Design criteria: urban WSS Bangladesh

Design criteria: urban WSS Banglades

Water sanitation and hygiene status in the neighbourhood of Bangladeshi Islamic schools and mosques

Faith based interventions have been underutilized to improve water, sanitation and hygiene status and offers promise to promote behaviour in the community. Prior to delivering a faith based WASH intervention, we conducted a survey among the neighbouring households of eight Bangladeshi Islamic schools and associated mosques. We randomly selected 192 families from where any male attend mosque and interviewed adult women from that family. At baseline, almost all households used improved water sources and improved toilets. However, toilet cleanliness was poor. Faecal matter was disposed into the environment after emptying the pit/septic tank. Defecation and disposal among children <3years mostly occurred directly in the open which should be improved using behaviour change recommendations. Presence of hand washing agent in the hand washing place was low. Islamic faith based intervention should be designed and delivered in way that can promote hand washing, safe sanitation practices and safe disposal of child faeces

Human exposure to antimicrobial resistance from poultry production: assessing hygiene and waste-disposal practices in Bangladesh

The unregulated use of antibiotics is linked with intensive poultry farming in developing economies. In low-and middle-income countries, the dissemination of antimicrobial resistance (AMR) has also been attributed to contamination, poor public health infrastructure and inadequate waste disposal practices. There are limited data on hygiene and waste disposal practices in small-scale commercial and household poultry farming and market sales in Bangladesh. Our objective was to explore human exposures, hygiene and waste disposal practices in poultry raising and processing to identify probable pathways for transmission of AMR bacteria. We employed mixed methods approaches of in-depth interviews and structured observations to assess exposures, hygiene behaviours and waste-disposal practices relating to poultry production in Bangladesh. Interviews (n=18) were conducted with commercial poultry farmers, backyard poultry owners, and live poultry market workers. Structured observations were conducted for six-hours in five households, five commercial farms and five urban live bird markets to assess the frequency of transmission/ exposure events in these settings. Interviews highlighted existing practices that can contribute to transmission of antimicrobial resistant bacteria from poultry to humans. In households and farms, untreated poultry waste and carcasses were disposed of on agricultural fields and in water bodies which may contaminate surface water and soil with poultry faeces. Biosecurity precautions were not used, and hands were rarely washed with soap after handling poultry. In urban markets, live poultry slaughter and processing was done on site with bare hands which were subsequently rinsed in water stored in containers without soap. Solid waste from poultry processing was disposed into municipal waste disposal stations and liquid waste was discarded into open drains. Structured observations revealed that workers in live poultry markets had the highest direct contact with poultry and poultry waste, almost tenfold higher than those working in poultry farms or with domestic poultry (59 vs 544 observed direct poultry exposure events) placing them at particularly high risk of exposure to faecal bacteria. Biosecurity measures were limited; in some cases, workers in commercial farms and urban markets had gloves and masks but often did not use them. In 88% (606/689) of exposure events no handwashing took place. Eating and drinking after handling poultry and without washing hands was observed in all three settings. These data suggest effective intervention strategies to reduce environmental contamination and to decrease risks of transmission should be prioritized. Data on prevalence of risk behaviours and AMR transmission to humans along environmental pathways can inform policy and intervention strategies

Drivers of antibiotic use in poultry production in Bangladesh: dependencies and dynamics of a patron-client relationship

Background: There is increasing concern around the use of antibiotics in animal food production and the risk of transmission of antimicrobial resistance within the food chain. In many low and middle-income countries, including Bangladesh, the commercial poultry sector comprises small-scale producers who are dependent on credit from poultry dealers to buy day-old chicks and poultry feed. The same dealers also supply and promote antibiotics. The credit system is reliant upon informal relationships among multiple actors as part of social capital. This paper aims to describe dependencies and relationships between different actors within unregulated broiler poultry production systems to understand the social and contextual determinants of antibiotic use in low-resource settings. Methods: We used a cross-sectional qualitative design including in-depth interviews among purposefully selected commercial poultry farmers (n = 10), poultry dealers (n = 5), sales representatives of livestock pharmaceutical companies (n = 3) and the local government livestock officer as a key-informant (n = 1). We describe the food production cycle and practices relating to credit purchases and sales using social capital theory. Findings: Poultry dealers provide credit and information for small-scale poultry farmers to initiate and operate their business. In return for credit, farmers are obliged to buy poultry feed and medicine from their dealer and sell their market-ready poultry to that same dealer. All farms applied multiple antibiotics to poultry throughout the production cycle, including banned antibiotics such as colistin sulfate. The relationship between dealers and poultry farmers is reciprocal but mostly regulated by the dealers. Dealers were the main influencers of decision-making by farmers, particularly around antibiotic use as an integral part of the production cycle risk management. Our findings suggest that strategies to improve antibiotic stewardship and responsible use should exploit the patron-client relationship which provides the social and information network for small-scale farmers. Conclusion: Social capital theory can be applied to the patron-client relationship observed among poultry farmers and dealers in Bangladesh to identify influences on decision making and antibiotic use. Within unregulated food production systems, strategies to promote the prudent use of antibiotics should target commercial feed producers and livestock pharmaceutical manufacturers as a first step in developing a sustainable poultry value chain

Additional file 1: of It’s not only what you say, it’s also how you say it: communicating Nipah virus prevention messages during an outbreak in Bangladesh

Frequently asked questions and responses in the community meetings. This file includes list of questions that participants frequently asked to the facilitators (research team) during four meetings with community residents and the detailed responses the facilitators provided to the participants. This additional data will help the readers to get an overview of practical sessions how to deal the affected residents during an outbreak situation and respond to their concerns. The description included in the file also supported the basis of several points we presented under the “Results” section. (DOCX 24 kb

Mean Self-Efficacy in Addressing Menstrual Needs Scale (SAMNS) scores by responses to validation items (n = 381).

Mean Self-Efficacy in Addressing Menstrual Needs Scale (SAMNS) scores by responses to validation items (n = 381).</p

Questionnaire instructions and response options developed for the Self-Efficacy in Addressing Menstrual Needs Scale, tested in Bangladesh, 2017–2018.

Questionnaire instructions and response options developed for the Self-Efficacy in Addressing Menstrual Needs Scale, tested in Bangladesh, 2017–2018.</p

Self-Efficacy in Addressing Menstrual Needs Scale (SAMNS-26) [Bengali version].

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Process of development and testing of the Self-Efficacy in Addressing Menstrual Needs Scale in 8 urban and rural schools in Bangladesh 2017–2018.

Process of development and testing of the Self-Efficacy in Addressing Menstrual Needs Scale in 8 urban and rural schools in Bangladesh 2017–2018.</p

Exemplar tasks across categories which girls enact to address their menstrual needs, as reported by schoolgirls in Bangladesh during focus group discussions for the development of the Self-Efficacy in Addressing Menstrual Needs Scale, 2017–2018.

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