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Article ; Online: Prevention of social exclusion and role of antenatal care by BRAC community health workers in improving safe motherhood and neonatal care in urban slums of Bangladesh.

Saira Parveen Jolly / Tridib Roy Chowdhury / Mahfuzar Rahman / Ariful Alam / Kaosar Afsana

PLoS ONE, Vol 15, Iss 7, p e

2020 Volume 0235340

Abstract: The transformation of the BRAC MANOSHI programme from humanitarian to a social enterprise model, has made it increasingly urgent to enumerate the minimum number of door-to-door antenatal care (ANC) visits by community health workers (CHWs), for the ... ...

Abstract	The transformation of the BRAC MANOSHI programme from humanitarian to a social enterprise model, has made it increasingly urgent to enumerate the minimum number of door-to-door antenatal care (ANC) visits by community health workers (CHWs), for the purpose of effectively improving facility delivery. Thus prevent social exclusion of poor slum communities in Bangladesh with regard to safe motherhood and essential newborn care (ENC). This cross-sectional study was conducted, during March-July, 2015 in slums of Chittagong, Dhaka and Sylhet city corporations of Bangladesh. A census was conducted among 25,700 households covering 10 branch offices of MANOSHI to identify women with a delivery outcome in the preceding three years of the survey. A total of 1100 respondents were interviewed randomly through a structured questionnaire. These women were stratified into three categories-1, 2 & 3, consisting of 497, 205 and 398 women respectively. Women in category-1 did not receive any ANC checkup from the BRAC CHWs, while women in category-2 and category-3 received one to three and ≥four ANC checkups from BRAC CHWs respectively. Data was analysed using STATA Version 13 (Chicago Inc.). Findings revealed that women, who received ≥four ANC checkups from BRAC CHWs, are 25% more likely to avail facility delivery [adjusted Prevalence Ratio (aPR) 1.25; 95% confidence interval (CI) (1.01-1.54)] compared to the women who did not receive any ANC from BRAC CHWs. Women in category-2 [aPR3.64; 95% CI (1.76-7.54)] and in category-3 [aPR5.92; 95% CI (3.04-11.53)] respectively had four and six folds higher tendency to receive postnatal care (PNC) within 48 hours after delivery. Furthermore, facility delivery improved PNC assisted by medically trained providers (MTPs) within 48 hours after delivery and ENC in both categories 2 & 3. The evidence shows that at least four ANC visits of BRAC CHWs can increase institutional delivery, and which can further facilitate PNC and ENC visits. At present, the BRAC MANOSHI programme needs to ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Demographic, Socio-economic and Lifestyle Determinants of Under- and Over-nutrition among Bangladeshi Adult Population

Dipak K. Mitra / Sabuj Kanti Mistry / Kaosar Afsana / Mahfuzar Rahman

Journal of Epidemiology and Global Health, Vol 8, Iss

Results from a Large Cross-Sectional Study

2018 Volume 3

Abstract: Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated ... ...

Abstract	Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50– 22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5–18.8) and 33.7% (95% CI: 32.9–34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11–1.71), older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89–2.86), for 60–69 years is 1.62 (1.36–1.93), for 50–59 years 1.34 (1.13–1.58) and for 40–49 years 1.05 (0.87–1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14–1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55–0.84), for second highest quintile 0.77 (0.65–0.91), for middle quintile 0.81 (0.69–0.94) and for second lowest quintile 0.89 (0.77–1.03)], urban residence (ARRR-0.66, 95% CI: 0.66–0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65–0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12–1.63), ...
Keywords	Underweight ; overweight ; nutritional transition ; factors ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2018-12-01T00:00:00Z
Publisher	Springer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Arsenic and hypertension in Bangladesh

Mahfuzar Rahman

Bulletin of the World Health Organization, Vol 80, Iss 2, Pp 173-

2002 Volume 173

Keywords	Public aspects of medicine ; RA1-1270 ; Medicine ; R ; DOAJ:Public Health ; DOAJ:Health Sciences
Language	English
Publishing date	2002-01-01T00:00:00Z
Publisher	World Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Arsenic and hypertension in Bangladesh

Mahfuzar Rahman

Bulletin of the World Health Organization, Vol 80, Iss 2, Pp 173-

2002 Volume 173

Keywords	Public aspects of medicine ; RA1-1270 ; Medicine ; R
Language	English
Publishing date	2002-01-01T00:00:00Z
Publisher	World Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Arsenic exposure and young adult's mortality risk

Mahfuzar Rahman / Nazmul Sohel / Fakir Md Yunus / Nurul Alam / Qamrun Nahar / Peter Kim Streatfield / Mohammad Yunus

Environment International, Vol 123, Iss , Pp 358-

A 13-year follow-up study in Matlab, Bangladesh

2019 Volume 367

Abstract: Background: Widespread arsenic contamination in underground water is a well-documented public health concern that threatens millions of lives worldwide. We investigated the risk of young-adult mortality due to high chronic exposure to arsenic through ... ...

Abstract	Background: Widespread arsenic contamination in underground water is a well-documented public health concern that threatens millions of lives worldwide. We investigated the risk of young-adult mortality due to high chronic exposure to arsenic through years of drinking arsenic contaminated water. Methods: A prospective cohort study of 58,406 individuals was enrolled who were 4–18 years at baseline. Since Matlab HDSS (Health and Demographic Surveillance System) has an active surveillance system, all individuals were included in the follow up. Each individual's arsenic exposure was calculated at (1) baseline As level as current exposure (2) time-weighted lifetime (average or lifetime average) and (3) cumulative arsenic exposure. Age, sex, educational attainment and SES were adjusted during the analysis. In this 13 years closed-cohort study (2003–2015), all young-adult deaths were captured through verbal autopsy (VA) using International Classification of Diseases (ICD-10) to define the causes. Results: Although, girls had higher values of cumulative arsenic exposure via tube well water than boys (median: 1858.5 μg/year/L vs. 1798.8 μg/year/L) but higher mortality due to cancers and due to cerebro-vascular disease, cardio-vascular disease, and respiratory disease (7.0 vs. 5.7 per 100,000 person-years and 6.4 vs. 4.2 per 100,000 person-years respectively). Higher risk of deaths among young adults (Adjusted HR: 2.7, 1.3–5.8) due to all cancers among those who were exposed to As > 138.7 compared to As ≤ 1.1 μg/L. For cerebro-vascular disease, cardio-vascular disease, and respiratory disease deaths, average arsenic in well water (>223.1 μg/L vs. ≤90.9 μg/L) and cumulative arsenic in well water (>2711.0 μg/year/L vs. ≤1013.3 μg/year/L) had 4.8 (1.8–12.8) and 5.1 (1.7–15.1) times higher risks of mortality than to those lowest exposed. Conclusion: Higher concentration of, and chronic exposure to arsenic in drinking water, increases the mortality risk among the young adults, regardless of gender. Keywords: Arsenic exposure, Toxicity, Global health, Ground water
Keywords	Environmental sciences ; GE1-350
Language	English
Publishing date	2019-02-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What Constitutes Health Care Seeking Pathway of TB Patients

Tanvir Shatil / Nusrat Khan / Fakir Md. Yunus / Anita Sharif Chowdhury / Saifur Reza / Shayla Islam / Akramul Islam / Mahfuzar Rahman

Journal of Epidemiology and Global Health, Vol 9, Iss

A Qualitative Study in Rural Bangladesh

2019 Volume 4

Abstract: Given the targeted 4–5% annual reduction of tuberculosis (TB) cure cases to reach the “End TB Strategy” by 2020 milestone globally set by WHO, exploration of TB health seeking behavior is warranted for insightful understanding. This qualitative study ... ...

Abstract	Given the targeted 4–5% annual reduction of tuberculosis (TB) cure cases to reach the “End TB Strategy” by 2020 milestone globally set by WHO, exploration of TB health seeking behavior is warranted for insightful understanding. This qualitative study aims to provide an account of the social, cultural, and socioeconomic breadth of TB cases in Bangladesh. We carried out a total of 32 In-depth Interviews (IDIs) and 16 Key Informant Interviews (KIIs) in both rural and urban areas of Bangladesh. We covered both BRAC [a multinational Non-governmental Organization (NGO)] and non-BRAC (other NGOs) TB program coverage areas to get an insight. We used purposive sampling strategy and initially followed “snowball sampling technique” to identify TB patients. Neuman’s three-phase coding system was adopted to analyze the qualitative data. Underestimation of TB knowledge and lack of awareness among the TB patients along with the opinions from their family members played key roles on their TB health seeking behavior. Quick decision on the treatment issue was observed once the diagnosis was confirmed; however, difficulties were in accepting the diseases. Nevertheless, individual beliefs, intrinsic ideologies, financial abilities, and cultural and social beliefs on TB were closely inter-connected with the “social perception” of TB that eventually influenced the care seeking pathways of TB patients in various ways. Individual and community level public health interventions could increase early diagnosis; therefore, reduce recurrent TB.
Keywords	Tuberculosis ; health care seeking ; pathway ; Bangladesh ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2019-10-01T00:00:00Z
Publisher	Springer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of Maternal Health Service Indicators in Urban Slum of Bangladesh.

Saira Parveen Jolly / Mahfuzar Rahman / Kaosar Afsana / Fakir Md Yunus / Ahmed M R Chowdhury

PLoS ONE, Vol 11, Iss 10, p e

2016 Volume 0162825

Abstract: A continuous influx of poor people to urban slums poses a challenge to Bangladesh's health system as it has failed to tackle maternal morbidity and mortality. BRAC is the largest non-governmental organisation in Bangladesh. BRAC has been working to ... ...

Abstract	A continuous influx of poor people to urban slums poses a challenge to Bangladesh's health system as it has failed to tackle maternal morbidity and mortality. BRAC is the largest non-governmental organisation in Bangladesh. BRAC has been working to reduce maternal, neonatal and under-five children morbidity and mortality of slum dwellers in cities. BRAC has been doing this work for a decade through a programme called MANOSHI. This programme provides door-to-door services to its beneficiaries through community health workers (CHWs) and normal delivery service through its delivery and maternity centres. BRAC started the 'MANOSHI' programme in Narayanganj City Corporation during 2011 to address maternal, neonatal and child health problems facing slum dwellers. We investigated the existing maternal health-service indicators in the slums of Narayanganj City Corporation and compared the findings with a non-intervention area.This cross-sectional study was conducted during 2012, in 47 slums of Narayanganj City Corporation as intervention and 10 slums of Narsingdi Sadar Municipality as comparison area. A total of 1206 married women, aged 15-49 years, with a pregnancy outcome in the previous year were included for interview. Data on socio-demographic characteristics, reproductive and maternal health-care practices like use of contraceptive methods, antenatal care (ANC), delivery care, postnatal care (PNC) were collected through a structured questionnaire. The chi-square test, Student t test, Mann Whitney U-test, factor analysis and log-binominal test were performed by using STATA statistical software for analysing data.The activities of BRAC CHWs significantly improved four or more ANC (47% vs. 21%; p<0.000) and PNC (48% vs. 39%; p<0.01) coverage in the intervention slums compared to comparison slums. Still, about half of the deliveries in both areas were attended at home by unskilled birth attendants, of which a very few received PNC within 48 hours after delivery. The poorest and illiterate women received fewer maternal health services from medically trained providers (MTPs). The poorest had a lower likelihood of receiving services from MTPs during delivery complications.The MANOSHI programme service coverage for delivery care and PNC-checkup for women who prefer home delivery needs to be improved. For sustainable improvement of maternal health outcomes in urban slums, the programme needs to facilitate access to services for poor and illiterate women.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of Maternal Health Service Indicators in Urban Slum of Bangladesh.

Saira Parveen Jolly / Mahfuzar Rahman / Kaosar Afsana / Fakir Md Yunus / Ahmed M R Chowdhury

PLoS ONE, Vol 11, Iss 10, p e

2016 Volume 0162825

Abstract	A continuous influx of poor people to urban slums poses a challenge to Bangladesh's health system as it has failed to tackle maternal morbidity and mortality. BRAC is the largest non-governmental organisation in Bangladesh. BRAC has been working to reduce maternal, neonatal and under-five children morbidity and mortality of slum dwellers in cities. BRAC has been doing this work for a decade through a programme called MANOSHI. This programme provides door-to-door services to its beneficiaries through community health workers (CHWs) and normal delivery service through its delivery and maternity centres. BRAC started the 'MANOSHI' programme in Narayanganj City Corporation during 2011 to address maternal, neonatal and child health problems facing slum dwellers. We investigated the existing maternal health-service indicators in the slums of Narayanganj City Corporation and compared the findings with a non-intervention area.This cross-sectional study was conducted during 2012, in 47 slums of Narayanganj City Corporation as intervention and 10 slums of Narsingdi Sadar Municipality as comparison area. A total of 1206 married women, aged 15-49 years, with a pregnancy outcome in the previous year were included for interview. Data on socio-demographic characteristics, reproductive and maternal health-care practices like use of contraceptive methods, antenatal care (ANC), delivery care, postnatal care (PNC) were collected through a structured questionnaire. The chi-square test, Student t test, Mann Whitney U-test, factor analysis and log-binominal test were performed by using STATA statistical software for analysing data.The activities of BRAC CHWs significantly improved four or more ANC (47% vs. 21%; p<0.000) and PNC (48% vs. 39%; p<0.01) coverage in the intervention slums compared to comparison slums. Still, about half of the deliveries in both areas were attended at home by unskilled birth attendants, of which a very few received PNC within 48 hours after delivery. The poorest and illiterate women received fewer maternal health services from medically trained providers (MTPs). The poorest had a lower likelihood of receiving services from MTPs during delivery complications.The MANOSHI programme service coverage for delivery care and PNC-checkup for women who prefer home delivery needs to be improved. For sustainable improvement of maternal health outcomes in urban slums, the programme needs to facilitate access to services for poor and illiterate women.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Review of Groundwater Arsenic Contamination in Bangladesh

Fakir Md. Yunus / Safayet Khan / Priyanka Chowdhury / Abul Hasnat Milton / Sumaira Hussain / Mahfuzar Rahman

International Journal of Environmental Research and Public Health, Vol 13, Iss 2, p

The Millennium Development Goal Era and Beyond

2016 Volume 215

Abstract: Arsenic contamination in drinking water has a detrimental impact on human health which profoundly impairs the quality of life. Despite recognition of the adverse health implications of arsenic toxicity, there have been few studies to date to suggest ... ...

Abstract	Arsenic contamination in drinking water has a detrimental impact on human health which profoundly impairs the quality of life. Despite recognition of the adverse health implications of arsenic toxicity, there have been few studies to date to suggest measures that could be taken to overcome arsenic contamination. After the statement in 2000 WHO Bulletin that Bangladesh has been experiencing the largest mass poisoning of population in history, we researched existing literature to assess the magnitude of groundwater arsenic contamination in Bangladesh. The literature reviewed related research that had been initiated and/or completed since the implementation of the Millennium Development Goals (MDGs) under four domains: (1) extent of arsenic contamination; (2) health consequences; (3) mitigation and technologies and (4) future directions. To this means, a review matrix was established for analysis of previous literature based on these four core domains. Our findings revealed that several high-quality research articles were produced at the beginning of the MDG period, but efforts have dwindled in recent years. Furthermore, there were only a few studies conducted that focused on developing suitable solutions for managing arsenic contamination. Although the government of Bangladesh has made its population’s access to safe drinking water a priority agenda item, there are still pockets of the population that continue to suffer from arsenic toxicity due to contaminated water supplies.
Keywords	review ; arsenic ; Bangladesh ; Millennium Development Goal ; Medicine ; R
Subject code	306
Language	English
Publishing date	2016-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Exploring the gap between coverage, access, and utilization of long-lasting insecticide-treated nets (LLINs) among the households of malaria endemic districts in Bangladesh

Fouzia Khanam / Md Belal Hossain / Tridib Roy Chowdhury / Md Sajedur Rahman / Moktadir Kabir / Shamsun Naher / Md Akramul Islam / Mahfuzar Rahman

Malaria Journal, Vol 17, Iss 1, Pp 1-

2018 Volume 12

Abstract: Abstract Background Malaria is still a major public health concern in Bangladesh in spite of mass distribution of long-lasting insecticide-treated nets (LLINs) as a key preventive strategy. There might be a considerable gap between coverage and actual ... ...

Abstract	Abstract Background Malaria is still a major public health concern in Bangladesh in spite of mass distribution of long-lasting insecticide-treated nets (LLINs) as a key preventive strategy. There might be a considerable gap between coverage and actual use of nets by the population in endemic areas. This study intended to assess the gap between coverage, access to and use of LLINs among the households in malaria-endemic settings in Bangladesh. Methods This cross-sectional study collected data from 2640 households of 13 endemic districts of Bangladesh through three-stage cluster random sampling. The gap between coverage, access and use of LLINs were calculated using the procedure established by the Roll Back Malaria Monitoring and Evaluation Reference Group. To support the quantitative findings, qualitative data were also collected through in-depth interview, focus group discussion and key informant interview and analysed accordingly. Results Of 2640 total households, 77.4% (n = 2044) possessed at least two LLINs, 56.8% (n = 1499) had insufficient access, and 18.8% (n = 495) had excess LLINs. Members of 77.9% (n = 2056) households had used LLINs the previous night and 6.0% (n = 68) did not use LLINs despite having sufficient access. LLIN use was lower in non-hill track areas, in Bengali community, in richer households and households with more than four members. Moreover, qualitative findings revealed that the major reasons behind not using LLINs were insufficient access, sleeping outside the home, migration, perceived low efficacy of LLINs, or fear of physical side effects. Conclusion Closing the access gap by providing enough nets through solid investment and well-designed behavioural change interventions are crucial for achieving and sustaining universal coverage.
Keywords	Long-lasting insecticide net (LLIN) ; LLIN use ; LLIN coverage ; LLIN access ; Malaria control programme ; Bangladesh ; Arctic medicine. Tropical medicine ; RC955-962 ; Infectious and parasitic diseases ; RC109-216
Subject code	070
Language	English
Publishing date	2018-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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