768 women of 15-49 years of age and who had delivery within one year prior to data collection were interviewed. For the analysis of determinants of C- section, the explanatory variables were maternal age, educational status of women and their husbands, women's religion, employment status and access to mobile phone, wealth index of the household, distance to the nearest health facility from the household, the number of ANC visits and presence of complications during pregnancy and the last childbirth. Logistic regression model was run among 850 women, who had facility delivery. Variables found significantly associated with the outcome (C-section) in bivariate analysis were included in the multivariable logistic model. A p-value ResultsOf the 2,768 women included in the study, 13% had C-sections. The mean (±SD) age of respondents was 25.4 (± 0.1) years. The adjusted prevalence of C-section was 13.1 times higher among women who had their delivery in private facilities than women who delivered in public facilities (Adjusted Odds Ratio, AOR: 13.1; 95% CI 8.6-19.9; p-value: ConclusionsThe study identifies that the prevalence of C-sections in four HtR areas of Bangladesh in substantially below the national average, although, the prevalence was higher in coastal areas than three other HtR regions. Both public and private health services for C-section should be made available and accessible in remote HtR areas for women with pregnancy complications. Establishment of an accreditation system for regulating private hospitals are needed to ensure rational use of the procedure