ORCID Profile
0000-0003-0916-2631
Current Organisation
BRAC University
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Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.SOCSCIMED.2018.05.002
Abstract: Close-to-community (CTC) providers have been identified as a key cadre to progress universal health coverage and address inequities in health service provision due to their embedded position within communities. CTC providers both work within, and are subject to, the gender norms at community level but may also have the potential to alter them. This paper synthesises current evidence on gender and CTC providers and the services they deliver. This study uses a two-stage exploratory approach drawing upon qualitative research from the six countries (Bangladesh, Indonesia, Ethiopia, Kenya, Malawi, Mozambique) that were part of the REACHOUT consortium. This research took place from 2013 to 2014. This was followed by systematic review that took place from January-September 2017, using critical interpretive synthesis methodology. This review included 58 papers from the literature. The resulting findings from both stages informed the development of a conceptual framework. We present the holistic conceptual framework to show how gender roles and relations shape CTC provider experience at the in idual, community, and health system levels. The evidence presented highlights the importance of safety and mobility at the community level. At the in idual level, influence of family and intra-household dynamics are of importance. Important at the health systems level, are career progression and remuneration. We present suggestions for how the role of a CTC provider can, with the right support, be an empowering experience. Key priorities for policymakers to promote gender equity in this cadre include: safety and well-being, remuneration, and career progression opportunities. Gender roles and relations shape CTC provider experiences across multiple levels of the health system. To strengthen the equity and efficiency of CTC programmes gender dynamics should be considered by policymakers and implementers during both the conceptualisation and implementation of CTC programmes.
Publisher: Institute of Development Studies
Date: 10-2006
Publisher: Springer Science and Business Media LLC
Date: 02-06-2016
Publisher: Inishmore Laser Scientific Publishing Ltd
Date: 15-05-2020
DOI: 10.29392/001C.12682
Abstract: In the global journey towards Universal Health Coverage (UHC), strong primary healthcare systems are essential. This includes the frontline health workers, the bedrock of which are community health workers (CHWs). In Bangladesh, this largely female workforce plays a critical role in health promotion and linking communities with the formal health care system. With the launch of the new national strategy on CHWs, and its ambitions around the implementation of harmonized systems of financing, certification, job harmonization, performance assessment and supportive supervision, it is important to reference the perceptions, experiences, needs and aspirations of CHWs themselves. This qualitative exploratory study examines three UNICEF supported maternal and newborn health (MNH) programs in rural Bangladesh, with two districts s led for each program. In-depth interviews were conducted with CHWs, community members, other health workers, and program managers. Data were analyzed using a thematic analysis approach, with a particular focus on the voice and experience of CHWs and the programmatic features that support them in serving their communities. Across all three programs, CHWs function as critical local agents for health promotion and referral whose recruitment from and support by the community, enhances their effectiveness. Regular communication and collaboration between CHWs and public-sector frontline workers were perceived as important in enabling their role in increasing the coverage of essential services. Support for structured systems of training, supervision and monitoring which encompass the support of referral decisions, was also apparent. Of particular note were the needs and aspirations of CHWs regarding work-life balance, job satisfaction and desire for professional development. These concerns emphasize the importance of flexibility in how the CHW workforce is configured such that roles, responsibilities and remuneration are keyed to experience and qualifications, and the dynamic needs and aspirations of CHWs over the life course. As Bangladesh pursues its UHC agenda, CHWs are pivotal in linking underserved communities to the formal health system. Flexibility in the scope of CHW roles and responsibilities, as well as supportive supervision, regular training and fair remuneration, will optimize their contributions towards UHC and better MNH outcomes.
Publisher: Springer Science and Business Media LLC
Date: 03-09-2018
Publisher: Springer Science and Business Media LLC
Date: 11-08-2021
DOI: 10.1057/S41287-021-00439-4
Abstract: Bangladesh has made progress in advancing adolescent girls’ education, but there remain substantial evidence gaps around age and gender differences in motivations, retention, and access to education for adolescents living in urban slums. This article draws on quantitative and qualitative data collected in 2017 and 2018 by Gender and Adolescence: Global Evidence (GAGE) with adolescents aged 10–17 across three low-income areas in Dhaka to explore adolescent educational attainment, aspirations, and environmental factors that constrain both. We find high educational and professional aspirations among adolescents and their parents, with parental support being an important predictor of both current enrolment and adolescent aspirations. Location is also an important predictor of adolescent aspirations and enrolment, highlighting the importance of infrastructure and services, integration into the city, and stability of the community (including schools and facilities), along with higher incomes and better employment opportunities for households.
Publisher: Springer Japan
Date: 2013
Publisher: Wiley
Date: 2021
Abstract: This study aimed at examining health sufferings of readymade garments (RMG) workers, the factors that affect their health sufferings, their healthcare seeking pattern, knowledge about health insurance and health related rights in Bangladesh. A cross‐sectional study was conducted among 486 RMG workers recruited randomly from eight garments factories located on the periphery of Dhaka, Bangladesh. The prevalence of musculoskeletal pain, headache, fever and abdominal pain was estimated and multivariable logistic regression analysis was performed to examine association between these illnesses of workers and their socio‐demographic characteristics and other work related information. We also explored their healthcare seeking patterns, knowledge about health insurance and health related rights. The prevalence of musculoskeletal pain, headache, fever and abdominal pain was found to be 78.1%, 57.9%, 52.2% and 24.6%, respectively, among the RMG workers. Factors that increased the odds of: musculoskeletal pain were working for more than 10 h per day (adjusted odds ratio [AOR]: 2.3, 95% confidence interval [CI]: 1.1–4.7) and being female [AOR: 4.6, 95% CI: 2.0–10.6] fever was living in slums [AOR: 1.9, 95% CI: 1.1–3.5] and abdominal pain was being female [AOR: 3.6, 95% CI: 1.4–9.3]. The workers commonly reported visiting drug sellers in local pharmacies for reported illnesses. They also had better knowledge of health related rights but poor knowledge of health insurance. In order to address the overall health and well‐being of the RMG workers, it is imperative to lay out a blueprint for a safe and healthy workplace.
Publisher: Wiley
Date: 03-2007
DOI: 10.1525/MAQ.2007.21.1.108
Abstract: I carried out ethnographic fieldwork among 153 married adolescent girls, aged 15-19, in a Dhaka slum from December 2001 to January 2003, including 50 in-depth interviews and eight case studies. I also held discussions with family and community members. In this article, I focus on popular understandings of vaginal discharge being caused by durbolota (weakness) and chinta rog (worry illness), as mentioned by young women. Eighty-eight young women reported that they had experienced white discharge, blaming it on a number of factors such as stress and financial hardships, tensions in the household, marital instability, hunger anxiety, and reproductive burdens. For married adolescent women in the urban slum, white discharge has many levels of meaning linked to the broader social, political, and material inequalities in their everyday lives.
Publisher: MDPI AG
Date: 23-08-2022
Abstract: COVID-19 significantly affected people with disabilities, with many facing additional barriers in access to services and increased risks of poor health and social outcomes. Focusing on the impact of COVID-19 in the Global South, this study took place in Bangladesh and Liberia, where 14% and 16% of the population are thought to live with disabilities. However, there is minimal research on the needs and experiences of this population group and how these are shaped by intersecting axes of inequity. Furthermore, disabled people are often excluded from being actively involved in research. To address these evidence gaps, we used the creative participatory method of photovoice remotely to document experiences of COVID-19 through the lens of people with physical and psychosocial disabilities and their caregivers as co-researchers. The findings present themes relating to inaccessibility, social connection, hopes and fears. The nexus between disability and poverty was exacerbated for many in both settings, while psychosocial impacts of COVID-19 included increased stigmatisation and isolation. However, themes of faith, support and adaptability were also highlighted in stories of community care, nature and healing. Photovoice, through imagery and storytelling, was a powerful tool in prioritising the voices of disabled people, adding to an evidence base to inform inclusive pandemic responses.
Publisher: SAGE Publications
Date: 2001
DOI: 10.1177/104973201129118957
Abstract: The discourses of the female body in rural Bangladesh illustrate gender relations in rural society and the degree to which village ideologies of shame, purity, and pollution affect women’s attitudes toward contraceptive practices. Women’s understanding of their body and perception of flow, buildup, and blockage related to Norplant use reveal a belief in the disruption of the internal state of the body. Humeral notions underlie descriptions of Norplant use, which are understood to agree with women differently. Bengalis believe that blockage in the body can endanger the wider social and moral sphere. Culturally promoted fears of illnesses motivate in iduals to conform to social norms. Some rural women chose to ignore their health problems, some dropped out, and some preferred Norplant.
Publisher: Springer Science and Business Media LLC
Date: 16-09-2009
Publisher: Elsevier BV
Date: 05-2019
Publisher: Elsevier BV
Date: 05-2019
Publisher: Elsevier BV
Date: 10-2022
Publisher: Springer Science and Business Media LLC
Date: 22-04-2014
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S13031-020-00329-2
Abstract: Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee c s of Cox’s Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crises, delivering sexual and reproductive health (SRH) services is critical for better health outcomes of this most-at-risk population where more than half are adolescent girls and women. This is a reflective paper on challenges and related mitigation strategies to conduct SRH research among FDMNs. The research on which this paper is based employed a concurrent mixed-method design combining a cross-sectional survey and qualitative interviews and group discussions with FDMNs to understand their SRH needs and demand-side barriers. Assessment of health facilities and qualitative interviews with healthcare providers and key stakeholders were carried out to assess facility readiness and supply-side barriers. The researchers faced different challenges while conducting this study due to the unique characteristics of the FDMN population and the location of the refugee c s. The three key challenges researchers encountered include: sensitivity regarding SRH in the FDMNs, identifying appropriate s ling strategies, and community trust issues. The key approaches to overcome these challenges involved: actively engaging community members and gatekeepers in the data collection process to access respondents, identifying sensitive SRH issues through survey and exploring in-depth during qualitative interviews and contextually modifying the s ling strategy. Contextual adaptation of research methods and involving community and local key stakeholders in data collection are the key lessons learnt from this study. Another important lesson was researchers’ identity and positionality as a member of the host country may create distrust and suspicion among the refugees. The multi-level complexities of humanitarian settings may introduce unforeseen challenges and interrupt research plans at different stages of research which require timely and contextual adaptations.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Mark Allen Group
Date: 11-2007
DOI: 10.12968/BJOM.2007.15.11.27474
Abstract: Gender roles and relations, that is, the social constructions of what it means to be female or male and the multiple and complex power relationships between females and males affects women's experiences of maternal health and maternal health outcomes. In the Bangladeshi context, the social construction of gender means that the sexuality and reproductive capacity of women is seen as belonging to husband, family or community.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-028340
Abstract: Rohingya diaspora are one of the most vulnerable groups seeking refuge in c s of Cox’s Bazar, Bangladesh, arising an acute humanitarian crisis. More than half of the Rohingya refugees are women and adolescent girls requiring quality sexual and reproductive health (SRH) services. Minimum initial service package of SRH are being rendered in the refugee c s however, WHO is aiming to provide integrated comprehensive SRH services to meet the unmet needs of this most vulnerable group. For sustainable and successful implementation of such comprehensive SRH service packages, a critical first step is to undertake a situation analysis and understand the current dimensions and capture the lessons learnt on their SRH-specific needs and implementation challenges. This situation analysis is pertinent in current humanitarian condition and will provide an overview of the needs, availability and delivery of SRH services for adolescent girls and women, barriers in accessing and providing those services in Rohingya refugee c s in Cox’s Bazar, Bangladesh, and similar humanitarian contexts. A concurrent mixed-methods design will be used in this study. A community-based household survey coupled with facility assessments as well as qualitative in-depth interviews, key informant interviews and focus group discussions will be conducted with community people of Rohingya refugee c s and relevant stakeholders providing SRH services to Rohingya population in Cox’s Bazar, Bangladesh. Survey data will be analysed using univariate, bivariate and multivariable regression statistics. Descriptive analysis will be done for facility assessment and thematic analysis will be conducted with qualitative data. Ethical approval from Institutional Review Board of BRAC James P Grant School of Public Health (2018-017-IR) has been obtained. Findings from this research will be disseminated through presentations in local, national and international conferences, workshops, peer-reviewed publications, policy briefs and interactive project report.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Informa UK Limited
Date: 2011
Publisher: SAGE Publications
Date: 09-2001
DOI: 10.1177/004908570103100306
Abstract: BRAC, a local non-governmental organisation is providing reproductive health knowledge for rural adolescents belonging to poor families. There productive curriculum covers a wide range of issue from puberty reproduction and menstruation, marriage and pregnancy, STDs and AIDS, family planning and birth control, are recruited and trained. Classes are taught to both male and female adolescents. An important aspect of implementation is the involvement of stakeholders (teachers, students, parents, religious leaders and community members) in selecting location of schools and deciding school management committees. To ensure effective implementation, a system of supervising and monitoring is in place. The strengths of the programme are many-there is an emphasis on community involvement, the introduction of basic knowledge on reproductive matters and links have been created whereby students, teachers and programme staff act as referrals to health centres and other formal health facilities for community members. Some weaknesses are identified, such as, monitoring constraints, insufficient training, teaching hours and teaching aids, and a lack of awareness of interactive teaching methods. Cultural considerations hinder female teachers from teaching adolescents boys freely. Some of the challenges to the programme are the conservative cultural environment and religious opposition in some areas. Currently the programme is on in 803 schools, covering a population of 27,175 rural adolescents.
Publisher: Informa UK Limited
Date: 2006
Publisher: Informa UK Limited
Date: 23-01-2021
Publisher: BMJ
Date: 04-2021
Publisher: Informa UK Limited
Date: 11-01-2020
Publisher: Springer Science and Business Media LLC
Date: 14-01-2017
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.SOCSCIMED.2016.07.019
Abstract: In LMICs, Community Health Workers (CHW) increasingly play health promotion related roles involving 'Empowerment of communities'. To be able to empower the communities they serve, we argue, it is essential that CHWs themselves be, and feel, empowered. We present here a critique of how erse national CHW programs affect CHW's empowerment experience. We present an analysis of findings from a systematic review of literature on CHW programs in LMICs and 6 country case studies (Bangladesh, Ethiopia, Indonesia, Kenya, Malawi, Mozambique). Lee & Koh's analytical framework (4 dimensions of empowerment: meaningfulness, competence, self-determination and impact), is used. CHW programs empower CHWs by providing CHWs, access to privileged medical knowledge, linking CHWs to the formal health system, and providing them an opportunity to do meaningful and impactful work. However, these empowering influences are constantly frustrated by - the sense of lack/absence of control over one's work environment, and the feelings of being unsupported, unappreciated, and undervalued. CHWs expressed feelings of powerlessness, and frustrations about how organisational processual and relational arrangements hindered them from achieving the desired impact. While increasingly the onus is on CHWs and CHW programs to solve the problem of health access, attention should be given to the experiences of CHWs themselves. CHW programs need to move beyond an instrumentalist approach to CHWs, and take a developmental and empowerment perspective when engaging with CHWs. CHW programs should systematically identify disempowering organisational arrangements and take steps to remedy these. Doing so will not only improve CHW performance, it will pave the way for CHWs to meet their potential as agents of social change, beyond perhaps their role as health promoters.
Publisher: Informa UK Limited
Date: 31-05-2021
Publisher: Cold Spring Harbor Laboratory
Date: 21-04-2022
DOI: 10.1101/2022.04.18.22273840
Abstract: The Rohingya and Bangladeshi host communities live at a heightened risk of COVID-19 impact due to their pre-existing vulnerabilities, religious beliefs, and strict socio-cultural and gender norms that render primarily women and girls vulnerable. However, the extent of this vulnerability varies within and across population groups in the host and Rohingya communities. The intersectionality lens helps identify, recognize, and understand these factors that create inequities within populations. This study explored the factors that influenced the women and girls’ access to information during the COVID-19 pandemic through an intersectional lens. This paper presents partial findings from the exploratory qualitative part of mixed-method research conducted in ten Rohingya c s and four wards of the adjacent host communities in Cox’s Bazar, Bangladesh. Data were extracted from 24 in-depth interviews (12 in each community) conducted from November 2020 to March 2021 with erse participants, including adolescent girls, younger women, adult women, pregnant and lactating mothers, persons with disabilities, older adults, and single female-household heads. All participants provided verbal informed consent before the interviews. In the case of the adolescents, assent was taken from the participants, and verbal informed consent was taken from their parents/guardians. The ethical clearance of this study was sought from the institutional review board of BRAC James P Grant School of Public Health, BRAC University. We find that the women and girls living in Rohingya communities exhibit a more profound structural interplay of factors within their socio-ecological ecosystem depending on their age, power, and position in the society, physical (dis)abilities, and pre-existing vulnerabilities stemming from their exodus, making them more vulnerable to COVID-19 impact by hindering their access to information. Unlike Rohingya, the host women and girls explain the impact of the COVID-19 pandemic on their access to information through the lens of intergenerational poverty and continuous strain on existing resources, thereby highlighting shrinking opportunities due to the influx, COVID-19 infodemic and misinformation, access to digital devices amongst the adolescents, and restricted mobility mainly due to transport, school closures, and distance-related issues. Moreover, the socio-cultural beliefs and the gender norms imposed on women and adolescent girls played an essential role in accessing information regarding the COVID-19 pandemic and consequently influenced their perception of and response to the disease and its safety protocols. Socio-cultural gender norms led to mobility restrictions, which compounded by lockdowns influenced their access to information resulting in dependency on secondary sources, usually from male members of their families, which can easily mislead rovide mis artial information. The younger age groups had more access to primary sources of information and a broader support network. In comparison, the older age groups were more dependent on secondary sources, and their social networks were limited to their family members due to their movement difficulty because of age/aging-related physical conditions. This study explored and analyzed the intersectional factors that influenced the women and girls’ access to information during the COVID-19 pandemic from two contexts with varying degrees of pre-existing vulnerability and its extent. These include gender, age, state of vulnerability, power and privilege, socio-economic status, and physical (dis)ability. It is imperative that services geared towards the most vulnerable are contextualized and consider the intersectional factors that determine the communities’ access to information.
Publisher: Springer Science and Business Media LLC
Date: 12-2011
Publisher: Informa UK Limited
Date: 2001
DOI: 10.1016/S0968-8080(01)90094-1
Abstract: Despite initiatives and interventions undertaken at national and international levels, maternal health is still neglected in Bangladesh, and the maternal mortality ratio remains one of the highest in the world. In order to improve rural women's access to maternity care, in 1996 the Bangladesh Rural Advancement Committee (BRAC) instituted services for birthing women in 21 health facilities in each Thana. This paper reports on research conducted three years later, based on interviews with women who gave birth in one BRAC Health Centre (BHC) and women who gave birth at home, interviews with staff of the BHC and observation of provider-patient relations. Acceptance of delivery in a health facility by rural women is still minimal. Most women only attended the BHC due to complications, yet the BHC was unable to handle most complications and referred women to the district hospital, where they received poor quality care. Cost, fear of hospitals and the stigma of an 'abnormal' birth were also important constraints. Female paramedics who attended normal deliveries were praised for being caring, but made women deliver lying down, did not always use aseptic procedures and were too busy to give information, making birth a passive experience. Recommendations to provide comprehensive emergency obstetric care at the BHC and upgrade staff skills, introduce rural health insurance and others have already begun to be implemented.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.LFS.2016.02.063
Abstract: Anxiety disorders are major health problems in terms of costs stemming from sick leave, disabilities, healthcare and premature mortality. Despite the availability of classic anxiolytics, some anxiety disorders are still resistant to treatment, with higher rates of adverse effects. In this respect, several toxins isolated from arthropod venoms are useful in identifying new compounds to treat neurological disorders, particularly pathological anxiety. Thus, the aims of this study were to identify and characterize an anxiolytic peptide isolated from the venom of the social wasp Polybia paulista. The peptide was identified as Polisteskinin R, with nominal molecular mass [M+H](+)=1301Da and primary structure consisting of Ala-Arg-Arg-Pro-Pro-Gly-Phe-Thr-Pro-Phe-Arg-OH. The anxiolytic effect was tested using the elevated plus maze test. Moreover, adverse effects on the spontaneous behavior and motor coordination of animals were assessed using the open field and rotarod tests. Polisteskinin R induced a dose-dependent anxiolytic effect. Animals treated with the peptide and diazepam spent significantly more time into the open arms when compared to the groups treated with the vehicle and pentylenetetrazole. No significant differences in spontaneous behavior or motor coordination were observed between the groups, showing that the peptide was well tolerated. The interaction by agonists in both known BK receptors induces a variability of physiological effects Polisteskinin R can act on these receptors, inducing modulatory activity and thus, attenuating anxiety behaviors. The results of this study demonstrated that the compound Polisteskinin R exerted potent anxiolytic effects and its analogues are promising candidates for experimental pharmacology.
Publisher: Springer Science and Business Media LLC
Date: 09-11-2015
Publisher: MDPI AG
Date: 13-04-2023
Abstract: Vaccine hesitancy or low uptake was identified as a major threat to global health by the World Health Organization (WHO) in 2019. Vaccine hesitancy is context-specific and varies across time, place, and socioeconomic groups. In this study, we aimed to understand the perceptions of and attitudes toward COVID-19 vaccination through time among urban slum dwellers in Dhaka, Bangladesh. In-depth telephone interviews were conducted between October 2020 and January 2021 with 36 adults (25 females and 11 males) living in three urban slums of Dhaka City, Bangladesh. Follow-up interviews were undertaken in April and August 2021 to capture any shift in the participants’ perceptions. Our findings show that for many there was an initial fear and confusion regarding the COVID-19 vaccine among people living in urban informal settlements this confusion was soon reduced by the awareness efforts of government and non-government organizations. Women and young people were more interested in being vaccinated as they had had more exposure to the awareness sessions conducted by non-governmental organizations (NGOs) and on social media. However, people living in the slums still faced systemic barriers, such as complicated online vaccine registration and long queues, which led to low uptake of the vaccine despite their increased willingness to be vaccinated. This study highlights the importance of using sources such as NGO workers and television news to debunk myths, disseminate COVID-19 vaccine information, and support adherence to vaccination among urban slum dwellers. Our study underscores the importance of addressing systemic barriers blocking access and understanding community perceptions in order to develop effective communication strategies for vulnerable groups that will then improve the COVID-19 vaccine uptake.
Publisher: Springer Science and Business Media LLC
Date: 17-11-2009
Publisher: Springer Science and Business Media LLC
Date: 24-04-2020
Publisher: Informa UK Limited
Date: 07-2000
DOI: 10.1080/741923625
Publisher: BMJ
Date: 04-2019
DOI: 10.1136/BMJ.L1083
Publisher: Public Library of Science (PLoS)
Date: 08-06-2023
DOI: 10.1371/JOURNAL.PGPH.0000451
Abstract: The COVID-19 pandemic has had an adverse impact on the Rohingya and the Bangladeshi host communities, which have been well documented in the literature. However, the specific groups of people rendered most vulnerable and marginalized during the pandemic have not been studied comprehensively. This paper draws on data to identify the most vulnerable groups of people within the Rohingya and the host communities of Cox’s Bazar, Bangladesh, during the COVID-19 pandemic. This study employed a systematic sequential method to identify the most vulnerable groups in the context of Rohingya and Host communities of Cox’s Bazar. We conducted a rapid literature review (n = 14 articles) to list down Most vulnerable groups (MVGs) in the studied contexts during the COVID-19 pandemic and conducted four (04) group sessions with humanitarian providers and relevant stakeholders in a research design workshop to refine the list. We also conducted field visits to both communities and interviewed community people using In-depth interviews (n = 16), Key-informant Interviews (n = 8), and several informal discussions to identify the most vulnerable groups within them and their social drivers of vulnerabilities. Based on the feedback received from the community, we finalized our MVGs criteria. The data collection commenced from November 2020 to March 2021. Informed consent was sought from all participants, and ethical clearance for this study was obtained from the IRB of BRAC JPGSPH. The most vulnerable groups identified in this study were: single female household heads, pregnant and lactating mothers, persons with disability, older adults, and adolescents. Our analysis also found some factors that may determine the different levels of vulnerabilities and risks faced by some groups more than others in the Rohingya and host communities during the pandemic. Some of these factors include economic constraints, gender norms, food security, social safety-security, psychosocial well-being, access to healthcare services, mobility, dependency, and a sudden halt in education. One of the most significant impacts of COVID-19 was the loss of earning sources, especially for the already economically vulnerable this had far-reaching consequences on in iduals’ food security and food consumption. Across the communities, it was found that the economically most affected group was single female household heads. The elderly and pregnant and lactating mothers face challenges seeking health services due to their restricted mobility and dependency on other family members. Persons living with disabilities from both contexts reported feelings of inadequacy in their families, exacerbated during the pandemic. Additionally, the shutdown in the formal education, and informal learning centres in both communities had the most significant impact on the adolescents during the COVID-19 lockdown. This study identifies the most vulnerable groups and their vulnerabilities amid the COVID-19 pandemic in the Rohingya and Host communities of Cox’s Bazar. The reasons behind their vulnerabilities are intersectional and represent deeply embedded patriarchal norms that exist in both communities. The findings are essential for the humanitarian aid agencies and policymakers for evidence-based decision-making and service provisions for addressing the vulnerabilities of the most vulnerable groups.
Publisher: Public Library of Science (PLoS)
Date: 18-12-2017
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.JADOHEALTH.2021.12.001
Abstract: Although there is a growing evidence base on the drivers of child marriage, comparatively little is known about the experiences of married girls in refugee settings and how their development trajectories erge from those of their nonmarried peers, particularly in the context of the COVID-19 pandemic. Drawing on cross-national panel data from Bangladesh and Jordan, this article explores ersity in child marriage experiences in contexts affected by forced displacement, highlighting how married girls' well-being differs from that of their unmarried peers, and how COVID-19 has reinforced these differences. We analyzed longitudinal survey data-collected pre- and post-COVID-19-from the Gender and Adolescence: Global Evidence study with 293 ever-married and 1,102 never-married adolescent girls. Multivariate regression analysis assessed the well-being of married and unmarried girls across contexts and refugee status, both prior to and during the COVID-19 pandemic. These quantitative data are complemented by in-depth qualitative data from adolescents (n = 112), and key informant interviews with service providers and community leaders (n = 62). Our findings highlight that married girls in contexts affected by displacement are disadvantaged in multiple ways, but that the patterning of disadvantage varies across contexts, and that marriage can also have protective effects in certain contexts. The COVID-19 pandemic has, however, served to exacerbate existing inequalities in all contexts. Although child marriage prevention efforts remain critical, there is also an urgent need for programming that targets married girls in refugee and host communities to mitigate negative outcomes among this vulnerable group.
Publisher: BMJ
Date: 06-2020
Publisher: Elsevier BV
Date: 2020
DOI: 10.2139/SSRN.3608577
Publisher: Wiley
Date: 14-05-2021
DOI: 10.1111/NYAS.14608
Abstract: Adolescent birth is a major global concern owing to its adverse effects on maternal and child health. We assessed trends in adolescent birth and examined its associations with child undernutrition in Bangladesh using data from seven rounds of Demographic and Health Surveys (1996–2017, n = 12,006 primiparous women with living children years old). Adolescent birth (10–19 years old) declined slowly, from 84% in 1996 to 71% in 2017. Compared with adult mothers (≥20 years old), young adolescent mothers (10–15 years old) were more likely to be underweight (+11 pp), have lower education (−24 pp), have less decision‐making power (−10 pp), live in poorer households (−0.9 SD) with poorer sanitation (−15 pp), and have poorer feeding practices (10 pp), and were less likely to access health and nutrition services (−3 to −24 pp). In multivariable regressions controlled for known determinants of child undernutrition, children born to adolescents had lower height‐for‐age Z‐scores (−0.29 SD for young and −0.10 SD for old adolescents (16–19 years old)), weight‐for‐age Z‐score (−0.18 and −0.06 SD, respectively) as well as higher stunting (5.9 pp) and underweight (6.0 pp) than those born to adults. In conclusion, birth during adolescence, a common occurrence in Bangladesh, is associated with child undernutrition. Policies and programs to address poverty and improve women's education can help delay marriage, reduce early childbearing, and improve child growth.
Publisher: SAGE Publications
Date: 11-2007
Abstract: This article reports on the problem of obtaining reproductive histories from women in the slums of Dhaka, the capital of Bangladesh. Access to women in these slums is controlled by several gatekeepers. The gatekeeper problem is common in all field research, but the problem is particularly difficult when the research involves interviewing young Muslim women on the sensitive issue of reproductive health and family planning.
Publisher: SAGE Publications
Date: 23-05-2014
Abstract: This study was aimed to estimate the prevalence of intimate partner violence (IPV) in a s le of 226 women with disabilities living in four different districts of Bangladesh. It also explored the physical and psychological suffering of women experiencing violence and their various coping strategies. A cross-sectional survey was carried out with 226 women with disabilities to measure the prevalence of IPV, and 16 in-depth interviews were conducted to document in detail the experiences of violence encountered by the abused women. Among the 226 women interviewed in the survey, about 84% reported ever having experienced at least one act of emotional abuse, physical, or sexual violence from their partner during their lifetime. Women who were older (aged above 32 years), separated, and members of economic/savings group were more likely to report ever having experienced any IPV than women with disabilities who were younger (aged 32 years and less), married, and not members of economic/savings group. Most of the women experiencing violence reported sufferings from physical and psychological problems. Of all the women who experienced violence, less than half (45%) reported seeking support to minimize or avoid violence experiences. However, seeking support from informal network such as family and relatives was commonly reported by many (81.4%) of them. Study findings suggest that women with disabilities who possess poor socio-economic status coupled with economic dependency on husbands’ income and wide-spread social stigma against disability make them vulnerable to IPV. Future interventions to address IPV against women with disabilities should include building community knowledge of disability and IPV, countering the pervasive social stigma against disabilities, and improving the socio-economic conditions of women with disabilities through education and employment.
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-039195
Abstract: To explore how adolescent and young men negotiate the complex realities of lives to explain their pathways into and reasons for early marriage in urban slums of Bangladesh. The qualitative data used here came from a larger 3-year study that used both quantitative and qualitative research methods. Interviews were conducted in two of the largest slums in Dhaka and Chittagong city of Bangladesh between December 2015 and March 2018. This paper uses qualitative data from 22 in-depth interviews (IDIs) and three focus group discussions (FGDs) with adolescent and young men aged 15–24 years 13 IDIs and 4 FGDs with parents and 11 key-informant interviews with community leaders. The purposively selected respondents were interviewed in their respective settings. In the context of urban slums, this study revealed multiple factors influence early marriage decision-making processes among young men. These factors include socially perceived phenomenon of adulthood and readiness of marriage, poverty leading to drop out from schools and early initiation to earning livelihood, manifestations of increasing in idual aspiration and agency, fulfilment of romance and erotic desires and dreams of forming one’s own family. In addition, parental and immediate societal interference to preserve norms around gender and society can act as catalysts for this decision. Study findings imply that complex structural factors, social and gender norms that are contributing to the early marriage for both adolescent boys and young men in Bangladesh’s urban slums. These are locations where conservatism, poverty and urbanisation intersect resulting in early and often unprepared entry to adulthood for young men impacting on their development and well-being. It is, therefore, critical that young men should be included in the national and global conversations around child marriage and child marriage prevention programme.
Publisher: Springer International Publishing
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 16-06-2011
Publisher: Springer Science and Business Media LLC
Date: 26-02-2021
DOI: 10.1186/S13031-021-00346-9
Abstract: There is growing attention to addressing the menstrual hygiene management (MHM) needs of the over 21 million displaced adolescent girls and women globally. Current approaches to MHM-related humanitarian programming often prioritize the provision of menstrual materials and information. However, a critical component of an MHM response includes the construction and maintenance of water, sanitation and hygiene (WASH) facilities, including more female-friendly toilets. This enables spaces for menstruating girls and women to change, dispose, wash and dry menstrual materials all of which are integral tasks required for MHM. A global assessment identified a number of innovations focused on designing and implementing menstruation-supportive WASH facilities in the Rohingya refugee c s located in Cox’s Bazar (CXB), Bangladesh. These pilot efforts strove to include the use of more participatory methodologies in the process of developing the new MHM-supportive WASH approaches. This study aimed to capture new approaches and practical insights on innovating menstrual disposal, waste management and laundering in emergency contexts through the conduct of a qualitative assessment in CXB. The qualitative assessment was conducted in the Rohingya refugee c s in CXB in September of 2019 to capture new approaches and practical insights on innovating for menstrual disposal, waste management and laundering. This included Key Informant Interviews with 19 humanitarian response staff from the WASH and Protection sectors of a range of non-governmental organizations and UN agencies Focus Group Discussions with 47 Rohingya adolescent girls and women and direct observations of 8 WASH facilities (toilets, bathing, and laundering spaces). Key findings included: one, the identification of new female-driven consultation methods aimed at improving female beneficiary involvement and buy-in during the design and construction phases two, the design of new multi-purpose WASH facilities to increase female beneficiary usage three, new menstrual waste disposal innovations being piloted in communal and institutional settings, with female users indicating at least initial acceptability and four, novel strategies for engaging male beneficiaries in the design of female WASH facilities, including promoting dialogue to generate buy-in regarding the importance of these facilities and debate about their placement. Although the identified innovative participatory methodologies and design approaches are promising, the long term viability of the facilities, including plans to expand them, may be dependent on the continued engagement of girls and women, and the availability of resources.
Publisher: Public Library of Science (PLoS)
Date: 05-12-2022
DOI: 10.1371/JOURNAL.PGPH.0000459
Abstract: The Rohingya and Bangladeshi host communities live at a heightened risk of COVID-19 impact due to their pre-existing vulnerabilities, religious beliefs, and strict socio-cultural and gender norms that render primarily women and girls vulnerable. However, the extent of this vulnerability varies within and across population groups in the host and Rohingya communities. The intersectionality lens helps identify, recognize, and understand these factors that create inequities within populations. This study explored the factors that influenced the women and girls’ access to information during the COVID-19 pandemic through an intersectional lens. This paper presents partial findings from the exploratory qualitative part of mixed-method research conducted in ten Rohingya c s and four wards of the adjacent host communities in Cox’s Bazar, Bangladesh. Data were extracted from 24 in-depth interviews (12 in each community) conducted from November 2020 to March 2021 with erse participants, including adolescent girls, younger women, adult women, pregnant and lactating mothers, persons with disabilities, older adults, and single female-household heads. All participants provided verbal informed consent before the interviews. In the case of the adolescents, assent was taken from the participants, and verbal informed consent was taken from their parents/guardians. The ethical clearance of this study was sought from the institutional review board of BRAC James P Grant School of Public Health, BRAC University. We find that the women and girls living in Rohingya communities exhibit a more profound structural interplay of factors within their socio-ecological ecosystem depending on their age, power, and position in the society, physical (dis)abilities, and pre-existing vulnerabilities stemming from their exodus, making them more vulnerable to COVID-19 impact by hindering their access to information. Unlike Rohingya, the host women and girls explain the impact of the COVID-19 pandemic on their access to information through the lens of intergenerational poverty and continuous strain on existing resources, thereby highlighting shrinking opportunities due to the influx, COVID-19 infodemic and misinformation, access to digital devices amongst the adolescents, and restricted mobility mainly due to transport, school closures, and distance-related issues. Moreover, the socio-cultural beliefs and the gender norms imposed on women and adolescent girls played an essential role in accessing information regarding the COVID-19 pandemic and consequently influenced their perception of and response to the disease and its safety protocols. Socio-cultural gender norms led to mobility restrictions, which compounded by lockdowns influenced their access to information resulting in dependency on secondary sources, usually from male members of their families, which can easily mislead rovide mis artial information. The younger age groups had more access to primary sources of information and a broader support network. In comparison, the older age groups were more dependent on secondary sources, and their social networks were limited to their family members due to their movement difficulty because of age/aging-related physical conditions. This study explored and analyzed the intersectional factors that influenced the women and girls’ access to information during the COVID-19 pandemic from two contexts with varying degrees of pre-existing vulnerability and its extent. These include gender, age, state of vulnerability, power and privilege, socio-economic status, and physical (dis)ability. It is imperative that services geared towards the most vulnerable are contextualized and consider the intersectional factors that determine the communities’ access to information.
Publisher: Informa UK Limited
Date: 20-07-2007
DOI: 10.1080/13648470701381465
Abstract: The paper is about the neglect of infertility and women's interests in the health policy of developing countries, and how this shapes married adolescent women's understandings and practices surrounding infertility. Ethnographic fieldwork among married adolescent girls, aged 15-19, was carried out in a slum in Dhaka, Bangladesh from December 2001 to January 2003, including 50 in-depth interviews and eight case studies from 153 married adolescent girls, and observations and discussions with family and community members. There are newer understandings with the re-labelling of infertility from spirit world afflictions to something that is also attributed to family planning and 'build up of fat' in the uterus and stomach. Corrective practices range from not using or discontinuing a contraceptive method, dilatation and curettage (D&C) and visiting traditional healers. The absence of state services to address infertility concerns has implications for contraceptive use, with unintended pregnancies and unsafe abortions. Local beliefs continue to largely attribute the primary cause of infertility to the spirit world, but the emergence of newer infertility understandings reveal the influence of Western cultural beliefs (family planning c aigns, health practices influenced by biomedicine) and highlight the gender politics in the harsh environment of urban slums.
Publisher: Elsevier BV
Date: 06-2022
Publisher: BMJ
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 08-2021
Publisher: Wiley
Date: 03-2000
Abstract: This paper explores the experiences of female adolescents during the 1998 floods in Bangladesh, focusing on the implications of socio-cultural norms related to notions of honour, shame, purity and pollution. These cultural notions are reinforced with greater emphasis as girls enter their adolescence, regulating their sexuality and gender relationships. In Bangladeshi society, adolescent girls are expected to maintain their virginity until marriage. Contact is limited to one's family and extended relations. Particularly among poorer families, adolescent girls tend to have limited mobility to safeguard their 'purity'. This is to ensure that the girl's reputation does not suffer, thus making it difficult for the girl to get married. For female adolescents in Bangladesh, a disaster situation is a uniquely vulnerable time. Exposure to the unfamiliar environment of flood shelters and relief c s, and unable to maintain their 'space' and privacy from male strangers, a number of the girls were vulnerable to sexual and mental harassment. With the floods, it became difficult for most of the girls to be appropriately 'secluded'. Many were unable to sleep, bathe or get access to latrines in privacy because so many houses and latrines were under the water. Some of the girls who had begun menstruation were distressed at not being able to keep themselves clean. Strong social taboos associated with menstruation and the dirty water that surrounded them made it difficult for the girls to wash their menstrual cloths or change them frequently enough. Many of them became separated from their social network of relations, which caused them a great deal of anxiety and stress. Their difficulty in trying to follow social norms have had far-reaching implications on their health, identity, family and community relations.
Publisher: Public Library of Science (PLoS)
Date: 08-03-2023
DOI: 10.1371/JOURNAL.PGPH.0001588
Abstract: Empirical evidence suggests that the health outcomes of children living in slums are poorer than those living in non-slums and other urban areas. Improving health especially among children under five years old (U5y) living in slums, requires a better understanding of the social determinants of health (SDoH) that drive their health outcomes. Therefore, we aim to investigate how SDoH collectively affects health outcomes of U5y living in Bangladesh slums through an intersectionality lens. We used data from the most recent national Urban Health Survey (UHS) 2013 covering urban populations in Dhaka, Chittagong, Khulna, Rajshahi, Barisal, Sylhet, and Rangpur isions. We applied multilevel analysis of in idual heterogeneity and discriminatory accuracy (MAIHDA) to estimate the Discriminatory Accuracy (DA) of the intersectional effects estimates using Variance Partition Coefficient (VPC) and the Area Under the Receiver Operating Characteristic Curve (AUC-ROC). We also assessed the Proportional Change in Variance (PCV) to calculate intersectional effects. We considered three health outcomes: cough, fever, and acute respiratory infections (ARI) in U5y.We found a low DA for cough (VPC = 0.77%, AUC-ROC = 61.90%), fever (VPC = 0.87%, AUC-ROC = 61.89%) and ARI (VPC = 1.32%, AUC-ROC = 66.36%) of intersectional strata suggesting that SDoH considered do not collectively differentiate U5y with a health outcome from those with and without a health outcome. The PCV for cough (85.90%), fever (78.42%) and ARI (69.77%) indicates the existence of moderate intersectional effects. We also found that SDoH factors such as slum location, mother’s employment, age of household head, and household’s garbage disposal system are associated with U5y health outcomes. The variables used in this analysis have low ability to distinguish between those with and without health outcomes. However, the existence of moderate intersectional effect estimates indicates that U5y in some social groups have worse health outcomes compared to others. Therefore, policymakers need to consider different social groups when designing intervention policies aimed to improve U5y health outcomes in Bangladesh slums.
Start Date: 2022
End Date: 2022
Funder: European University Institute
View Funded ActivityStart Date: 2005
End Date: 2010
Funder: Department for International Development, UK Government
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End Date: 2009
Funder: Japan International Cooperation Agency
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End Date: 2012
Funder: Research and Development
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End Date: 2017
Funder: Nuffic
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End Date: 2015
Funder: United States Agency for International Development
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End Date: 2017
Funder: European Commission
View Funded ActivityStart Date: 2020
End Date: 2022
Funder: Bill and Melinda Gates Foundation
View Funded ActivityStart Date: 2019
End Date: 2024
Funder: Social Sciences and Humanities Research Council of Canada
View Funded ActivityStart Date: 2017
End Date: 2020
Funder: Wellcome Trust
View Funded ActivityStart Date: 2020
End Date: 2023
Funder: International Development Research Centre
View Funded ActivityStart Date: 2018
End Date: 2019
Funder: World Health Organization
View Funded ActivityStart Date: 2018
End Date: 2021
Funder: Universiteit Maastricht
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