James P. Grant School of Public Health (JPGSPH)http://hdl.handle.net/10361/1202024-03-28T17:37:41Z2024-03-28T17:37:41ZUnderstanding decision-making and health-seeking practices of the Hijra community in accessing informal healthcare services in Bangladesh: an exploratory qualitative studyIftekhar, Yeasir Inzzamamhttp://hdl.handle.net/10361/189782023-07-25T05:25:29Z2023-01-01T00:00:00ZUnderstanding decision-making and health-seeking practices of the Hijra community in accessing informal healthcare services in Bangladesh: an exploratory qualitative study
Iftekhar, Yeasir Inzzamam
In Bangladesh and other South Asian countries, Hijra people, mainly a community of
transgender women who follow a particular cultural system, faces a multitude of barriers while
trying to access their right to healthcare services. In this paper, we aimed to understand
decision-making factors and health-seeking practices of Hijra community in accessing informal
healthcare services, focusing on their common health problems, their perception and knowledge
of health, patterns of healthcare utilization along with the challenges faced and reasons for
decision making in seeking healthcare from informal facilities in Bangladesh.
The exploratory qualitative study was conducted among 26 self-identified Hijra persons, and 5
key informants affiliated with the Hijra community, during the period of November to December
of 2022 in different areas of Dhaka. Two qualitative guidelines were used to collect data via
face-to-face in-depth and key-informant interviews. Thematic analysis was used to identify key
concepts, cluster themes into patterns and conclude meaning from those patterns.
Findings reveal that Hijra persons have poor knowledge and understanding about their own
health, and sought healthcare services from informal health facilities more than formal health
facilities, particularly from pharmacies, kobiraji, hujur, homeopathy and through
self-medication. The Hijra population reported a number of reasons in opting for informal
services, including better availability and accessibility, influence from peers and support
network, negative attitude of formal healthcare providers, non-friendly interaction and
discrimination from other patients, attendants and staff, along with long waiting times and
harassment in formal health facilities. Our findings highlight the need for understanding of
gender orientation, and sensitization of Hijra lifestyle for formal healthcare providers, policies
for Hijra inclusivity in healthcare services.
This project report is submitted in partial fulfillment of the requirements for the degree of Master of Public Health (MPH), 2023.; Cataloged from the PDF version of the project report.; Includes bibliographical references (pages 37-41).
2023-01-01T00:00:00ZExperiences of volunteers as change agents for prevention of COVID-19 in Cox’s Bazaar, Bangladesh: an exploratory qualitative studyMariam, Warishahttp://hdl.handle.net/10361/189772023-07-24T21:01:56Z2023-01-01T00:00:00ZExperiences of volunteers as change agents for prevention of COVID-19 in Cox’s Bazaar, Bangladesh: an exploratory qualitative study
Mariam, Warisha
Background: Community volunteers are an important backbone for engaging communities
to bring about health related behaviour change among the people of the communities. In
recent years the pandemic due to Coronavirus 2019 has gained all the momentum and most of
the preventive strategies have been shifted in reducing the further transmission of this virus
and curbing the pandemic. This study examines the volunteering experience of the volunteers
working in the BRAC Community Support Team intervention as change agents in the Cox
Bazaar community. The area has been chosen for its high urban and peri urban type of
population density.
Methods: This was an exploratory qualitative study done among ten volunteers involved in
BRAC CST project in Ramu, Sadar and Kutubdia upazilas of Cox’s Bazaar. In depth
interviews were conducted and data was organised, coded and analysed using manual coding
and web-based software Dedoose. Thematic analysis has been done and results has been
interpreted using the Social Cognitive Theory.
Results: Ten volunteers were interviewed, out of which 1 is female and 9 males. The age
ranges from 21 to 38 years. All volunteers perceived their desire to work as a volunteer a
noble cause for the community. They were also recognised and respected in the society for
their work done. Social recognition, job satisfaction for working in public welfare and
support from their families and communities helped them to perform their job better.
However, social, cultural and language barrier and shaming of their work by abusing and
harassing played an important role in hindrance to performing their activities as change
agents. There were also some power distribution roles in community which hampered the
volunteering activity. Lack of refresher training and limited resources and absence of
mobility support are some of the identified factors that also hampered their activity as a
change agent.
Conclusion: In general volunteers were able to perform their assigned tasks. However,
ensuring continuous organisational support, refresher trainings can lead to a greater
motivation for acting as a change agent and performing their tasks better. Future research
directed towards exploring the gender differences in experiences will also add to the
knowledge gap.
This project report is submitted in partial fulfillment of the requirements for the degree of Master of Public Health (MPH), 2023.; Cataloged from the PDF version of the project report.; Includes bibliographical references (pages 23-26).
2023-01-01T00:00:00ZPrevalence of varied perception of mothers about their under-five child’s nutritional status with the measured status and the factors associated with the varied perception of mothers. a cross-sectional study in slums of Dhaka city, BangladeshSarker, Tanmoyhttp://hdl.handle.net/10361/189762023-07-24T21:01:55Z2023-01-01T00:00:00ZPrevalence of varied perception of mothers about their under-five child’s nutritional status with the measured status and the factors associated with the varied perception of mothers. a cross-sectional study in slums of Dhaka city, Bangladesh
Sarker, Tanmoy
Abstract
Objective: Childhood malnutrition is a serious public health concern as it hampers a child’s
physical and cognitive development. Maternal misperception about their child’s nutritional status
can increase the burden of malnutrition. There was very limited literature on maternal perception
of their under-five child’s nutritional status in Bangladesh. The purpose of this study was to
assess the burden of mother’s varied perception about their under-five child’s nutritional status
and associated factors of it in urban slum context.
Design: Cross-sectional study
Setting: Two largest urban slums one from the Dhaka south city corporation (Dholpur) and
another from Dhaka north city corporation (Korail).
Participants: A total of 437 mothers were included in the final analysis, of whom 215 were
from Dholpur and 222 were from Korail slum.
Primary outcome: Mothers’ varied perception about their under-five child’s nutritional status
was the primary outcome of interest. The varied perception is defined as the discrepancy
between the mother's opinion of their child's nutritional state and the measured nutritional status.
Results: The prevalence of mother’s varied perception was 45.8%. The prevalence was higher
for Dholpur slum compared to Korail slum (Dholpur 52.5% vs Korail 47.5%). 37.1% of mothers
underestimated their child’s nutritional status, while 8.7% overestimated it. “Child doesn’t want
to eat” (AOR=3.77; 95% CI: 2.35 to 6.05; p<0.001) and “feel light when I carry” (AOR=4.09;
95% CI: 2.01 to 8.34; p<0.001) was the significant reason behind the mother’s perception.
Mother’s monthly household income 10000 to less than 15000 BDT (AOR=2.41; 95% CI: 1.17
to 4.99; p<0.05) and 20000 to less than 25000 BDT (AOR=2.51; 95% CI: 1.10 to 5.71; p<0.05)
had significantly higher odds of varied perception.
Conclusion: The prevalence of varied perception about their child’s nutritional status was high
for the urban slums. Health education on appropriate feeding practices for children and MUAC
measurement can help mothers to perceive their child’s nutritional status more precisely. Further
qualitative research is required to explore maternal perception.
This project report is submitted in partial fulfillment of the requirements for the degree of Master of Public Health (MPH), 2023.; Cataloged from the PDF version of the project report.; Includes bibliographical references (pages 24-27).
2023-01-01T00:00:00ZDouble burden of malnutrition among mothers having under-five children: a cross-sectional study in the slums of Dhaka cityShapla, Mst. Sharmin Akterhttp://hdl.handle.net/10361/189722023-07-24T05:50:45Z2023-01-01T00:00:00ZDouble burden of malnutrition among mothers having under-five children: a cross-sectional study in the slums of Dhaka city
Shapla, Mst. Sharmin Akter
Objective: We sought to estimate the prevalence and factors associated factors with the double
burden of malnutrition (underweight, overweight/obesity) among mothers who have children less
than 5 years of age residing in the slum areas of Dhaka city.
Methods: We conducted a cross-sectional quantitative study to assess the prevalence and related
factors that affect the double burden of malnutrition including underweight, overweight/obesity
of those mothers who have children less than 5 years of age. The study was conducted in two big
slums; Dholpur slum from South Dhaka city corporations and Korail slum from North Dhaka
city corporations in Bangladesh. A total of 424 mothers who have children less than 5 years of
age were included in this analysis. The primary outcome variable was underweight and
overweight/obesity compared to normal weight as reference category, measured by mother’s
body mass index (BMI). And BMI was calculated following by dividing body weight (kg) by
total height squared (m2).
Results The overall prevalence of underweight and overweight/obesity was respectively 13.4%
and 45.3% among under-five children’s mothers who were living in big slums of Dhaka city in
Bangladesh. The prevalence of both underweight and overweight/obesity was higher among
mothers of 20-29 years of age. We got significant relationship between underweight and
overweight/obesity with the mothers’ age, household monthly income, no. of children, frequency
of pregnancy, childbirth order, mode of delivery, NCD history, and food insecurity. The
associated factors of being underweight are frequency of pregnancy and food insecurity
(AOR=4.8, 95% CI: 1.2- 18.3) and (AOR=2.4, 95% CI: 1.1- 5.4) respectively. The most
significant factors of being overweight/obese are household monthly income, childbirth order,
and mode of delivery (AOR=2.7, 95% CI: 1.3– 5.9), (AOR=3.0, 95% CI: 2.0–9.0) and
(AOR=0.4, 95% CI: 0.2-0.7).
Conclusion In Bangladesh, overweight and as well as obesity have been tremendously rising but
simultaneously underweight did not fall significantly. The Ministry of Health of Bangladesh should consider these findings while whereas creating and executing health programs for the
double burden of malnutrition among mothers who have under-five years of children.
This project report is submitted in partial fulfillment of the requirements for the degree of Master of Public Health (MPH), 2023.; Cataloged from the PDF version of the project report.; Includes bibliographical references (pages 31-35).
2023-01-01T00:00:00Z