2022

Assuring Bangladesh’s future: non‐communicable disease risk factors among the adolescents and the existing policy responses

2026-02-18T06:15:04Z

Assuring Bangladesh’s future: non‐communicable disease risk factors among the adolescents and the existing policy responses Biswas, Tuhin Background: The aim of this study is to assess the current status of non-communicable disease (NCD) risk factors amongst adolescents in Bangladesh. We also critically reviewed the existing policy responses to NCD risk among adolescents in Bangladesh. Methods: This study used a mixed method approach. To quantify the NCD risk burden, we used data from the Global School-based Student Health Survey conducted in Bangladesh. To understand policy response, we reviewed NCD- related policy documents introduced by the Government of Bangladesh between 1971 and 2018 using the WHO rec‐ ommended NCD Action Plan 2013–2020as study framework. Information from the policy documents was extracted using a matrix, mapping each document against the six objectives of the WHO 2013–2020 Action Plan. Results: Almost all adolescents in Bangladesh had at least one NCD risk factor, and there was a high prevalence of concurrent multiple NCD risk factors; 14% had one NCD risk factor while 22% had two, 29% had three, 34% had four or more NCD risk factors. Out of 38 policy documents, eight (21.1%) were related to research and/or surveys, eight (21.1%) were on established policies, and eleven (29%) were on legislation acts. Three policy documents (7.9%) were related to NCD guidelines and eight (21.1%) were strategic planning which were introduced by the government and non-government agencies/institutes in Bangladesh. Conclusions: The findings emphasize the needs for strengthening NCD risk factors surveillance and introducing appropriate intervention strategies targeted to adolescents. Despite the Government of Bangladesh introducing several NCD-related policies and programs, the government also needs more focus on clear planning, implementa‐ tion and monitoring and evaluation approaches to preventing NCD risk factors among the adolescents in Bangladesh.

Screening for adverse childhood experiences in antenatal care settings: A scoping review

2026-02-18T06:15:06Z

Screening for adverse childhood experiences in antenatal care settings: A scoping review Biswas, Tuhin Background: Adverse childhood experiences (ACEs) are associated with many health problems in women during pregnancy, including depression/anxiety, gestational diabetes and adverse birth outcomes. However, unlike other health risk factors, screening for ACEs has not been widely implemented in antenatal care settings. Aims: The aim of the scoping review was to explore the challenges in screen- ing for ACEs in antenatal care settings and to provide the lessons learnt and evi- dence that guide the practice of ACE screening for both healthcare providers and pregnant women. Methods: A five-stage process for conducting the scoping review was utilised. Searches of four key databases (PubMed, PsycINFO, CINAHL and SCOPUS) and ref- erence lists from relevant studies were conducted. Results: Seven publications met the inclusion criteria. Challenges identified for healthcare providers in screening for ACEs include lack of knowledge and confi- dence in ACE tool and shortage of time and resources to undertake screening. Impediments for pregnant women include concerns about privacy. However, there were examples of effective practice for ACE screening in antenatal care settings that could apply widely. Conclusion: Addressing impediments to ACE screening is critical in implement- ing trauma-informed practices that can identify women at risk of adverse health outcomes during pregnancy. A study on screening for ACEs in antenatal care in both public and private settings is needed to examine its feasibility and accept- ability in the Australian context before being included in the National Perinatal Data Collection.

Geographical and socioeconomic inequalities in the double burden of malnutrition among women in Southeast Asia: A population-based study

2026-02-18T06:15:05Z

Geographical and socioeconomic inequalities in the double burden of malnutrition among women in Southeast Asia: A population-based study Biswas, Tuhin Background Countries in the South and Southeast Asia region grapple with significant challenges due to the double burden of malnutrition (DBM) in women. An understanding of the country specific DBM geographical and socio- economic distribution in South and Southeast Asian countries will enable targeting of DBM interventions towards high-risk populations in the region. This study aimed to analyse anthropometric indicators for women’s nutrition at national and subnational levels in seven South and Southeast Asian countries and assess the association between nutritional status and socioeconomic factors. Methods We used population-representative cross-sectional data from the Demographic and Health Surveys con- ducted between 2000 and 2017, for seven South and Southeast Asian countries (Bangladesh, Cambodia, India, Myanmar, Nepal, Pakistan, and Timor-Leste) and estimated national and subnational prevalence of women under- weight and overweight. Using a concentration index (CI), we measured relative and absolute inequality across under- weight and overweight in urban and rural areas in these countries. In addition, we estimated the health achievement index, integrating mean coverage of nutritional status and the distribution of coverage by rural and urban populations. Findings The prevalence of underweight women ranged from 7.0% (95% CI: 7.0-8.0%) in Pakistan in 2017 to 44.0% (95% CI: 42-45%) in Bangladesh in 2000 and overweight from 11.0% (95% CI: 10-12%) in Bangladesh in 2000 to 67.0% (95% CI: 66-68%) in Pakistan in 2017. In most countries, underweight disproportionately affected the poorest. The concentration indices for underweight were significant in all countries and ranged from 0.04 in Cambodia in 2014 to 0.38 in Pakistan in 2017. In contrast, overweight disproportionately affected the richest, with concentration indices for overweight significant in all countries, ranging from 0.16 in Cambodia in 2010 to 0.45 in Bangladesh in 2007. In most of the countries an absolute measure of inequality decreased overtime, whereas relative measures increased. Disachievement of underweight is more pronounced in rural populations compared to the urban ones. Interpretations We noted large geographical and socioeconomic disparities in women DBM in South and Southeast Asian countries, at national and subnational levels. Planning, implementation, and evaluation of existing interven- tion programmes for food and nutrition should be based on subnational level needs and outcomes. Funding This research is partially funded by the Australian Government through the Australian Research Council’s Centre of Excellence for Children and Families over the Life Course (Project ID CE200100025).

Double burden of malnutrition among women of reproductive age in 55 low- and middle-income countries: progress achieved and opportunities for meeting the global target

2026-02-18T06:15:07Z

Double burden of malnutrition among women of reproductive age in 55 low- and middle-income countries: progress achieved and opportunities for meeting the global target Biswas, Tuhin Objective To examine trends and projections of underweight (Body Mass Index, BMI < 18.5 kg/m2 ) and overweight (BMI ≥ 25.0 kg/m2 ) in women of reproductive age in 55 low- and middle-income countries (LMICs). Methods We used data from 2,337,855 women aged 15–49 years from nationally representative Demographic and Health Survey conducted between 1990 and 2018. Bayesian linear regression analyses were performed. Results During 1990–2018, the prevalence of underweight decreased in 35 countries and overweight increased in 50 countries. The highest underweight increase was in Morocco (5.5%) and overweight in Nepal (12.4%). In 2030, >20% of women in eight LMICs will be underweight, with Madagascar (36.8%), Senegal (32.2%), and Burundi (29.2%) projected to experience the highest burden of underweight. Whereas >50% of women in 22 LMICs are projected to be overweight, with Egypt (94.7%), Jordan (75.0%), and Pakistan (74.1%) projected to have the highest burden of overweight. 24 LMICs are projected to experience the double burden of malnutrition (both underweight and overweight >20%) in 2030. Noticeable variations in underweight and overweight were observed across wealth, residence, education, and age of women, with a higher rate of overweight in high-income, high-education, and urban women. These inequalities have widened in many countries and are projected to continue. The probability of eradicating overweight and underweight is nearly 0% for all countries by 2030, except Egypt is on track to eradicate underweight. Conclusions Although the prevalence of underweight declined, this decline has been superseded by the dramatic increase of overweight. None of the 55 LMICs is likely to eradicate malnutrition in women by 2030.