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Objective To compare the prevalence of unintended pregnancy measured by the Demographic and Health Survey (DHS) and the London Measure of Unplanned Pregnancy in Bangladesh, and explore the extent of discordance between the measures and the factors associated with the discordance. Methods In 2023, we conducted a cross-sectional survey in four randomly selected districts in Bangladesh: Kurigram, Mymensingh, Pabna and Satkhira. We randomly selected 20 hospitals, five from each district. We collected data from 1200 women who had recently delivered a baby and were visiting the hospitals for postnatal care. We interviewed the women about their pregnancy intention in their last pregnancy using questions in the DHS and the London Measure of Unplanned Pregnancy and examined the discordance in their responses. We used multivariable logistic regression analysis to identify factors associated with discordant responses in reported pregnancy intention. Findings The prevalence of unintended pregnancy was 24.3% (292/1200) using the DHS measure and 31.0% (373/1200) using the London Measure of Unplanned Pregnancy. Discordance in responses to pregnancy intention between the two measures was 27.1% (325/1200). Factors associated with discordance were older age, female sex of the last child born, having more than two children, being in a poorer wealth quintile, living in a rural area and living in Kurigram district. Conclusion The prevalence of unintended pregnancy in Bangladesh measured by the DHS measure may be an underestimate, suggesting that the adverse effects of unintended pregnancy are greater than realized and emphasizing the need to bolster Bangladesh's family planning programme. Objectif Comparer la prevalence des grossesses non desirees mesuree par l'Enquete demographique et de sante (EDS) et par la London Measure of Unplanned Pregnancy au Bangladesh et explorer letendue de la discordance entre les mesures et les facteurs associes a cette discordance. Methodes En 2023, nous avons mene une enquete transversale dans quatre districts du Bangladesh choisis au hasard: Kurigram, Mymensingh, Pabna et Satkhira. Nous avons choisi au hasard 20 hopitaux, cinq par district. Nous avons recueilli des donnees aupres de 1200 femmes qui avaient recemment accouche et qui se rendaient a l'hopital pour des soins postnatals. Nous avons interroge ces femmes sur le desir de leur derniere grossesse en leur posant des questions issues de l'Enquete demographique et de sante et de la London Measure of Unplanned Pregnancy. Nous avons ensuite examine la discordance entre leurs reponses. Nous avons applique une analyse de regression logistique multivariable afin d'identifier les facteurs associes aux reponses discordantes dans les intentions de grossesse declarees. Resultats La prevalence des grossesses non desirees etait de 24,3% (292/1200) selon l'Enquete demographique et de sante et de 31,0% (373/1200) selon la London Measure of Unplanned Pregnancy. La discordance dans les reponses portant sur l'intention de grossesse entre les deux mesures etait de 27,1% (325/1200). Les facteurs associes a la discordance etaient l'age avance, le sexe feminin du dernier enfant ne, le fait d'avoir plus de deux enfants, d'appartenir a un quintile de richesse inferieur, de vivre dans une zone rurale et de vivre dans le district de Kurigram. Conclusion Il se peut que la prevalence des grossesses non desirees au Bangladesh, telle que mesuree par l'Enquete demographique et de sante, soit sous-estimee, ce qui suggere que les effets defavorables des grossesses non desirees sont plus importants qu'on ne le pense et souligne la necessite de renforcer le programme de planification familiale du Bangladesh. Objetivo Comparar la prevalencia del embarazo no deseado medida por la Encuesta Demografica y de Salud (EDS) y la London Measure of Unplanned Pregnancy en Bangladesh, y explorar el grado de discordancia entre las medidas y los factores asociados con la discordancia. Metodos En 2023, se realizo una encuesta transversal en cuatro distritos de Bangladesh seleccionados al azar: Kurigram, Mymensingh, Pabna y Satkhira. Se seleccionaron al azar 20 hospitales, cinco de cada distrito. Se recopilaron datos de 1200 mujeres que habian dado a luz recientemente y acudian a los hospitales para recibir atencion posnatal. Se entrevisto a las mujeres sobre su intencion de embarazo en su ultimo embarazo utilizando preguntas de la EDS y la London Measure of Unplanned Pregnancy, y se examino la discordancia en sus respuestas. Se utilizo un analisis de regresion logistica multivariable para identificar los factores asociados a las respuestas discordantes en la intencion de embarazo declarada. Resultados La prevalencia de embarazos no deseados fue del 24,3% (292/1200) utilizando la medida EDS y del 31,0% (373/1200) utilizando la London Measure of Unplanned Pregnancy. La discordancia en las respuestas a la intencion de embarazo entre las dos medidas fue del 27,1% (325/1200). Los factores asociados a la discordancia fueron la edad avanzada, el sexo femenino del ultimo hijo nacido, tener mas de dos hijos, pertenecer a un quintil de riqueza mas pobre, vivir en un area rural y vivir en el distrito de Kurigram. Conclusion La prevalencia de embarazos no deseados en Bangladesh medida por la EDS puede ser una subestimacion, lo que sugiere que los efectos adversos de los embarazos no deseados son mayores de lo que se cree y subraya la necesidad de reforzar el programa de planificacion familiar de Bangladesh., Introduction Globally, about half of pregnancies (roughly 121 million) are unintended, with low- and middle-income countries bearing the brunt due to lower use of modern contraception and higher unmet contraceptive [...]

Background: Women with disabilities in low‐ and middle‐income countries face unique challenges in managing menstruation, affecting their health, dignity, and quality of life. Aim: This study aimed to explore menstrual hygiene management (MHM) practices among reproductive‐aged women with disabilities in Bangladesh and its impact on social participation. Methods: We analyzed data from 51,535 women from the 2019 Multiple Indicator Cluster Survey (MICS). The outcome variables were: (i) material used to manage blood flow while menstruating (appropriate, inappropriate), (ii) availability of a private place for washing and changing menstruation rags (yes, no), and (iii) impact on attendance of social activities, school, or work during menstruation (yes, no). Disability status was considered as a major explanatory variable and categorized as no disabilities, moderate disabilities, and severe disabilities. Associations of outcome variables with explanatory variables were determined using a multilevel mixed‐effects binary logistic regression model adjusted for individual‐level factors, household‐level factors, and community‐level factors. Results: Among the sample, 2.7% reported severe disability and 19.2% moderate disabilities, with vision‐related disabilities (12.2%) being the most prevalent, followed by cognitive (9.5%) and walking disabilities (8.2%). Overall, 4% reported using inappropriate materials for menstrual flow, rising to 8.0% among those with severe disabilities and 5.8% for moderate disabilities. Women with moderate to severe disabilities had 33%–47% lower odds of using appropriate materials and 34%–44% lower odds of having a private place to change at home. Additionally, women with severe disabilities were 1.66 times more likely to report that menstruation impacted their social activities. Conclusion: Women with disabilities in Bangladesh face significant barriers to effective MHM. Addressing these issues requires targeted interventions, including disability‐inclusive menstrual health education, improved access to menstrual products and sanitation facilities, and community initiatives to reduce stigma. Key points: What is known Disabilities pose an ongoing challenge in low‐ and middle‐income countries, often leading to poor health outcomes and lower utilization of healthcare services. What is new We found poor menstrual health management among reproductive‐aged women with disabilities.Participation in social activities among women with disabilities was also found to be severely affected. Clinical implications of the study findings Poor menstrual health indicates a risk of facing menstrual‐related health issues, including reproductive tract infections. [ABSTRACT FROM AUTHOR]

Background. Despite global efforts to promote contraceptive use and ensure reproductive health, Somalia continues to face significant challenges in this regard. This study aims to explore the prevalence of contraceptive use in Somalia and identify the determinants influencing its use. Methods. A total of 8,162 reproductive‐aged women's data were analyzed extracted from 2020 Somali Health and Demographic Survey. The outcome variable was contraception use, classified as any contraception use (yes vs. no), any modern contraception use (yes vs. no), and any traditional contraception use (yes vs. no). The explanatory variables were factors at the individual, household, and community level. The multivariate binary logistic regression model was used to explore associations of outcome variables with explanatory variables. Results. The findings revealed low prevalence of contraceptive use among Somalia women, with only 7% reporting its use. Among them, less than 1% utilized modern contraceptive methods. Several determinants of contraception use were identified, including younger age, higher educational attainment (primary and secondary education), higher parity, exposure to family planning messages through mass media, urban place of residence, and residing in the northwest and northeast regions of Somalia. Conclusion. The results underscore the urgent need for substantial efforts to improve contraceptive use in Somalia. Strengthening healthcare facilities to provide comprehensive sexual and reproductive health services, with a particular focus on promoting contraception uptake, is crucial. Public awareness campaigns and educational programs should also be prioritized to enhance knowledge and understanding of contraception among Somali women. [ABSTRACT FROM AUTHOR]

Background: The stagnation and relatively low use of modern contraceptives are ongoing public health concerns in Bangladesh and other low- and middle-income countries. Although a cultural preference for sons may be linked to the current use of contraceptives, this linkage has not been adequately explored in the Bangladesh context. We investigated the effects of child sex composition on the current use of modern contraceptives. Methods: We extracted and analysed data from 17,333 women who participated in the 2017/18 Bangladesh Demographic and Health Survey. The outcome variable was the current use of modern contraceptive methods. The study factor was the parity and sex composition of the living children. We used multilevel logistic regressions to determine the association between the study factor and outcome variables, adjusting for potential covariates at the individual-, household-, and community-levels. Results: Women with relatively high parity had higher odds of currently using modern contraceptives. Among the individual parities, compared to women with no live sons, women with one or more live sons were more likely to report currently using modern contraceptives. However, this association is significant for women up to three children. When examining both parity and children's sex composition in a regression model, in each parity category, the likelihood of using modern contraceptives tend to rise with an increasing number of sons compared to women with just one daughter. Conclusion: The findings of this study suggest that while the use of modern contraceptives by women increases with the increasing number of children and son preference is prevalent in Bangladesh, women also want to have a mixed composition of son and daughter. The study findings can be used in family planning programmes to customise contraceptive promotion and counselling messages. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to explore the relationship between various forms of child nutritional disorders and early childhood development in Bangladesh. Design: We analysed data from the nationally representative cross-sectional 2019 Multiple Indicator Cluster Survey. Early childhood development was evaluated using the Early Childhood Development Index (ECDI), which comprised 10 yes-or-no questions across four domains: literacy-numeracy, physical well-being, socio-emotional development, and learning abilities. Nutritional disorders (e.g. stunting, wasting, and underweight) were measured based on the World Health Organization's height and weight guidelines. To investigate the relationships between child development and nutritional disorders, we used multilevel logistic regression models. Setting: Bangladesh. Participants: Data of 9,455 children aged 3 and 4 years. Results: Approximately 38 % of the children analysed experienced a nutritional disorder, with stunting being the most prevalent at 28·15 %. Overall, 25·27 % did not meet expected developmental progress measured by the ECDI. Stunted children were more likely to be off track developmentally, while those without any nutritional disorder were more likely to be on track. Socio-demographic factors, including age, sex, attendance in early childhood education programme, maternal education, maternal functional difficulties, region, and income, were identified as determinants of ECDI. Conclusions: Childhood nutrition and socio-demographic factors significantly affect multiple developmental domains and overall ECDI among children aged 3–4 years. Prioritising policies and programmes that improve nutrition and address these determinants are crucial for fostering optimal development in children. [ABSTRACT FROM AUTHOR]

Background: In Bangladesh, as in other low- and middle-income countries, parents frequently migrate to other areas, often for employment opportunities, leaving their children behind with the hope that their earnings will contribute to securing a better future for them. However, the absence of parents due to migration can have negative implications for the well-being of these left-behind children. Despite the existence of studies investigating this phenomenon, the evidence thus far has produced inconclusive findings, with no specific data available from Bangladesh. Therefore, the objective of this study was to examine the effects of parental migration on the early childhood development of left-behind children in Bangladesh. Methods: The present study utilized data from the Bangladesh Multiple Indicator Cluster Survey (MICS) conducted in 2019. A sample of 8,833 children aged 3–4 years was included in the analysis. The Early Childhood Development Index (ECDI) and its individual domains served as the outcome variables of interest. The primary explanatory variables considered in the analysis were father migration, mother migration, migration of both parents, and migration of either parent. To assess the association between the outcomes and explanatory variables, multilevel logistic regression analysis was employed, controlling for relevant covariates. Results: Approximately 29% of all children in the study were not developmentally on track, as measured by the ECDI. When examining the individual domains of the ECDI, only 9% of the total children demonstrated developmental progress in the learning domain. Regarding the association between parental migration and ECDI outcomes, we observed a 26% decrease in the likelihood of overall ECDI among children with a migrated father (OR: 0.74, 95% CI: 0.54–0.93). This decrease became even more pronounced, reaching 37% (OR: 0.63, 95% CI: 0.48–0.97), among children with both parents migrated, compared to children with neither parent migrated. Conclusion: The findings of this study indicate that parental migration, especially when both parents are involved, has a substantial negative impact on the likelihood of achieving favourable ECDI outcomes for children in Bangladesh. To ensure the optimal development of children with migrating parents, it is crucial to strengthen early childhood development education programs and implement robust social safety nets. These efforts should specifically target the unique needs and challenges faced by children with migrated parents, providing them with the necessary support and resources for their holistic development. [ABSTRACT FROM AUTHOR]

The article discusses the challenges facing the health care system in Somalia as well as the low rate of contraception uptake in the country. Topics include findings of the 2020 Somali Health and Demographic Survey, factors attributed to an underdeveloped health-care infrastructure and a severe shortage of health-care personnel in the country, and the need of Somalia to prioritize sexual and reproductive health-care services.

Objectives: Child undernutrition among under 5 aged children is a prevalent global issue, especially in Bangladesh. This study aimed to explore relationships of household environmental conditions (HECs) with child under-nutrition in Bangladesh, with a specific focus on rural-urban differences., Design: We analysed children's data from the 2017/18 Bangladesh Demographic Health Survey (BDHS). The outcome variable considered were measures of child under-nutrition, including stunting, wasting, and underweight. The major exposure variable considered was indicators of HECs. We used a hierarchical Poisson regression model to explore the association between outcomes and exposures adjusted for potential confounders., Setting: Nationally representative cross-sectional survey., Participants: 8,057 under-5 aged children., Results: The prevalence of stunting, wasting and underweight in Bangladesh was 31%, 8% and 22%, respectively, with significant urban-rural variations. Under-5 children who lived in houses constructed with unimproved materials (aRR: 1.17), exposed to household air pollution (HAP) (aPR: 1.37), had unimproved drinking water sources (aPR: 1.28), or had poor handwashing facilities (aPR: 1.24) had a greater likelihood of stunting compared to their counterparts. Similar associations were observed for underweight. The likelihood of stunting and underweight increased with increasing scores of poor HECs, varying significantly across urban-rural areas., Conclusion: The high prevalence of stunting and underweight in Bangladesh is linked to poor HECs. Therefore, policies and programs aimed at reducing child undernutrition need to account for household environmental conditions, with a particular focus on children in poor household environments.

Background: Non-institutional births remain prevalent in low- and middle-income countries, associated with a majority of adverse maternal and child health outcomes, including maternal and child mortality. Ensuring essential newborn care (ENC) practices for these non-institutional births is crucial for reducing these adverse outcomes. This study aimed to identify the prevalence, and factors associated with the adoption of ENC practices among non-institutional births in urban Bangladesh., Methods: A total of 2,165 children's data were analyzed, extracted from the 35,186 ever-married women interviewed in the 2021 Bangladesh Urban Health Survey. Six ENC components and their level (lowest/none, moderate, and highest) were considered as the outcome variables. Several socio-demographic factors were considered as the explanatory variables. Multivariate binary and multinomial logistic regression model were used to explore the association between outcome and explanatory variables., Results: Approximately 49% of all mothers reported practicing the highest level of ENC. Among the individual components, the highest adherence was observed for the use of a disinfected instrument to cut the umbilical cord (90%). The likelihood of adopting the highest level of ENC practices was higher among mothers with relatively higher education and wealth quintiles and lower among those residing in slum and other urban areas of city corporations compared to non-slum areas. Mothers living in the Khulna and Sylhet divisions had a lower likelihood of adopting the highest level of ENC practices., Conclusion: Awareness building programs are needed to educate the population, particularly mothers, about the importance of practicing ENC for improving maternal and child health outcomes.