https://repository.auw.edu.bd/handle/123456789/1078 2026-09-12T01:35:03Z https://repository.auw.edu.bd/handle/123456789/1170 Barriers to sexual and reproductive healthcare services as experienced by female sex workers and service providers in Dhaka city, Bangladesh Alam, Nazmul Objectives This study aimed to identify the barriers female sex workers (FSWs) in Bangladesh face with regard to accessing sexual and reproductive health (SRH) care, and assess the satis- faction with the healthcare received. Methods Data were collected from coverage areas of four community-based drop-in-centers (DICs) in Dhaka where sexually transmitted infection (STI) and human immunovirus (HIV) preven- tion interventions have been implemented for FSWs. A total of 731 FSWs aged 15–49 years were surveyed. In addition, in-depth interviews (IDIs) were conducted with 14 FSWs and 9 service providers. Respondent satisfaction was measured based on recorded scores on dig- nity, privacy, autonomy, confidentiality, prompt attention, access to social support networks during care, basic amenities, and choice of institution/care provider. Results Of 731 FSWs, 353 (51%) reported facing barriers when seeking sexual and reproductive healthcare. Financial problems (72%), shame about receiving care (52.3%), unwillingness of service providers to provide care (39.9%), unfriendly behavior of the provider (24.4%), and distance to care (16.9%) were mentioned as barriers. Only one-third of the respondents reported an overall satisfaction score of more than fifty percent (a score of between 9 and16) with formal healthcare. Inadequacy or lack of SRH services and referral problems (e.g., financial charge at referral centers, unsustainable referral provision, or unknown loca- tion of referral) were reported by the qualitative FSWs as the major barriers to accessing and utilizing SRH care. Conclusions These findings are useful for program implementers and policy makers to take the neces- sary steps to reduce or remove the barriers in the health system that are preventing FSWs from accessing SRH care, and ultimately meet the unmet healthcare needs of FSWs. 2017-01-01T00:00:00Z https://repository.auw.edu.bd/handle/123456789/1169 KNOWLEDGE, USE AND ASSOCIATED FACTORS RELATING TO MODERN CONTRACEPTIVE METHODS AMONG FEMALE SEX WORKERS IN DHAKA, BANGLADESH Alam, Nazmul Background: Female sex workers (FSWs) are an isolated population of the world who have unmet needs of contraceptive services. This study assessed knowledge on and use of modern contraceptive methods among FSWs. Methods: A survey (n=731) and 14 qualitative in-depth interviews with 15-49 year old FSWs were implemented in 2015 in Dhaka, Bangladesh. Descriptive statistics and multivariate logistic regression analyses were applied to assess knowledge on use of contraceptives including associated factors. Qualitative data was managed using content analysis where in-depth perceptions regarding contraceptive methods were illustrated. Results: About 73% of FSWs had good knowledge of names and physical sources of contraceptives. The qualitative data added various concerns about contraceptives which included having problems of irregular menstruation, vertigo, becoming weak or fat, displacement of the intra-uterine contraceptive device in the vagina. According to survey results, the majority of FSWs used condoms (71%) but use of oral contraceptive pills (20.9%), Injectable (16.2%), Intra Uterine Device (IUD) (1.5%), implant (4.7%) and female sterilization (4.5%) was very poor. Dual protection (condom plus any other method) was only reported in 22% of the women studied. Being divorced/separated/widowed/husband lived out of country [OR with 95% CI: 2.34 (1.2-4.5)] and performing sec acts in multiple settings [OR with 95% CI: 3.95 (1.7- 9.4)] were significantly associated with use of any modern methods of contraception. Conclusions: The use rate of contraception except condom is evidence of poor accessibility of services. We recommend integrating or making linkage to contraceptive services with existing HIV prevention services targeting FSWs in Bangladesh. 2017-01-01T00:00:00Z https://repository.auw.edu.bd/handle/123456789/1168 Sexual and reproductive health behaviors of female sex workers in Dhaka, Bangladesh Alam, Nazmul The objective of this study was to document sexual and reproductive health (SRH) practices among female sex workers (FSWs) including abortion, pregnancy, use of maternal health- care services and sexually transmitted infections (STIs) with the aim of developing recom- mendations for action. Methods A total of 731 FSWs aged between 15 and 49 years were surveyed using a stratified sam- pling in Dhaka, Bangladesh. A workshop with 23 participants consisted of policy makers, researchers, program implementers was conducted to formulate recommendations. Results About 61.3% of 731 FSWs reported SRH-related experiences in the past one year, including abortion (15.5%), ongoing pregnancy (9.0%), childbirth (8.3%) or any symptoms of STIs (41.6%). Among FSWs who had an abortion (n = 113), the most common methods included menstrual regulation through manual vacuum aspiration (47.8%), followed by Dilation and Curettage procedure (31%) and oral medicine from pharmacies (35.4%). About 57.5% of 113 cases reported post abortion complications. Among FSWs with delivery in the past year (n = 61), 27.7% attended the recommended four or more antenatal care visits and more than half did not have any postnatal visit. Adopting sustainable and effective strategies to provide accessible and adequate SRH services for FSWs was prioritized by workshop participants. Conclusion There was substantial unmet need for SRH care among FSWs in urban areas in Dhaka, Bangladesh. Therefore, it is important to integrate SRH services for FSWs in the formal healthcare system or integration of abortion and maternal healthcare services within existing HIV prevention services. 2017-01-01T00:00:00Z