https://repository.auw.edu.bd/handle/123456789/714 2026-06-09T21:06:34Z 2026-06-09T21:06:34Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/898 2026-02-18T06:15:20Z 2018-01-01T00:00:00Z

Knowledge and Acceptance of Human Papillomavirus Vaccine for Cervical Cancer Prevention Among Urban Professional Women in Bangladesh: A Mixed Method Study Chowdhury, Mohiuddin Ahsanul Kabir Prophylactic human papillomavirus (HPV) vaccination is the most effective preventive method against invasive cervical cancer, the second leading cause of cancer-related deaths among women in Bangladesh. Evidence on women’s knowledge and perception about cervical cancer and HPV vaccination are needed for effective imple- mentation of national cervical cancer prevention programs. The objective of this study was to assess the knowl- edge, attitude, and acceptance of cervical cancer, HPV, and HPV vaccination among urban professional women in Bangladesh. We recruited 160 female professionals employed at selected private banks in Bangladesh. Participants were selected using nonprobability-based convenience sampling for interviews through a self-administered ques- tionnaire. Later, in-depth interviews were conducted with nine of these women. Quantitative data were analyzed utilizing descriptive statistics, whereas qualitative data were analyzed using a thematic approach. Ninety-eight percent of participants reported that they had previously heard of cervical cancer, however, only half (51%) reported to have heard of HPV as a cause of the disease. Less than 1% of the 160 participants had previously undergone a pap smear, and only 2% were vaccinated with at least one dose of HPV vaccination. Although knowledge was low, intention for acceptance of vaccination was moderate for women and high for their chil- dren. Although the majority of women had heard of cervical cancer, few women had in-depth knowledge of HPV and the etiology of invasive disease. This study draws attention to the urgent need of educational interven- tions on cervical cancer and its prevention to improve uptake of available HPV vaccination

2018-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/897 2026-02-18T06:15:15Z 2018-01-01T00:00:00Z

A community-based cluster randomized controlled trial (cRCT) to evaluate the impact and operational assessment of “safe motherhood and newborn health promotion package”: study protocol Chowdhury, Mohiuddin Ahsanul Kabir Background: Despite considerable progress in reduction of both under-five and maternal mortality in recent decades, Bangladesh is still one of the low and middle income countries with high burden of maternal and neonatal mortality. The primary objective of the current study is to measure the impact of a comprehensive package of interventions on maternal and neonatal mortality. In addition, changes in coverage, quality and utilization of maternal and newborn health (MNH) services, social capital, and cost effectiveness of the interventions will be measured. Methods: A community-based, cluster randomized controlled trial design will be adopted and implemented in 30 unions of three sub-districts of Chandpur district of Bangladesh. Every union, the lowest administrative unit of the local government with population of around 20,000–30,000, will be considered a cluster. Based on the baseline estimates, 15 clusters will be paired for random assignment as intervention and comparison clusters. The primary outcome measure is neonatal mortality, and secondary outcomes are coverage of key interventions like ANC, PNC, facility and skilled provider delivery. Baseline, midterm and endline household survey will be conducted to assess the key coverage of interventions. Health facility assessment surveys will be conducted periodically to assess facility readiness and utilization of MNH services in the participating health facilities. Discussion: The current study is expected to provide essential strong evidences on the impact of a comprehensive package of interventions to the Bangladesh government, and other developmental partners. The study results may help in prioritizing, planning, and scaling-up of Safe Motherhood Promotional interventions in other geographical areas of Bangladesh as well as to inform other developing countries of similar settings.

2018-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/896 2026-02-18T06:15:29Z 2018-01-01T00:00:00Z

Report on Demographic profiling and needs assessment of maternal and child health (MCH) care for the Rohingya refugee population in Cox’s Bazar, Bangladesh Chowdhury, Mohiuddin Ahsanul Kabir Introduction: The number of forcibly displaced people labelled as refugees across the world have grown rapidly since the last few decades. The most recent inclusion being the Rohingya diasporas of Myanmar who have been fleeing en masse from their homes since August 25, 2017. To date, more than 1.2 million Rohingya refugees have settled in designated Rohingya camps (expansion sites) located in Cox’s Bazar district of Bangladesh. This recent sudden massive influx of Rohingya refugees have overwhelmed scarce resources and posed a substantial strain to the ad hoc health systems set up at these camps. The exploration of the health needs including ascertainment of prevalence of pregnant women, lactating mothers and age- sex distribution of the population is a timely and judicious necessity to help the Government of Bangladesh working in collaboration with national and international organizations to deliver key services in a more organized and efficient way. In this circumstances, icddr,b, with active supervision and assistance of UNFPA, conducted a brief needs assessment of maternal and child health with special attention to pregnancy, lactation and family planning status of the women, and current health status of the under-5 children. Methods: The study employed a cross-sectional quantitative study design in 11 Rohingya camps located in Ukhia and Teknaf upazilas of Cox’s Bazar, Bangladesh. Four modules of data collection tools were administered in the field that included household listing form for household heads, structured questionnaire for women of reproductive age (13-49 years), caregivers of under-5 children, and for the household heads regarding their food support. Given the linguistic similarities between the Rohingya people and locals in Cox’s Bazar, the data collectors were recruited locally from Cox’s Bazar. They were extensively trained on the data collection methods with data collection tools that were pre-tested before final phase of training. We collected information from 3,050 households that accounted for 16,588 Rohingya population of which 16,243 Rohingya refugees are currently living in Bangladesh. Among the 16,243 Rohingyas, 14,220 entered Bangladesh after the recent influx since 25 August, 2017. About 3,701 women of reproductive age were approached for interview of whom 3,664 (99%) could complete the questionnaire. After quality assurance, the data were analysed for descriptive statistics of basic demographics, pregnancy rates, reported illness and the services received. The frequency distributions are reported using tables and graphs in this report. The study protocol was approved by the Institutional Review Board (IRB) of icddr,b. Analyses were carried out using Stata version 13.0 SE. Results: We reached 16,588 populations from 3,050 household with a mean household size of 5.3 ± 2.3. Among the study population, 45.8% were of 13-49 years of age. It is noteworthy to mention that the age-sex distribution in the cumulative Rohingya population residing in Cox’s Bazar (Old camps) and the newly arrived Rohingyas were almost similar. About 70% of the Rohingya women of reproductive age (13-49 years) were below 30 years. The proportion of ever married women was 72.2% and mean age at first marriage was 16.8 ± 2.2 years. The mean age at first pregnancy was 18.0± 2.4 years. We identified 370 pregnant women (14.0% of ever married women) among the study population. If we consider women of reproductive age, the pregnancy prevalence has been 10.1%. However, among the total population, the pregnant women constitute about 2.3%. When the pregnant women were asked for their plan for future delivery, 54.1% reported that they did not decide on their plan yet. However, only 10% of them were willing to deliver at facility level and the rest (35.9%) wanted to deliver at home. Among the ever married women (N=2,643), 568 (21.5%) delivered their babies within the last 12 months. About 53% of these recently delivered women delivered their babies in Myanmar and the rest delivered after entering Bangladesh. Lactating women constitute almost 6.0% of the total study population of 16,243. However, if we consider, this proportion rises to 26.4% among the women of reproductive age and to 36.6% among the ever married women. Family planning (FP) related questionnaire was administered to currently married women (N=2,227). About 86.3% of them heard at least one method of family planning and injection Depot-Provera and Oral Contraceptive Pill (OCP) have been the two most cited Family planning methods. About 48.9% of the currently married women reported that they knew the service delivery place for Family planning method and most of them mentioned about NGO hospitals/clinics (93.1%) and NGO workers (22.4%) respectively. The contraceptive prevalence rate (CPR) has been measured as 33.7%. Injection Depot-Provera (70.5%) and OCP (28.9%) were the two most common methods they were currently using. Regarding illnesses, frequently mentioned complaints were general weakness (23.7%), sore throat (18.4%), joint pain (18.3%), pain during menstruation (11.1%) and malnourishment (16%). Regarding the satisfaction level for shelter, clothing and health care services, the respondents clearly marked the services as satisfying except for a few indicators like safe water, hand washing material, waiting time during health care services, and the travel time to go to the health services centre. Regarding hand washing practices, 93.1% women of reproductive age claimed to have always washed their hands. About 96.7% reported to use soap as hand washing material, although 33.7% admitted that sometimes they washed their hands with water only. Some others reported to use ash (17.4%) and earth (11.6%). During the data collection period, about 2,937 children had illness complaints of which cough (69.5%), fever (41.1%), difficulty in breathing (12.4%), and passage of loose stools (9.8%) were the most common symptoms. Conclusion: Firstly, our report highlights the need for special attention and care required for the pregnant and lactating women. Second, we find that the Rohingya population in Bangladesh should be informed of the different family planning methods available and delivery points where they can procure family planning and other healthcare services. Finally, we have assessed the level of satisfaction and explored the need for shelter, food, clothing and health care services in this vulnerable population group. We expect our findings would help the Government of Bangladesh and other stakeholders to take effective steps to ensure the welfare and well- being of the Rohingya Diaspora.

2018-01-01T00:00:00Z Chowdhury, Mohiuddin Ahsanul Kabir https://repository.auw.edu.bd/handle/123456789/895 2026-02-18T06:15:16Z 2018-01-01T00:00:00Z

Initiation of breastfeeding within one hour of birth and its determinants among normal vaginal deliveries at primary and secondary health facilities in Bangladesh: A case- observation study Chowdhury, Mohiuddin Ahsanul Kabir Background Initiation of breastfeeding within one hour of birth can avert 22% of newborn mortality. Sev- eral factors influence breastfeeding practice including mothers’ socio-demographic and obstetric characteristics, and factors related to time around child birth. This study explores breastfeeding initiation practices and associated influencing factors for initiating breastfeed- ing within one hour of birth in public health facilities of Bangladesh. Methods In this study, normal deliveries were observed in 15 public health facilities from 3 districts in Bangladesh. Study participants were selected by convenient sampling i.e. delivery cases attending health facilities during the study period were selected excluding caesarean section deliveries. Among 249 mothers, time of initiation of breastfeeding was observed and its asso- ciation was measured with type of health facility, privacy in delivery room, presence of sepa- rate staff for newborn, spontaneous breathing, skin-to-skin contact and postnatal contact of mother or newborn with health care providers within one hour after delivery. Data was col- lected during August-September, 2016. Kruskal-Wallis test was used to measure equality of median duration of breastfeeding initiation time among two or more categories of indepen- dent variables. Series of simple logistic regressions were conducted followed by multiple logistic regression to identify the determinants for breastfeeding initiation within one hour. Results Among 249 mothers observed, 67% initiated breastfeeding within one hour of birth at health facilities and median time to initiate breastfeeding was 38 minutes (Inter-quartile range: 20–56 minutes). After controlling for maternal age as potential confounder, the odds of initiating breastfeeding within one hour of birth was significantly higher if mothers gave birth in district hospitals (AOR 3.5: 95% CI 1.5, 6.4), visual privacy was well-maintained in delivery room (AOR 2.6: 95% CI 1.2, 4.8), newborns cried spontaneously (AOR 4.9: 95% CI 3.4, 17.2), were put to skin-to-skin contact with mothers (AOR 3.4: 95% CI 1.9, 10.4) or were examined by health care providers in the facilities (AOR 2.4: 95% CI 1.3, 12.9). Conclusions In health facilities, initiation of breastfeeding within one hour is associated with some critical practices and events around the time of birth. With the global push toward facility-based deliveries, it is very important to identify those key factors, within the landscape of maternal and newborn care, which significantly enable health care providers and parents to engage in the evidence-based newborn care activities including early initiation of breastfeeding that will, in turn, reduce global rates of newborn mortality.

2018-01-01T00:00:00Z