Mosiur Rahman

Although antenatal care (ANC) is one of the key interventions for maternal and newborn health, simply providing ANC does not mean that facilities will be r

Background and Aims: In rural Bangladesh, despite efforts to improve maternal healthcare, women still face mistreatment during childbirth, which can affect their satisfaction with care. This study aims to investigate the prevalence of disrespect and abuse (D&A) during facility‐based childbirth, explore its impact on women's satisfaction, and identify key factors that influence these experiences, to inform strategies for improving maternal care. Methods: This facility‐based cross‐sectional study was conducted at four community clinics in rural Rajshahi, Bangladesh. The study included 400 women who gave birth in designated healthcare facilities and were preparing to leave for a postpartum room. D&A care was defined using six categories: physical abuse, non‐confidential care, non‐consented care, non‐dignified care, invasion of privacy, and abandonment. Maternal satisfaction outcomes included satisfaction with care received and willingness to recommend the facility to others. Results: 25.8% of women received D&A care. According to multivariate logistic regression analysis, mothers who gave birth at night or without the presence of birth companions, mothers who had a vaginal birth or did not receive four or more ANC visits, mothers in the poorest wealth bands, and mothers who had assisted births other than by medical professionals were more likely to report D&A care than their counterparts. There was a higher likelihood of satisfaction (adjusted odds ratio [AOR]: 3.35; 95% CI: 2.81 to 5.81) and of recommending the facility to others (AOR: 2.74; 95% CI: 1.95 to 4.23) among women who reported not having D&A experiences. Conclusions: D&A care is highly prevalent in primary healthcare settings in rural Bangladesh. The significant contributing factors identified in this study should be addressed to reduce the occurrence of D&A care.

Child morbidity has been, and still is, an enormous public health concern everywhere around the world and a major cause of child mortality in low- and middle-income countries like Bangladesh. Even if some improvements are seen with child health indicators in Bangladesh recently, the burden of child morbidity, on the other hand, remains high. This study investigated the prevalence, spatial distribution, and risk factors of child morbidity in Bangladesh utilizing data from the 2022 Bangladesh Demographic and Health Survey. Spatial analyses were carried out using Moran’s I and Getis-Ord Gi* statistics, which identified hot spots of child morbidity in Rangpur, Khulna, Barisal, and Chattogram divisions. Multilevel logistic regression analysis indicated that children aged 24–59 months (adjusted odds ratio [aOR] = 0.71; 95% CI: 0.57–0.88), children currently being breastfed (aOR = 0.82; 95% CI: 0.68–0.99), children from the richest households (aOR = 0.74; 95% CI: 0.56–0.97), and those living in rural areas (aOR = 0.78; 95% CI: 0.65–0.95) were all significantly less likely to experience morbidity. The high level of overall prevalence (33.6%) suggests a geographically targeted intervention is required as a matter of urgency, particularly in the hot spot divisions (Rangpur, Khulna, Barisal and Chattogram). These spatial results have programmatically clear implications: to enhance the prioritization of child health resources and preventive care (like addressing integrated management of childhood illness as well WASH-related interventions) at hotspots and strengthen geographically targeted monitoring to inform sub-national level planning. Understanding spatial patterns and risk factors of the morbidity will help policymakers to develop more focused interventions to decrease under-five mortality and improve child health outcomes in Bangladesh.

Childhood undernutrition remains a significant public health challenge in Bangladesh, affecting both the physical and cognitive development of children and

Background: Hypertension (HT) and diabetes mellitus (DM) are two major noncommunicable diseases (NCDs) with a high rate of comorbidity that utilize similar health system resources. Limited evidence exists, however, on the level of readiness of health facilities in Bangladesh to manage HT and integrated HT–DM care. The objective of this study was an assessment of facility readiness for HT and integrated HT–DM management and to identify key factors influencing levels of readiness. Methods: The study involved the analysis of data from 382 health facilities at or above sub-district level from the most recent nationally representative dataset, the 2017 Bangladesh Health Facility Survey (BHFS). Readiness for HT and integrated HT–DM services was assessed based on composite scores as constructed from the WHO–Service Availability and Readiness Assessment (SARA) indicators. Negative binomial regression models were applied to determine the factors associated with facility readiness. Results: Facilities showed low readiness scores for both HT and integrated HT–DM care, with mean scores of 3.72 (out of 8) and 6.71 (out of 16), respectively. Although most facilities have basic equipment like BP apparatuses (98.7%) and stethoscopes (98.8%), a huge gap is observed in the training of staff (20.5%) and availability of guidelines for management (16.6%) of HT, diagnostic tools for DM, and essential medicines including ACE inhibitors (7.3%), thiazide diuretics (12.0%), and metformin (49.4%). Significant determinants of HT readiness included type of facility, client feedback system, and the number of HT care providers, while for integrated HT-DM readiness, important predictors were a type of facility, treatment-only service provision, client feedback mechanism, and structure of user-fees. Conclusions: In Bangladesh, health facilities are still not adequately ready to deliver integrated HT-DM services, illustrating deficits in human resources, clinical protocols, diagnostics, and availability of medicines at an overall system level. There are several areas that need improvement-the need for strengthening integrated training, free availability of medicines, client feedback systems, and collaboration between the public-private-NGO sectors. The results, though based on 2017 data, remain important in capturing system readiness prior to the reform and serve as a nationally representative baseline to assess the upspring of HT and NCD program improvements in Bangladesh.

Background and Aims: Bangladesh is experiencing a rapid rise in the prevalence of diabetes mellitus (DM), imposing a significant public health challenge. Identifying the predictors of glycemic control can inform targeted intervention. The study aimed to examine the sociodemographic, behavioral, and clinical factors associated with glycemic control and to estimate their relative contributions among DM individuals. Methods: A cross‐sectional study was conducted among 500 DM individuals attending outpatient clinics in Dhaka. Data on sociodemographic, DM history and awareness, health‐related behaviors, and comorbidities were collected through structured questionnaires and medical records. Glycemic control was categorized by HbA1c levels as poor ( ≥ 8%), fair (7–7.9%), and good ( < 7%). Ordinal logistic regression was performed to identify the predictors of good glycemic control and hierarchical regression analyses were applied to assess the variance by different domains of factors. Results: Among participants, 33% had poor glycemic control, 15% had fair control, and only 52% achieved good control. Males were more likely than females to attain good glycemic control (Adjusted odds ratio [AOR] = 2.56, 95% confidence interval [CI]: 1.06–3.56). Individuals with higher secondary education or above had greater odds of achieving good control (AOR = 2.45, 95% CI: 1.07–5.39). Conversely, a DM duration ≥ 12 years reduced the odds of good control by 58%. High DM knowledge (AOR = 7.97, 95% CI: 3.53–17.99), adherence to diet (AOR = 2.99, 95% CI: 1.65–5.41), and physical activity (AOR = 1.84, 95% CI: 1.04–3.26) were significant positive predictors. Hierarchical regression analysis showed that DM history/awareness and health‐related behaviors accounted for most of the explained variance, while sociodemographic factors and comorbidities contributed less. The full model explained 23.7% of the variance. Conclusions: DM history and awareness, along with health behavior, were most influential determinants of glycemic control. Education and behavior‐focused interventions should be prioritized in DM management to improve outcomes and reduce the growing burden of DM in Bangladesh.

Objectives: Children from poor socioeconomic status (SES) households in Bangladesh and other developing countries face a heightened risk of chronic undernutrition, yet the underlying mechanisms remain unclear. This study investigates the association between poor SES and chronic undernutrition in children and explores the mediating factors driving this relationship. Methods: A cross‐sectional study was conducted in urban and rural areas of Rajshahi District, Bangladesh. A two‐phase sampling strategy was employed: five wards and five union parishads (UPs) were randomly selected, followed by stratified random sampling of 664 households (332 urban, 332 rural). Chronic undernutrition was assessed using height‐for‐age z ‐scores. SES was the primary exposure, with five mediating variables: inadequate dietary diversity and delayed breastfeeding initiation, insufficient micronutrient supplementation, disease occurrence, inappropriate health‐seeking behaviors, and poor living conditions (e.g., indoor air pollution). Mediation analysis was performed using the Baron and Kenny approach. Results: The prevalence of chronic undernutrition was 23.9%. Multivariate logistic regression revealed that children from middle and high SES households had 0.81 (95% CI: 0.71–0.93) and 0.67 (95% CI: 0.57–0.77) times lower odds of chronic undernutrition, respectively, compared to poor‐SES children. Mediation analysis identified key contributing factors: inadequate dietary diversity (17.3%), the lack of use of iodized salt (8.8%), history of recent acute respiratory infection (11%), incomplete vaccination (11.1%), and use of unclean cooking fuel (13.1%). Conclusions: Poor SES significantly increases the risk of chronic undernutrition in children, mediated by factors such as inadequate diet, disease, incomplete immunization, and poor living conditions. Targeted interventions addressing these mediators could reduce SES‐based disparities in child undernutrition.

Background and Aims: There is conflicting research regarding the negative effects of electronic gaming and addictive social media use on psychological disorders and academic achievement. Therefore, we aimed to examine the association between social media use and electronic gaming addiction with depression and academic achievement. Methods: This investigation is cross‐sectional. The selection process involved 800 adolescents enrolled in grades 9 and 10 across four public and private high schools in the Rajshahi City Corporation. The outcomes of interest were depression and academic performance. Addiction to playing electronic games and using social media (mainly Facebook) were exposure of interest. Results: From the total sample, 9.3% and 28.3% reported that they were addicted to electronic games and social media use. The mean scores for depression and academic achievement were 10.2 and 3.2, respectively. For one unit increase in depression scores, the odds of addiction to playing electronic games and using social media increase by a factor of 1.14 and 1.12. Additionally, it was found that for one unit an increase in academic performance scores, the odds of addiction to playing electronic games and using social media decrease by a factor of 0.67 and 0.71. Conclusions: Adolescents who are more likely to engage in addictive behaviors such as playing electronic games or using social media should be the focus of public health initiatives, as they are more susceptible to depression along with poor academic accomplishment.

Research on the relationship between socioeconomic status (SES), the prevalence of disability, and the use of healthcare services by people with disabilities is limited. The aim of this study is to identify socioeconomic predictors of disability and examine the utilization of healthcare services among people with disabilities in Bangladesh. We used the first national representative, the National Household Survey on Persons with Disabilities (NSPD) 2021 survey data. The data utilized in our analysis came from 100,859 people who were at least 18 years old. Standard of living (henceforth referred to as wealth) was our proxy indicator of SES. The variables of interest for the outcome were the respondents’ disability status and frequency of use of healthcare services. Adjusted odds ratio, relative, and slope inequality index are three regression-based techniques we utilized to evaluate different aspects of SES disparities in use of healthcare services and disability status. The prevalence of disability of our study sample was 3.40% and about 74.06% of people with disabilities have used healthcare services in the past three months. When compared to people in the poor SES group, people in the rich and middle SES group had 0.69 (95% CI 0.60–0.78) and 0.80 (95% CI 0.78–0.95) times lower chance of developing disability. When compared to individuals in the poor SES group, those in the rich and middle SES groups were 2.12 times (95% CI 1.55–2.89) and 1.39 times (95% CI 1.12–1.72) more likely to use of healthcare services. SES should be a key consideration in designing public health programs aimed at improving healthcare access and reducing disability prevalence in Bangladesh.