Search

Background: Mental disorder account for 13% global burden of disease which has affected more than 970 million people worldwide in 2017. About 1 in 17 suffers from serious mental illness in worldwide. Therefore, the affected person is dependent on caregiver and their wellbeing is directly related to nature and quality of care provided by caregiver. Caregiver are especially vulnerable as they face complex, high burden care situation resulting in higher caregiver stress. The aim of this study is to determine the level of stress and coping of caregivers of Psychiatric patients. Materials and Methods: This cross sectional study was conducted among 171 caregivers, aged more than 18 years in National Institute of Mental Health (NIMH) Shyamoli, Dhaka. Study period was from 1 January to 31 December 2020. The research participants were selected following the convenient sampling method based on defined selection criteria. A semi-structured questionnaire was developed and the respondents were interviewed face to face individually while maintaining privacy and confidentiality. Result: Distribution of the socio demographic status of the study participants were females74% and male 26%. Their mean age was 40.09(±13.31) years. In educational level 33.9 % of the participants were illiterate, secondary level education up to 21.1%. In occupation housewife 57.9%, service holder 18.7%. Caregiver having 76.6% moderate stress, low stress 21.6% and 1.8% having high perceived stress. Association between stress and coping average, good coping 74.8% and 88.2% had moderate stress respectively. Their significant P value .009(p

Purpose of the study: The purpose of the study is to determine whether the partial relocation of Hazaribagh tanneries has any effect on the area’s soil quality with respect to chromium and to determine a possible link between human exposure/diseases to chromium, with the focus being placed on children and vulnerable population. Methodology: Geochemical sampling and public health research related to fieldwork (Focus Group Discussions, two In-Depth Interview, and Key Informant Interview). Main Findings: The study indicates that there is a significant presence of chromium in the area’s soil two years following the partial relocation of Hazaribagh tanneries. Flu-like symptoms, generalized skin rash, and fertility issues are common in the vulnerable population. The residents are ignorant, belong to the marginalized section of the society, and do not fully comprehend of the impact of environmental exposure to chromium. Applications of this study: The geochemical data may be used to identify in situ treatment technologies for remediation of the area’s soil. The public health data will allow health policymakers to generate ideas and implement solutions to one of the greatest health challenges faced by the impacted population. Novelty/Originality of this study: The study is multidisciplinary by nature and employs science and technology to systematically develop an insight into the environmental contamination resulting from the release of untreated effluent and solid waste containing chromium.

Biofilms are dense bacterial colonies, derived from microbially derived sessile community, networked within a polysaccharide matrix with a distinct architecture that has the attachment potential to both alive and abiotic surfaces. Pseudomonas aeruginosa is a model biofilm forming microorganism associated with remarkable morbidity and mortality rate due to emergence of antibiotic resistant pathogenic bacteria. Moreover, Pseudomonas aeruginosa originating from a biofilm is more resistant to a wide range of antibiotics than the planktonic bacteria. This research was planned to develop a comparative study of the biofilm production between potential, antimicrobial resistance of Pseudomonas aeruginosa isolated from mature environmental biofilm and clinical strain of the same species that did not derive from biofilm. It was observed that the Pseudomonas aeruginosa from environmental isolates were resistant to 15 prominent antibiotics, while clinical strain was comparatively resistant to only few of them. A confirmatory analysis of biofilm formation and antibiotic resistance pattern of these two groups of organisms was checked by 96-well microtiter plate and the disc diffusion method respectively. Finally, the results portrayed that the environmental strains with high drug resistance, potentially formed a considerable amount of biofilm in the period of a week whereas; clinical stains formed a negligible amount of biofilm within the same time frame.

To identify how 10 low- and middle-income countries achieved accelerated progress, ahead of comparable countries, towards meeting millennium development goals 4 and 5A to reduce child and maternal mortality.We synthesized findings from multistakeholder dialogues and country policy reports conducted previously for the Success Factors studies in 10 countries: Bangladesh, Cambodia, China, Egypt, Ethiopia, the Lao People's Democratic Republic, Nepal, Peru, Rwanda and Viet Nam. A framework approach was used to analyse and synthesize the data from the country reports, resulting in descriptive or explanatory conclusions by theme.Successful policy and programme approaches were categorized in four strategic areas: leadership and multistakeholder partnerships; health sector; sectors outside health; and accountability for resources and results. Consistent and coordinated inputs across sectors, based on high-impact interventions, were assessed. Within the health sector, key policy and programme strategies included defining standards, collecting and using data, improving financial protection, and improving the availability and quality of services. Outside the health sector, strategies included investing in girls' education, water, sanitation and hygiene, poverty reduction, nutrition and food security, and infrastructure development. Countries improved accountability by strengthening and using data systems for planning and evaluating progress.Reducing maternal and child mortality in the 10 fast-track countries can be linked to consistent and coordinated policy and programme inputs across health and other sectors. The approaches used by successful countries have relevance to other countries looking to scale-up or accelerate progress towards the sustainable development goals.Déterminer comment dix pays à revenu faible et intermédiaire ont réussi à accomplir des progrès accélérés, vis-à-vis de pays comparables, en vue d'atteindre les objectifs 4 et 5A du Millénaire pour le développement visant à réduire la mortalité infantile et maternelle.Nous avons synthétisé les conclusions de dialogues multipartites et de rapports d'orientation nationaux précédemment établis pour étudier les facteurs de succès dans les dix pays concernés: le Bangladesh, le Cambodge, la Chine, l'Égypte, l'Éthiopie, le Népal, le Pérou, la République démocratique populaire lao, le Rwanda et le Viet Nam. Une approche de cadre a été utilisée pour analyser et synthétiser les données tirées des rapports nationaux, ce qui a donné lieu à des conclusions descriptives ou explicatives en fonction de différents thèmes.Les approches politiques et de programme réussies ont été classées dans quatre domaines stratégiques: leadership et partenariats multipartites; secteur de la santé; secteurs autres que celui de la santé; et responsabilisation en matière de ressources et de résultats. Les contributions cohérentes et coordonnées dans les différents secteurs, basées sur des interventions à fort impact, ont été évaluées. Dans le secteur de la santé, les principales stratégies politiques et de programme incluaient la définition de normes, la collecte et l'utilisation de données, l'amélioration de la protection financière et l'amélioration de l'accessibilité et de la qualité des services. En dehors du secteur de la santé, les stratégies impliquaient des investissements dans l'éducation des filles, l'eau, l'assainissement et l'hygiène, la réduction de la pauvreté, la nutrition et la sécurité alimentaire et le développement des infrastructures. Les pays ont amélioré leur responsabilisation grâce au renforcement et à l'utilisation de systèmes de données permettant de planifier et d'évaluer les progrès.La réduction accélérée de la mortalité maternelle et infantile dans les dix pays peut être liée à l'élaboration de politiques et de programmes cohérents et coordonnés au sein du secteur de la santé et des autres secteurs. Les approches utilisées par les pays qui enregistrent des succès présentent un intérêt pour d'autres pays cherchant à augmenter ou à accélérer les progrès en vue des objectifs de développement durable.Identificar el modo en que diez países con ingresos bajos y medios han logrado un progreso acelerado, por delante de países comparables, camino de cumplir los objetivos de desarrollo del milenio 4 y 5A para reducir la mortalidad infantil y materna.Se sintetizaron los resultados de diálogos entre varias partes y los informes de políticas de países redactados anteriormente en relación con los estudios de los factores de éxito en los diez países: Bangladesh, Camboya, China, Egipto, Etiopía, Nepal, Perú, República Democrática Popular Lao, Rwanda y Viet Nam. Se utilizó un enfoque de marco para analizar y sintetizar los datos de los informes de países, lo que dio lugar a conclusiones descriptivas o explicativas por tema.Se categorizaron los enfoques de programas y políticas que tuvieron éxito en cuatro áreas estratégicas: alianzas de liderazgo y de diversas partes interesadas; sector sanitario; sectores no sanitarios; y contabilidad de recursos y resultados. Se evaluaron las contribuciones coherentes y coordinadas en todos los sectores, en base a las intervenciones con gran impacto. Dentro del sector sanitario, las estrategias fundamentales de programas y políticas incluyeron la definición de estándares, la recopilación y el uso de datos, la mejora de la protección financiera y la mejora de la disponibilidad y calidad de los servicios. Fuera del sector sanitario, las estrategias incluyeron la inversión en la educación de niñas, agua, saneamiento e higiene, reducción de la pobreza, nutrición y seguridad alimentaria, y desarrollo de infraestructuras. Los países mejoraron su contabilidad consolidando y utilizando sistemas de datos para el progreso de planificación y evaluación.La reducción de la mortalidad materna e infantil en los diez países de vía rápida puede estar relacionada con las contribuciones coherentes y coordinadas de programas y políticas, tanto en el sector sanitario como en otros. Los enfoques utilizados por los países que han tenido éxito son relevantes para otros países que buscan aumentar y acelerar el progreso hacia los objetivos de desarrollo sostenible.تحديد كيفية تفوق 10 من البلدان منخفضة الدخل والبلدان متوسطة الدخل على الدول النظيرة لها في تحقيق التقدم الحثيث نحو تنفيذ الأهداف 4 و5أ من الأهداف الإنمائية لهذه الألفية من أجل الحد من وفيات الأمهات والأطفال.عملنا على توليف النتائج التي أسفرت عنها الحوارات التي تشمل العديد من الجهات المعنية وكذلك التقارير التي سبق إعدادها بشأن السياسة التي تنتهجها الدول للخروج بدراسات تتناول عوامل النجاح في تلك الدول العشرة: بنغلاديش، وكمبوديا، والصين، ومصر، وإثيوبيا، وجمهورية لاو الديمقراطية الشعبية، ونيبال، وبيرو، ورواندا، وفييت نام. وتم استخدام نهج إطاري لتحليل وتوليف البيانات المستمدة من التقارير التي تتناول البلدان، مما أثمر عن استنتاجات وصفية أو توضيحية مصنفة حسب الموضوع.تم تصنيف الأساليب المتبعة لتطبيق السياسات والبرامج الناجحة إلى أربعة مجالات استراتيجية: شراكات بين القيادات والجهات المعنية؛ وقطاع الصحة؛ والقطاعات خارج نطاق الصحة؛ وتحمل المسؤولية عن الموارد والنتائج. وتم تقييم مدخلات تتسم بالاتساق والتنسيق فيما بين العديد من القطاعات بناءً على التدخلات بالغة الأثر. وتضمنت الاستراتيجيات الرئيسة للسياسات والبرامج التي يشملها قطاع الصحة تحديد المعايير، وجمع البيانات واستخدامها، وتعزيز الحماية المالية، وتحسين مدى توفر الخدمات وجودتها. وفيما يتعلق بالقطاع خارج نطاق الصحة تضمنت الاستراتيجيات الاستثمار في مجال تعليم الفتيات، والمياه، والنظافة والعادات الصحية، والحد من الفقر، والتغذية والأمن الغذائي، وتطوير البنية التحتية. ورفعت الدول من مستوى تحمل المسؤولية عن طريق تعزيز نظم البيانات وتفعيلها للتخطيط وتقييم مدى إحراز التقدم.إن الحد من وفيات الأمهات والأطفال في الدول العشرة سريعة التقدم على ذلك الطريق يمكن ربطه باتباع سياسة تتسم بالاتساق والتنسيق وكذلك مدخلات البرامج عبر العديد من القطاعات التي تشمل قطاع الصحة وغيره من القطاعات. وتتصل الأساليب التي تتبعها الدول الناجحة بدول أخرى تتطلع إلى التقدم بمعدل أعلى أو وتيرة أسرع نحو تحقيق أهداف التنمية المستدامة.为了确定 10 个低收入和中等收入国家如何取得加速进展，领先于同等水平的国家，实现千年发展目标 4 和 5A，以及降低儿童死亡率和产妇死亡率。.我们综合了之前在10 个国家的成功要素研究中开展的多方利益相关者对话以及国家政策报告中的研究结果： 这 10 个国家是：埃及、埃塞俄比亚、柬埔寨、老挝人民民主共和国、卢旺达、孟加拉国、秘鲁、尼泊尔、越南和中国。 采用框架法来分析和综合来自国家报告的数据，依照主题生成描述性或解释性结论。.成功的政策和计划方法分为四个战略领域： 领导阶层和多方利益相关者的伙伴关系；卫生部门；卫生以外的部门以及资源和成果问责制。 基于极具影响力的干预措施，对各部门的一致性和协调性投入进行了评估。 在卫生部门，主要政策和计划策略包括定义标准、收集和使用数据、提高财务保障以及提高服务的可获得性和质量。 在卫生部门以外，战略包括女童教育投资、供水、环境卫生和个人卫生、减少贫困、营养和食品安全以及基础设施发展。国家通过加强和使用数据系统进行规划和评估进展以改善问责制。.在 10 个快速发展国家，可以将降低产妇死亡率和儿童死亡率与卫生部门和其他部门的一致性和协调性政策和计划投入相结合。 成功国家采用的方法可以与其他国家相关联，以寻求按比例增加或加速实现可持续发展目标的进展。.Определить, как 10 странам с низким и средним уровнем доходов удалось продемонстрировать ускоренный по сравнению с сопоставимыми странами прогресс в плане достижения целей тысячелетия 4 и 5A в области развития, сформулированных в Декларации тысячелетия, предполагающих сокращение детской и материнской смертности.Данные, полученные из ранее проведенных диалогов с участием широкого круга заинтересованных сторон и ранее составленных отчетов о стратегических направлениях развития стран, были обобщены для изучения факторов успеха в 10 странах: Бангладеш, Вьетнам, Египет, Камбоджа, Китай, Лаосская Народно-Демократическая Республика, Непал, Перу, Руанда и Эфиопия. С помощью рамочного подхода данные из докладов стран были проанализированы и обобщены, в результате чего были сделаны выводы по теме с описаниями или объяснениями.Успешные подходы к воплощению планов действия и программ были отнесены к четырем стратегическим областям: руководство и партнерство с большим количеством заинтересованных сторон, сфера здравоохранения, другие сферы экономики и ответственность за ресурсы и результаты. Была проведена оценка систематического и согласованного вклада из различных секторов, в основу которого были заложены высокоэффективные мероприятия. В сфере здравоохранения основные стратегии планов действий и программ включали определение стандартов, сбор и применение данных, повышение финансовой защиты, а также доступности и качества услуг. В других сферах стратегии включали инвестирование в системы образования для девочек, водоснабжение и область санитарии и гигиены, сокращение масштабов бедности, обеспечение продовольственной безопасности и безопасности питания и развитие инфраструктуры. Усиление механизмов подотчетности в странах было достигнуто за счет совершенствования и использования систем данных для планирования и анализа хода развития.Снижение уровней материнской и детской смертности в 10 странах, демонстрирующих ускоренный прогресс, может быть связано с систематическим и согласованным вкладом, внесенным в результате реализации стратегических планов и программ, в сферу здравоохранения и другие сферы. Подходы, которые использовали достигшие успеха страны, могут быть применены в других странах, стремящихся ускорить продвижение по пути к достижению целей в области устойчивого развития.

Urbanization is occurring at a rapid pace in Bangladesh, accompanied by the proliferation of slum settlements, whose residents have special health needs given the adverse social, economic, and public environmental conditions they face. Over the past 45 years, the country’s health and nutrition policies and programs have focused largely on rural health services. Consequently, equitable access of urban populations—particularly the urban poor—to quality health and nutrition services has emerged as a major development issue. However, the knowledge base on urban health and nutrition in Bangladesh remains weak. To address the knowledge gap, Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance examines the health and nutrition challenges in urban Bangladesh—looking at socioeconomic determinants in general and at health sector governance in particular. Using a mixed methods approach, the study identifies critical areas such as financing, regulation, service delivery, and public environmental health, among others that require policy attention. The study also proposes specific actions within and outside the health sector to address the issues, providing guidance on their sequencing and the specific responsibilities of government agencies and other actors. This study should be useful to policy makers and practitioners working on urban health and nutrition issues in Bangladesh and in other low- and middle-income countries.

South Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions. Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes? Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women’s education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction. The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals.

Background\ud A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh’s pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women’s choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women’s SRH needs.\ud \ud Methods\ud Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken.\ud \ud Results\ud Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services.\ud \ud Conclusion\ud Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.

Bangladesh Journal of Dental Research & Education, Vol. 01, No. 01, January 2011, Page 12-14 DOI: http://dx.doi.org/10.3329/bjdre.v1i1.15795

Land surface processes have become a great concern in the context of global change and increased natural hazards all over the world. In this paper, dynamic characteristics of land cover changes have been investigated over a period of about three and half decades (1972–2016). This study focuses on the temporally evolving geo-environmental characteristics of Dhaka (Capital City) in Bangladesh. The analysis has been performed in a platform of Geographical Information System (GIS) configured with Remote Sensing (RS) system and ground-based RS measurement facilities. Radiometric analyses of multi-sensor time series satellite data followed by a process of spectral characterization have been performed. Special focus has been made on biophysical properties of surface features, geo-environmental configuration, land physiography, properties of vegetation and co-existing surface features. Earth Resources Data Analysis System (ERDAS) Imagine Image Processing Software and ArcGIS software have been utilized. It appears that both energy and water regimes have been affected particularly across the outer end of the side encroaching the city. In general, the outer side of the city consists of low land areas that is used to drain out water and to hold run-off water from the city. Feature-based analysis of satellite-derived radiative signal demonstrates dependencies on biophysical characteristics of surface features in response to human intervention under demographic pressure. Important class categories, particularly, built-up areas, crop land, water bodies have been studied to figure out the zones experiencing unplanned human interventions due to recent urban growth. This generalized pattern of urban growth appears to be a useful finding for urban planning and policy for the government of Bangladesh. Finally, it is evident that integration of space-based RS technology with GIS provide better platform to perform such activities.

According to our current understanding iron absorption with weekly iron supplements is not higher than that with daily supplements (ie there is no mucosal block). However community-based trials have repeatedly shown that a weekly regimen is as effective as a daily one. Furthermore when differences in absorption are found they are commonly smaller than would be expected on the basis of differences in the amount of iron provided. The possibility of differential compliance between the regimens needs to be evaluated to explain these findings. Taking compliance into account we compared the efficacy and trial effectiveness of weekly and daily iron supplementation during pregnancy. In Bangladesh 50 antenatal centers were randomly assigned to prescribe either 2 doses of 60 mg Fe once weekly or 1 dose of 60 mg Fe/d. Compliance was monitored by using a pill bottle equipped with an electronic counting device. Hemoglobin concentrations were measured at baseline and after 4 8 and 12 wk of supplementation. There was no differential effect per iron tablet between weekly and daily regimens. A 12-wk daily regimen (68% compliance) produced a small but significantly greater hemoglobin response than did the weekly regimen (104% compliance). The first 20 tablets consumed produced most of the effect; after 40 tablets there was no further response. There was no evidence of a mucosal block in the daily regimen. Over 12 wk 50% of the amount of iron in a daily regimen was sufficient for maximum hemoglobin effect. The weekly regimen provided a large part of this amount explaining the limited difference in effect. It appears that the current international recommendation for iron supplementation in pregnancy is higher than necessary. (authors)

This study explored violence against women with chronic maternal disabilities in rural Bangladesh. During November 2006–July 2008, in-depth interviews were conducted with 17 rural Bangladeshi women suffering from uterine prolapse, stress incontinence, or fistula. Results of interviews showed that exposure to emotional abuse was almost universal, and most women were sexually abused. The common triggers for violence were the inability of the woman to perform household chores and to satisfy her husband's sexual demands. Misconceptions relating to the causes of these disabilities and the inability of the affected women to fulfill gender role expectations fostered stigma. Emotional and sexual violence increased their vulnerability, highlighting the lack of life options outside marriage and silencing most of them into accepting the violence. Initiatives need to be developed to address misperceptions regarding the causes of such disabilities and, in the long-term, create economic opportunities for reducing the dependence of women on marriage and men and transform the society to overcome rigid gender norms.

This paper analyzes data on approximately 30,000 women from a survey in Uttar Pradesh in 1995 together with the data from surveys of public and private providers of healthcare and family planning services. A framework was developed for analyzing the effects of quality of services on utilization, and for understanding the gradual evolution of the healthcare infrastructure. The empirical results from logistic regressions for use of female sterilization and IUD showed significant effects of quality of services in government and private hospitals, and of socioeconomic variables such as education, caste, and an index of household possessions. Secondly, models for infant mortality of children born in the preceding 3-year period showed significant effects of socioeconomic variables, quality of healthcare services and birth spacing. Lastly, analysis of data at a more aggregated (Primary Sampling Unit) level indicated differential effects of economic development on the quality of services available in the public and private facilities.