Suchergebnisse

Background: Obstetric fistula is one of themost serious and devastating childbirth-related injuries women suffer worldwide. This study investigated the association between delivery characteristics and the occurrence of obstetric fistula in Afghanistan. Methods: The study analysed data from the 2015 Afghanistan Demographic and Health Survey. The association between place of delivery and assistance during delivery with experience of fistula symptoms was investigated by fitting two binary logistic regression models. Results: Findings from this study revealed that 23.4% of the women surveyed ever heard about obstetric fistula and 3% reported symptoms of fistula. Women whose deliveries were assisted by traditional birth attendants were significantly more likely to experience fistula compared with those whose deliveries were assisted by doctors. Similarly, women whose deliveries were assisted by others were significantly more likely to experience fistula compared with women whose deliveries were assisted by doctors. Regarding place of delivery, women whose deliveries took place at a government hospital were less likely to experience fistula compared with those whose deliveries took place at home. Conclusions: This study highlights the importance of skilled delivery in reducing the risk for obstetric fistula among women in Afghanistan. Therefore, it is important for the various stakeholders in Afghanistan's healthcare delivery system, including healthcare providers, local authorities and international non-governmental organisations, to collaborate and institute measures that will promote health facility deliveries and improve access to skilled delivery.

BACKGROUND: The aim of this study is to assess the current status of non-communicable disease (NCD) risk factors amongst adolescents in Bangladesh. We also critically reviewed the existing policy responses to NCD risk among adolescents in Bangladesh. METHODS: This study used a mixed method approach. To quantify the NCD risk burden, we used data from the Global School-based Student Health Survey conducted in Bangladesh. To understand policy response, we reviewed NCD-related policy documents introduced by the Government of Bangladesh between 1971 and 2018 using the WHO recommended NCD Action Plan 2013–2020as study framework. Information from the policy documents was extracted using a matrix, mapping each document against the six objectives of the WHO 2013–2020 Action Plan. RESULTS: Almost all adolescents in Bangladesh had at least one NCD risk factor, and there was a high prevalence of concurrent multiple NCD risk factors; 14% had one NCD risk factor while 22% had two, 29% had three, 34% had four or more NCD risk factors. Out of 38 policy documents, eight (21.1%) were related to research and/or surveys, eight (21.1%) were on established policies, and eleven (29%) were on legislation acts. Three policy documents (7.9%) were related to NCD guidelines and eight (21.1%) were strategic planning which were introduced by the government and non-government agencies/institutes in Bangladesh. CONCLUSIONS: The findings emphasize the needs for strengthening NCD risk factors surveillance and introducing appropriate intervention strategies targeted to adolescents. Despite the Government of Bangladesh introducing several NCD-related policies and programs, the government also needs more focus on clear planning, implementation and monitoring and evaluation approaches to preventing NCD risk factors among the adolescents in Bangladesh. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41043-022-00294-x.

OBJECTIVES: Minimum Dietary Diversity (MDD) is an indicator to assess feeding practices of children aged 6–23 months. The WHO and UNICEF have recently revised the definition of MDD, replacing '≥4 out of 7 food groups (MDD-7FG)' with '≥5 out of 8 food groups (MDD-8FG)'. In the new definition, breast milk was considered as a separate food group. We aimed to estimate the implications of this change on the prevalence of MDD at the national and regional levels of Bangladesh. METHODS: We analyzed data from the national food security and nutrition surveillance round 2018–2019. MDD was defined and calculated according to the WHO-UNICEF guidelines. The prevalence of MDD-7FG and MDD-8FG was estimated and stratified by gender, age groups, place of residence, division, and wealth index. The difference between the prevalence between MDD-7FG and MDD-8FG was presented as percentages. RESULTS: Compared to the older definition, the overall prevalence of MDD was lower among 6 to 23 months old children in Bangladesh (46.2% vs. 54.7%). The absolute percentage point difference between the estimates (MDD-8FG vs. MDD-7FG) was higher among the boys (44.0% vs. 53.2%), 12–23 months aged old children (53.4% vs. 63.4%), children living in the non-slum urban areas (30.2% vs. 42.4%) and Dhaka division (42.0% vs. 56.3%), and among the children of middle-class families (40.3% vs. 57.6%). CONCLUSIONS: The new definition and the inclusion of breast milk intake as a new food group led to a decrease in the prevalence of minimum dietary diversity in Bangladesh. The country program needs to emphasize the continuation of breastfeeding until two years of age of the children. Moreover, the changes in the definition of MDD and the resultant consequence should be kept in mind while performing trend analysis of dietary diversity in Bangladesh and elsewhere. FUNDING SOURCES: Ministry of Health and Family Welfare, Government of Bangladesh.

OBJECTIVES: Though Bangladesh is passing through demographic, epidemiologic and nutritional transitions, national estimates on nutrition and health status of the elderly population are largely unknown. We aimed to determine the status of selected health and nutrition indicators among the elderly population in Bangladesh. METHODS: For the first time in Bangladesh, we included elderly population (≥60 years old females and males) as a separate population group in the national food security and nutrition surveillance round 2018–2019. We collected data on dietary diversity, nutritional status, behavioral risk factors of non-communicable diseases, blood pressure, and self-reported chronic diseases from 4,818 elderly people (48% female) living in 82 clusters (57 rural, 15 non-slums urban, and 10 slums) randomly selected from eight administrative division of Bangladesh. RESULTS: Majority (59% in rural, 53% in non-slum urban, and 69% in slums) of elderly people were consuming an inadequately diverse (4 or less food groups out of 10) diet. Overall, 89% of elderly people were malnourished (20%) or at risk of malnutrition (69%). The highest prevalence of malnutrition was in Mymensingh division (37%) followed by Sylhet division (27%). The prevalence of obesity was 5%, 16%, and 11%, in rural, non-slum urban, and slums, respectively. The national prevalence of smoking, smokeless tobacco consumption, physical inactivity was 18%, 52%, and 38%, respectively. There was a high burden of hypertension (49% in rural, 53% in non-slum urban, and 39% in slums). Overall, 16% of elderly people had heart diseases, 14% had chronic respiratory diseases, 3% had kidney diseases, 9% had diabetes, 8% had stroke, 0.5% had cancer and 1.4% had mental health problems. CONCLUSIONS: The government of Bangladesh should design and implement health and nutrition programs among the elderly population. The regional differences in the prevalence of health and nutrition indicators should be considered while designing such programs. FUNDING SOURCES: Ministry ...

AbstractThe World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.

OBJECTIVES: To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (≥ 2 risk factors) among adolescent boys and girls in Bangladesh. METHODS: Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018–2019, was used. Descriptive analysis and multivariable logistic regression were performed. RESULTS: The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. CONCLUSION: The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors.