Age and sex-specific disability-free life expectancy in urban and rural settings of Bangladesh

Background Disability-free life expectancy (DFLE) has been used to gain a better understanding of the population’s quality of life. Objectives The authors aimed to estimate age and sex-specific disability-free life expectancy (DFLE) for urban and rural areas of Bangladesh, as well as to investigate the differences in DFLE between males and females of urban and rural areas. Methods Data from the Bangladesh Sample Vital Statistics-2016 and the Bangladesh Household Income and Expenditure Survey (HIES)-2016 were used to calculate the disability-free life expectancy (DFLE) of urban and rural males and females in Bangladesh in 2016. The DFLE was calculated using the Sullivan method. Results With only a few exceptions, rural areas have higher mortality and disability rates than urban areas. For both males and females, statistically significant differences in DFLE were reported between urban and rural areas between the ages of birth and 39 years. In comparison to rural males and females, urban males and females had a longer life expectancy (LE), a longer disability-free life expectancy, and a higher share of life without disability. Conclusion This study illuminates stark urban–rural disparities in LE and DFLE, especially among individuals aged < 1–39 years. Gender dynamics reveal longer life expectancy but shorter disability-free life expectancy for Bangladeshi women compared to men, emphasizing the need for targeted interventions to address these pronounced health inequalities

A Non-Linear Biostatistical Graphical Modeling of Preventive Actions and Healthcare Factors in Controlling COVID-19 Pandemic

Background: With the insurgence of the COVID-19 pandemic, many people died in the past several months, and the situation is ongoing with increasing health, social, and economic panic and vulnerability. As most of the countries relying on different preventive actions to control the outcomes of COVID-19, it is necessary to boost the knowledge about the effectiveness of such actions so that the policymakers take their country-based appropriate actions. This study generates evidence of taking the most impactful actions to combat COVID-19. Objective: In order to generate community-based scientific evidence, this study analyzed the outcome of COVID-19 in response to different control measures, healthcare facilities, life expectancy, and prevalent diseases. Methods: It used more than a hundred countries’ data collected from different databases. We performed a comparative graphical analysis with non-linear correlation estimation using R. Results: The reduction of COVID-19 cases is strongly correlated with the earliness of preventive initiation. The apathy of taking nationwide immediate precaution measures has been identified as one of the critical reasons to make the circumstances worse. There is significant non-linear relationship between COVID-19 case fatality and number of physicians (NCC = 0.22; p-value ≤ 0.001), nurses and midwives (NCC = 0.17; p-value ≤ 0.001), hospital beds (NCC = 0.20; p-value ≤ 0.001), life expectancy of both sexes (NCC = 0.22; p-value ≤ 0.001), life expectancy of female (NCC = 0.27; p-value ≤ 0.001), and life expectancy of male (NCC = 0.19; p-value ≤ 0.001). COVID-19 deaths were found to be reduced with increased medical personnel and hospital beds. Interestingly, no association between the comorbidities and severity of COVID-19 was found excluding asthma, cancer, Alzheimer’s, and smoking. Conclusions: Enhancing healthcare facilities and early imposing the control measures could be valuable to prevent the COVID-19 pandemic. No association between COVID-19 and other comorbidities warranted further investigation at the pathobiological level

Influencing factors associated with maternal delivery at home in urban areas: a cross-sectional analysis of the Bangladesh Demographic and Health Survey 2017–2018 data

Abstract Background The associated factors and patterns of giving birth in home settings of rural areas have been extensively studied in Bangladeshi literature. However, urban areas still need to be explored, particularly with recent data. Therefore, the authors aimed to investigate the influential determinants of delivery at home in urban areas of Bangladesh. Materials and methods In this study, 1699 urban-dwelling women who had given birth within the previous 60 months of the survey and lived in urban areas were used. The secondary data were extracted from the latest Bangladesh Demographic and Health Survey 2017–2018. Descriptive statistics and logistic regression were applied along with the association among selected variables were examined by the Chi-square test. Results Findings depict that 36.49% of women who lived in urban areas of Bangladesh delivered at home, whereas, 63.51% delivered at different govt. and private health care facilities. Women who lived in Chittagong [adjusted odds ratio (AOR) = 2.11, 95% CI 1.24–3.60], Barisal [AOR = 2.05, 95% CI 1.16–3.64] and Sylhet [AOR = 1.92, 95% CI 1.08–3.43] divisions have more likelihood to deliver at home (36.85%). Urban women following Christian religion [AOR = 10.71, 95% CI 1.32–86.68] have higher odds of delivering child at home (0.47%). Urban women having three or more children before her latest delivery (22.37%) and who are employed (29.37%) have more likelihood to deliver at home. However, women aged between 25 and 34 years (43.50%), who have higher education (25.90%), play the role of household head (9.06%), have parity of more than two births (2.24%), and read daily newspapers (68.69%) had a lower chance of delivery at home. Furthermore, women from wealthier families (89.12%) and more antenatal care (ANC) visits (94.93%) were less likely to have a delivery at home. Conclusion Despite significant progress in women and reproductive health in Bangladesh, the proportion of delivery in the home in urban areas is alarming and should be emphasized more. The authors believe the identified factors will help design interventions and policy development on this issue

Trends and long-term variation explaining nutritional determinants of child linear growth: analysis of Bangladesh Demographic and Health Surveys 1996–2018

Abstract Objective: To examine the height-for-age z-score (HAZ) of 0–35 months’ children along with stunting prevalence to identify trends, changes and available nutrition-sensitive and specific determinants that could help explain the long-term variation in child linear growth using successive Bangladesh Demographic and Health Surveys (BDHS) data from 1996 to 2018. Design: The BDHS pooled data are used for determining the key outcome variables HAZ, stunting and severe stunting. Trends, kernel-weighted local polynomial smoothing illustrations, pooled multivariable linear probability model (LPM), ordinary least squares method (OLS) and regression decomposition were used. Participants: Mothers having 0–35 months’ children, the most critical age range for growth faltering. Results: The mean HAZ increased by 0·91(±1·53) with 0·041 annual average change, while the percentages of stunting (–26·63 ± 0·54) and severe stunting (–21·12 ± 0·48) showed a reduction with 1·21 and 0·96 average annual changes, respectively. The average HAZ improvement (0·42 ± 1·56) in urban areas was less than the rural areas (1·16 ± 1·44). Similar patterns followed for stunting and severe stunting. The prenatal doctor visits (3064·65 %), birth in a medical facility (1054·32 %), breastfeeding initiation (153·18 %) and asset index (144·73 %) demonstrated a huge change. The findings of OLS, LPM and regression decomposition identified asset index, birth order, paternal and maternal education, bottle-fed, prenatal doctor visit, birth in a medical facility, vaccination, maternal BMI and ever-breastfed as influencing factors to predict the long-term changes of stunting and severe stunting. Conclusion: The nutrition-sensitive and specific factors identified through regression decomposition describing long-term variation in child linear growth should be focused further to attain the sustainable development goals