Parallel Session E : Public Health Issues
Chair
Prof. Malabika Sarker BIO
Professor & Associate Dean, BRAC James P Grant School of Public Health &
Director of Center of Excellence for Science of Implementation & Scale Up
Co-Chair
Prof. Dr. Nawzia Yasmin BIO
Dean, School of Health Sciences,
Head, Dept. of Public Health
State University of Bangladesh
Moderator
Dr. Md. Khalequzzaman BIO
Associate Professor, Dept. of Public Health & Informatics,
Bangabandhu Sheikh Mujib Medical University, Dhaka
11:07 AM to 11:14 AM
Dr. Ashish Paul
Dhaka National Medical College
Bangladesh
Socio-economic condition, life style, occupational Behavior of the sanitation worker in the selected area of old Dhaka city, Bangladesh
Socio-economic condition, life style, occupational behavior of the sanitation worker in a selected area of old Dhaka city, Bangladesh
Dr Ashish Paul
National Medical College, Dhaka, Bangladesh
Background: Sanitation workers play an important role in maintaining the health- hygiene in the communities. Objectives: The aim of this study was to find out socio-economic condition, lifestyle, common health problems, occupational behavior of the sanitary workers. Material and methods: This was a cross sectional type of descriptive study. Data was collected from 149 respondents by face to face interview. The sampling technique was convenient type of non-probability sampling. Structural questionnaire was used as research instrument. Graphical presentation (pie chart), tables were applied and analyzed by SPSS 20 programme. Results: Among the respondents, 145 (97.3%) were sweeper and 4 were scavengers. 67 (45%) were literate. 124 lived in Semi Paccya house. 15 (10.07%) had sore throat, 21 (14.09%) had cough, 9 (6%) had breathlessness and 16 (10.74%) had chest tightness. 7 (20%) had lacrimation, 15 (42.9%) had redness of eye, 13 (37.1%) had itching problem in eye. 7 (4.10%) had abdominal pain and 2 (1.03%) had diarrhea. 92 (61.74%) had musculoskeletal pain. 43 (46.7%) had leg pain, 37 (40.2%) had back pain. 31 (20.81%) had knowledge about personal protection equipment, 12 (37.50%) used mask, 8 (25%) used hand gloves. 7 (4.70%) had a regular health checkup. 51 (46.36%) had a habit of taking betel nut, 31(28.18%) took cigarette, 27 (24.55%) took gul and 1 (0.91%) took tobacco. Conclusions: The occupational health hazards, the knowledge and attitude about the health conditions and occupation, socio-economic condition, lifestyle of the sanitation workers are not satisfactory.
Key words: sanitary workers, occupational behavior, socio-economic condition, personal protection equipment, health hygiene.
11:15 AM to 11:22 AM
Dr. Abu Sayeed Md. Abdullah
Senior Scientist, RCH Department,
Centre for Injury Prevention and Research, Bangladesh (CIPRB)
Understanding women's reproductive health in underprivileged community of Bangladesh: A Cross-sectional study
Understanding women's reproductive health in underprivileged community of Bangladesh: a cross-sectional study
Dr. Abu Sayeed Md. Abdullah1, Dr. Animesh Biswas2
1Department of RCH, CIPRB,
2UNFPA
Background: Every year around 5500 mothers are dying due to maternal complications in Bangladesh. A large number of deaths are still occurring in the marginalized community. Women living in the hard-to-reach tea gardens areas in Moulvibazar district are straggling with early marriage, adolescent pregnancy and poor health seeking behaviour during gestational period. Objectives: The aim of the study was to explore knowledge and practice on maternal health of tea garden women in Moulvibazar district. Methods: A cross sectional study was performed. 25 gardens were selected purposively in Moulvibazar districts out of 92 gardens. Total 529 mothers aged between 15-49 years who had a live birth between 1 March 2015 and 29 February 2016 were enrolled. Structured pretested questionnaire was used for face to face interview. Descriptive analysis of findings was performed. Results: The study revealed that over 56% of the women aged between 20-49 years did not know about antenatal care (ANC) during pregnancy, only 8% mothers aware of recommended four ANC, whereas, 51% of women aged between 15-19 years also unaware of ANC and only 6% mothers aware of four ANC visits. About 77% of mothers had their last delivery at home, 35% of them performed by the garden health care provider (paramedic) and rest of them were conducted by untrained birth attendant. Only around 18% of the mothers had their post-natal care in the last pregnancy. 40% of the others did not have any ideas of maternal complications during pregnancy. Conclusions: Women living in the tea gardens are still behind of knowledge on antenatal, delivery and post-natal care. Specific intervention focusing improvement of knowledge and practices of women on maternal health issues can help to improve overall maternal health status of this marginalized group. Thus, will reflect on overall reduction of maternal mortality to reach sustainable developmental goal by 2030.
Key words: Reproductive health, underprivileged community.
11:23 AM to 11:30 AM
Dr. Jannatul Ferdous
Lecturer, Community Medicine,
Mymensingh Medical College, Bangladesh
Phase wise evaluation of academic learning environment of selected medical colleges of Bangladesh
Phase-wise evaluation of academic learning environment of selected medical colleges of Bangladesh
Dr. Jannatul Ferdous1, Dr. Mazharul Islam2, Dr. Mohammad Kamruzzaman Khan1
1Department of Community Medicine, Mymensingh Medical College, Bangladesh,
2Department of Community Medicine, Mugda Medical College, Dhaka, Bangladesh
Background: Academic learning environment includes everything that happens in the educational institute. It surrounds the educational, physical, social and psychological situation in which students are immersed. It plays a significant role in the professional and moral development of the students and effectiveness of learning and educational activities. Objective: The study was conducted with an aim to evaluate the academic learning environment of selected medical colleges of Bangladesh. Methods: The cross sectional descriptive study was conducted among proportionately and randomly selected 358 undergraduate students of all phases of Mymensingh Medical College (MMC) and Community Based Medical College Bangladesh (CBMCB) during the period of January, 2019 to December, 2019. Data were collected by self- administered DREEM questionnaire. In addition to DREEM questions, students were asked to provide socio- demographic information. Collected data were analyzed by SPSS Version 21.0. Results: Among 358 students, 222 (62.01%) were from MMC and 136 (37.99%) were from CBMCB; 142 (39.66%) were male and 216 (60.34%) were female. Majority of the students (298, 83.24%) were Bangladeshi; while 40 (11.17%) from India, 15 (4.19%) from Nepal and 5 (1.40%) were from Malaysia. Overall mean DREEM score of MMC was 117.68±18.79 (58.84%) and that of CBMCB was 127.09±19.85 (63.55%). CBMCB was a better DREEM scorer than MMC (p<0.001). On interpretation, both medical colleges achieved “a more positive than negative” status. Total DREEM score was higher in female (124.13±18.96) than male (116.89±20.08) (p=0.001). Students of phase I scored more both in MMC (123.68±19.03) and in CBMCB (141.14±10.45) than other phases (p<0.05). Conclusions: Both medical colleges achieved “a more positive than negative” status which is just a level below the highest category of achievable scores. The authorities should consider and address the areas of problem for improvement of academic environment to ‘excellent’ status.
Key words: Academic Learning Environment, DREEM, Medical College, Bangladesh.
11:31 AM to 11:38 AM
Mr. Arup Jana
Research Scholar, International Institute for Population Sciences (IIPS),
India
Explaining Women’s Anaemia in two Bengals: Evidence from West Bengal of India and Bangladesh
Explaining women’s anaemia in two Bengals: evidence from West Bengal of India and Bangladesh
Mr. Arup Jana1, Dr. Aparajita Chattopadhyay2, Dr. Unnati Rani Saha3
1International Institute for Population Sciences (IIPS),
2Department of Development Studies, International Institute for Population Sciences, Mumbai, India,
3Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
Background: Anaemia is a global public health problem that affects reproductive-aged women. West Bengal and Bangladesh, divided during partition of India are having population with similar ethnic origin and social behaviour. However, 63% women in West Bengal of India against 41% in Bangladesh suffers from anaemia. Objectives: This study aimed to investigate the determinants of women’s anaemia in two Bengals. The resulted comparison may help policy makers to attain the sustainable development goal (SDG) related to women’s health. Methods: Using non-pregnant women and belonging to Hindu and Muslim religion, we analysed 5,983 and 15,756 women aged 15-49, from the nationally representative cross-sectional surveys, i.e. Bangladesh Demographic Health Survey (BDHS 2017) and National Family Health Survey (NFHS 4) respectively. We performed spatial and statistical analysis to determine the important risk factors of anaemia in two Bengals. Results: Significant role of contraception, sanitation, religion and food consumption were observed in explaining anaemia. Non-Muslim women and women who used female sterilization suffered more from anaemia. Exposed to unimproved sanitation facilities and use of groundwater for drinking were important factors explaining anaemia. Also, women who frequently consumed non-vegetarian items and fruits in West Bengal were less anaemic. On the other hand, Women with less food security level were most likely to have anaemia in Bangladesh. Women, who are poor, less educated, with high fertility and adolescents experienced greater probability of being more anaemic as compared to their counterpart women. Conclusions: It is necessary to provide family planning (FP) choices to help women reducing fertility and addressing anaemia. Also, national focus is essential to bring change in the food consumption pattern. Policies must target provision of safe drinking water and open defecation free environment in West Bengal.
Key words: Anaemia, West Bengal, Bangladesh, Food security, Female sterilization, Groundwater
11:39 AM to 11:46 PM
Shira Goldstein, MD
Assistant Professor of Family and Community Medicine,
University of Texas Health Sciences Center at Houston, Texas USA
Healthcare and the Environment: Preserving the Earth while Protecting Patients and Caregivers
Healthcare and the environment: preserving the earth while protecting patients and caregivers
Richard Hubbard
University of Texas Health Science Center at Houston
Background: Healthcare produces large amounts of waste products. While much of this material is equivalent to any other garbage, Regulated Medical Waste are products which may pose a threat to human health, and must therefore be processed via specific methods. Failure to do so places patients' and caregivers' health at risk. At the same time, inefficient waste management can cause a significant and unnecessary damage to the natural environment. Methods: In this talk, the presenter will present current understandings of environmentally-friends management of medical waste, especially as it relates to the operating room environment. Relevant published articles, including those written by the presenter, will be discussed. Results: Not Applicable Conclusions: While medical waste does pose a threat to both the environment and human health, there are real-world solutions that will help protect patients and caregivers while limiting environmental degradation.
Key words: Patient Safety, Waste Management, Green Medicine
11:47 AM to 11:54 PM
Dr Sharmin Kauser
Department of Medicine, BIRDEM
Bangladesh
Evaluation Of Association Of Perceived Stress With Chronic Illness Among Adult Population of Dhaka City
Evaluation of association of perceived stress with chronic illness among adult population of Dhaka city
Dr Sharmin Kauser1, Dr Nasim Jahan1, Dr Salma Ahmad1, Prof Sohel Reza Choudhury2
1Bangladesh Institute of Research and Rehabilitation in Diabetics, Endocrine and Metabolic Disorders,
2Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute
Background: Stress is present in all aspects of life, and factors which causes stress are termed as stressors. Stress has a somatic component that creates physical strain. Persistent exposure to stress may lead to higher risk of several major diseases like cardiovascular morbidity, diabetes, infection, auto immune disease, deformity and even mortality. Mental stress is multifaceted condition and evaluation of stress is difficult. PSS 10 is considered as most extensively applied instrument to quantify perceived stress among people. Objective: Aim of this study was to ascertain the relationship between perceived stress and chronic diseases. Method: A case control study was conducted in urban area of Dhaka city among adult people aged 25 to 75 years during the period of January to March 2020. Cases were selected purposively from patients attending OPD of different hospitals and had a positive history of any form of chronic diseases like diabetes, hypertension, asthma, cardiovascular diseases. Control subjects were selected from community who were apparently healthy. Validated Bangla translated version of PSS 10 was used to assess the level of stress in both groups. Data were analyzed with SPSS 23. Results: 311 study respondents were involved, 181 gave positive history of chronic diseases mostly diabetes, and 131 were apparently healthy. Bangla translated questionnaire of PSS 10 revealed satisfactory level of internal consistency (Cronbach’s Alpha =0.74). On bivariate analysis females with presence of disease showed strong association with moderate level of stress (p=.003). Private service holder and housewives had moderately high level of stress than any other occupational group (p=.007) while families with very low and very high expenditure per month were noted to have higher stress, (p=.002). Stress level was significantly higher in people with diabetes mellitus (p<0.001). ANOVA pointed that Diabetic people had higher mean of stress scores( 22.07),which is more than hypertensive and asthma group. Conclusion: People having diabetes mellitus were found to have high level stress in this study. This issue needs to be addressed while providing treatment for diabetes or other NCDs.
Key words: perceived stress, diabetes, chronic illness
11:55 AM to 12:02 PM
Md. Zohurul Islam
Department of Public Health and Informatics,
Jahangirnagar University,Bangladesh
Assessment of sleep quality and its association with problematic internet use among university students: a cross sectional investigation in Bangladesh
Assessment of sleep quality and its association with problematic internet use among university students: a cross sectional investigation in Bangladesh
Md. Zohurul Islam1, Md. Mahfuz Hossain1, Kamrul Hasan1, Md. Saiful Islam1, David Gozal2
1Department of Public Health and Informatics, Jahangirnagar University,Savar, Dhaka- 1342, Bangladesh, 2Department of Child Health, and the Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO 65201, USA
Background: Problematic internet use (PIU) is a major behavioral problem that has been closely associated with poor sleep quality in many different countries, but is poorly studied in Bangladesh. This study was conducted to investigate the sleep quality and its association with PIU among university students in Bangladesh. Method: A cross-sectional study was conducted between July 2019 and December 2019 among 400 students attending four public universities in Bangladesh. The Bangla version of the Pittsburgh sleep quality index (PSQI) was used to determine sleep quality and Young’s internet addiction test (IAT) was used to describe the degree of PIU. Result: A significant negative association emerged between good sleep quality and PIU (p<0.001). In the multivariate logistic regression, students having PIU were 0.28 folds less likely to have good sleep quality (AOR: 0.28, 95%CI=0.18-0.43, p<0.001) when compared to non-PIU students. In addition, significant associations between sleep quality and socio-demographic and lifestyle factors were identified. Conclusion: Implementation of an effective awareness program and development of education strategies are required to reduce internet addictive behaviors and improve sleep quality among Bangladeshi university students, and likely many other students around the world.
Key words: Sleep Quality; Problematic Internet Use; Internet Addiction; University Students; Bangladesh
12:03 PM to 12:10 PM
Prof Rumana Huque
Executive Director,
ARK foundation, Bangladesh
Communitydialogues for preventing and controlling antibiotics resistance in Bangladesh
Community dialogues for preventing and controlling antibiotic resistance in Bangladesh
Dr. Rumana Huque, Samina Huque
ARK Foundation, Bangladesh
Background: There is evidence that high prevalence of resistance to most antibiotics has been detected and many first-line drugs have been found to be ineffective in Bangladesh. Given the reach of health services into communities in low income countries like ours, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. Objectives: We aimed to develop, adapt and pilot-test the Community Dialogue Approach (CDA) for preventing and controlling antimicrobial resistance in Bangladesh and link that with the existing health system. Methods: We used a sequential mixed methods design that included formative research such as focus group discussion with community people and interviewed other local stakeholders and a household survey with 244 household heads to understand knowledge, attitude, practice (KAP) on using anti-microbial. We implemented the intervention in a smaller scale in 5 community clinic catchment area in Daudkandiupazila of Comilla district. Survey data was analysed descriptively, associations explored through multiple logistic regression. Qualitative data was analysed thematically. Results: In the formative research misuse of antimicrobial, purchasing them without prescription, sharing the leftovers with others identified as drivers. In survey 84% (95% CI: 67-93) have heard about antibiotics, while 81% (95% CI: 53-90) stated that they have used antibiotics. It seems the approach is feasible because Total number of 446 of community dialogues for 6months in the 5 Community clinic catchment area with the help of 55 facilitators and 15 supervisors. The evaluation data shows the approach brought a change in the attitude and practice of antimicrobial. Conclusions: This intervention has the potential to contribute to a body of urgent action recommended by WHO to prevent AMR; build health system capacity in Bangladesh to deliver community-based interventions; and empower communities in Bangladesh to build cohesion and social capital.
Key words: Community engagement, antimicrobial resistance, Bangladesh, feasibility
12:11 PM to 12:18 PM
Sabbir Ahmad Osmani
Shaheed Ziaur Rahman Medical College,
Bogura
Prevalence of depression & anxiety among adolescents in Bangladesh: A Cross-sectional study highlighting multifactorial associations.
Prevalence of depression and anxiety among adolescents in Bangladesh: a cross-sectional study highlighting multifactorial associations
Sabbir Ahmad Osmani, Israt Jahan Farhana
Shaheed Ziaur Rahman Medical College, Bogura
Background: Adolescents (aged 10-19 years) make up almost 21% of the population in Bangladesh. Depression and anxiety are the most alarming mental health problems in adolescents with multifactorial causes. This study aims to depict the picture of these mental hazards and the key factors associated withthese. Objectives: The prime goal was to acknowledge the rate of adolescents who are at danger by sinking into depression and anxiety and finally to find out the associated factors playing significant roles behind these mental hazards. Method: A cross-sectional study was performed involving 200 adolescents from 13 to 18 years age group. After providing written informed consent, participants completed a survey examining socio- demographic variables and lifestyle, along with the PHQ-9 and GAD-7 scales to assess depression andanxiety. Results: According to the study, the prevalence rates of depression and anxiety in Bangladesh were 48.62% and 39.7%, respectively. Based on multivariable analyses of several associated factors that worked prominently to build up those mental hazards: communication gap between parents and children, bullying,poor peer support, not having good perceived relationships with friends, sex discrimination, defect of academic curriculum in Bangladesh. Financial insecurities and lack of recreation during lockdown in COVID-19 situation were two moreassociated factors of depression and anxiety in adolescents. Conclusion: Several factors can be held responsible for the increasing prevalence of mental health problems specially for depression and anxiety. In our country, social stigma, and neglected attitude towardsthe problems play significant roles for the increasing numbers of mental health cases.
Key words: mental health, adolescents, depression, anxiety
12:19 PM to 12:26 PM
Mikhail I. Islam
Learning Designer (Consultant)
Transformative competency-based public health education for the developing world: indigenizing the MPH curriculum
Transformative competency-based public health education for the developing world: indigenizing the MPH curriculum
Mikhail I. Islam,
Learning Designer (Consultant)
Background: COVID-19 has not only exposed chronically ill-equipped Health Systems but also the incapacity of Schools ofPublic Health to develop the competent professionals desperately required. If health workforces are to tackle the current pandemic and similar 21st century health crises such as Poverty, Gender-Inequality, Urbanization, Unemployment or Climate Change, the standard MPH urgently needs radical innovation. At present, a fundamental disconnect persists between what MPH students academically learn; and the professional capabilities demanded by community health realities. Methods: This session presents an indigenous competency-based MPH, focusing on the distinct lived community health praxes and challenges within the Developing World through the health lens of Bangladesh. To develop the professional capacities that promote community health outcomes, MPH students rigorously engage in experiential and applied community-centric Learning. Through health systems immersion, intensive urban and rural fieldwork and pilot health solution projects; students empathetically comprehend the particular Developing World socio-economic and cultural contexts within which specific community health needs and constraints arise. Thus helping them learn to facilitate local health priorities and co- design community-led solutions accordingly; which are essential to achieving sustainable community healthoutcomes and well-being. Results: The session then elaborates how this Developing World MPH’s innovative Learning Ecosystem aligns community-based learning with health professionals’ skills development. By iteratively designing and thenintegrating Skills-based Curriculum, Skills Learning Methodologies, Faculty-Facilitator Development and Skills Assessment, students practically develop crucial workforce skills including Health Empathy, Community-Centric Design, Solutions Thinking, Patientcentric Care, Service Delivery Design, Public-Health Marketing, and Collaborative Teamwork. Conclusion: This session will experientially share the step-by-step, holistic learning design of an MPH rural fieldwork- based ‘Community Health Management’ module, to demonstrate how a ‘realworld public health classroom'within communities leads to transformative student learning success. To better equip our health professionals with the essential technical and management capabilities that enable sustainable health impact in the Developing World.
Key words: Transformative Competency-based MPH Learning Design
12:26 PM to 12:46 PM
Q/A Session
12:47 PM to 01:00 PM
Sum up by the Chair and Co-Chair
Troubleshooting
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