Md. Ismail Tareque

Inequality in Disability in Bangladesh

Objective To investigate inequality in disability in Bangladesh. Methods The study used both household level and individual level data from a large nationally representative data set, Bangladesh’s Household Income and Expenditure Survey - 2010. Principal component analysis was used to construct a wealth index based on household assets from household level data. Then, using data from 49,809 individuals aged 5 years and over, chi-square tests and logistic regression were performed to test the association between wealth level and disability. Findings Women and older people are significantly more likely to report having disabilities than men and younger people. For middle and rich families, respectively, there is a 14 percent lower likelihood of reporting disabilities than for poor families. Changes in the probability of having disabilities are linear with increasing wealth. In addition, the study identifies some significant factors affecting disability, namely, age, sex, education, marital status, and place of residence including divisional differences. Conclusion In Bangladesh, worse health among the poor argues for policies prioritizing this group while at the same time giving special attention to women and the elderly.

The intergenerational transmission of intimate partner violence in Bangladesh

Background A number of individual risk factors for intimate partner violence (IPV) have been identified in Bangladesh. However, the etiology of IPV, intergenerational transmission, has never been tested in Bangladesh. Objective We examined whether witnessing inter-parental physical violence (IPPV) was associated with IPV to identify whether IPV passes across generations in Bangladesh. Methods We used nationally representative data of currently married women from the Bangladesh Demographic and Health Survey-2007. Variations in experiencing IPV were assessed by Chi-square tests. Logistic regression models were fit to determine the association between witnessing IPPV and different types of IPV against women. Results One-fourth of women witnessed IPPV and experienced IPV. After adjusting for the covariates, women who witnessed IPPV were 2.4 (95% confidence interval [CI]: 2.0–2.8) times more likely to experience any kind of IPV, 2.5 (95% CI: 2.0–3.0) times more likely to experience moderate physical IPV, 2.3 (95% CI: 1.8–3.0) times more likely to experience severe physical IPV, and 1.8 (95% CI: 1.4–2.3) times more likely to experience sexual IPV. Age, age at first marriage, literacy, work status, wealth, justified wife beating, and womens autonomy were also identified as significant correlates of IPV. Conclusions This studys results indicate that IPV passes from one generation to another. We make recommendations for preventing IPPV so that subsequent generations can enjoy healthy, respectful, nonviolent relationships in married life without exposure to IPV in Bangladesh.Background A number of individual risk factors for intimate partner violence (IPV) have been identified in Bangladesh. However, the etiology of IPV, intergenerational transmission, has never been tested in Bangladesh. Objective We examined whether witnessing inter-parental physical violence (IPPV) was associated with IPV to identify whether IPV passes across generations in Bangladesh. Methods We used nationally representative data of currently married women from the Bangladesh Demographic and Health Survey-2007. Variations in experiencing IPV were assessed by Chi-square tests. Logistic regression models were fit to determine the association between witnessing IPPV and different types of IPV against women. Results One-fourth of women witnessed IPPV and experienced IPV. After adjusting for the covariates, women who witnessed IPPV were 2.4 (95% confidence interval [CI]: 2.0-2.8) times more likely to experience any kind of IPV, 2.5 (95% CI: 2.0-3.0) times more likely to experience moderate physical IPV, 2.3 (95% CI: 1.8-3.0) times more likely to experience severe physical IPV, and 1.8 (95% CI: 1.4-2.3) times more likely to experience sexual IPV. Age, age at first marriage, literacy, work status, wealth, justified wife beating, and womens autonomy were also identified as significant correlates of IPV. Conclusions This studys results indicate that IPV passes from one generation to another. We make recommendations for preventing IPPV so that subsequent generations can enjoy healthy, respectful, nonviolent relationships in married life without exposure to IPV in Bangladesh.

Are the Rates of Hypertension and Diabetes Higher in People from Lower Socioeconomic Status in Bangladesh? Results from a Nationally Representative Survey

Objective A well-established belief regarding inequalities in health around the world is that hypertension and diabetes are higher in groups of lower socioeconomic status. We examined whether rates of hypertension, diabetes, and the coexistence of hypertension and diabetes are higher in people from a lower socioeconomic status than in those from a higher socioeconomic status in Bangladesh. Methods We investigated a nationally representative dataset from the 2011 Bangladesh Demographic and Health Survey with objective measures for hypertension and diabetes. A wealth index was constructed from data on household assets using principal components analysis. Chi-square tests and logistic regressions were performed to test the associations between wealth level, hypertension and diabetes. Findings People from the highest wealth quintile were significantly more likely to have hypertension (Adjusted odds ratios [AOR] = 1.65, 95% confidence interval [CI] = 1.22-2.25), diabetes (AOR = 1.81, 95% CI = 1.21-2.71), and the coexistence of hypertension and diabetes (AOR = 2.17, 95% CI = 1.05-4.49) than people from the lowest wealth quintile. The odds of having hypertension, diabetes, and their coexistence were higher for older people, women, people who engaged in less physical labor, and people who were overweight and obese. Conclusion Wealthier people, particularly people from the fourth and highest wealth quintiles, should be careful to avoid unhealthy lifestyles to prevent hypertension and diabetes. Health policy makers and planners are urged to target wealthier strata in terms of hypertension and diabetes initiatives while paying special attention to older people, women, people who engage in less physical labor, and individuals who are overweight.

Relationships between the Active Aging Index and Disability-Free Life Expectancy: A Case Study in the Rajshahi District of Bangladesh

L’espérance de vie a considérablement augmenté dans le monde entier. Au Bangladesh, l’espérance de vie a augmenté d’environ 53 ans en 1975 à 69 ans en 2010. Cependant, on ne sait pas si l’augmentation de l’espérance de vie s’accompagne d’une augmentation simultanée d’espérance de vie sans incapacité (EVSI). Le but de l’étude décrite dans cet article était d’examiner la relation entre l’espérance de vie et l’EVSI dans le quartier de Rajshahi au Bangladesh, en examinant les relations entre l’indice de vieillissement actif (IVA) et EVSI. Les résultats de l’étude indiquent que les hommes âgés, urbains et plus cultivés sont plus actifs dans tous les aspects de la vie et avoir plus EVSI. On trouve que les femmes survivent les hommes, mais sont plus susceptibles de vivre une grande partie de leur vie restante avec un handicap. Des correlations positives entre l’IVA et EVSI indiquent que les personnes âgées pourraient bénéficier plus d’EVSI en s’impliquant dans les activités d’un vieillissement actif.

Maternal Pregnancy Intention and Professional Antenatal Care Utilization in Bangladesh: A Nationwide Population-Based Survey

Objective To investigate the association between maternal pregnancy intention and professional antenatal and delivery care utilization. Methods Our data were derived from the 2011 nationally representative Bangladesh Demographic Health Survey. We included antenatal and delivery care utilization data of the most recent live births for women for the previous three years (n = 4672). We used multilevel logistic regression models to assess the relationship between pregnancy intention and use of professional antenatal and delivery care, with adjustment for potential confounding variables. Results Approximately 13% and 16% of children were reported by their mothers as unwanted and mistimed at the time of conception, respectively. Among the women, 55% received at least one professional antenatal care service; 21% received four or more professional antenatal services, while 32% were attended by professionals during deliveries. Mothers of children whose pregnancies had been unwanted had a greater risk for not seeking professional antenatal and professional delivery care than those whose pregnancies had been wanted [1≥ ANC from professionals: AOR: 0.66; 95% CI:0.51–0.93; 4≥ ANC from professionals: AOR:0.56; 95% CI:0.37–0.84; and delivery care from professionals: AOR: 0.70; 95% CI:0.50–0.97]. Women who were married after age 18, had secondary or higher level of education, and were from the wealthiest households were more likely to utilize antenatal and delivery care. Conclusion Unwanted pregnancy is significantly associated with lower utilization of professional antenatal and delivery care services in Bangladesh. Reducing unwanted births and promoting access to professional antenatal and delivery care are crucial for achieving the Sustainable Development Goals (SDGs) 3 in Bangladesh.

Economic well-being and elder abuse in Rajshahi District of Bangladesh

This article examines the distribution of wealth and then tests associations between elder abuse and wealth in Rajshahi district of Bangladesh. Data from 896 respondents (60 years old and over) were collected in April 2009. Principal component analysis was used to construct a wealth index, and logistic regressions were performed to test the associations between wealth and elder abuse. Results reveal that about 62% of individuals from poor households face abuse of some kind, whereas only 6% of individuals from rich households do. The test of the relationship between elder abuse and wealth also suggests that individuals from rich households were more likely not to be abused than individuals from poor households. Results of this study may be useful to policy makers developing policies and programs aimed at preventing elder abuse and reducing inequalities in elder abuse in Rajshahi district as well as in the whole of Bangladesh.

Healthy life expectancy and the correlates of self-rated health in an ageing population in Rajshahi district of Bangladesh

ABSTRACT Ageing is going to be a major problem in Bangladesh given its population size, scarce resources, existing poverty, insufficient health facilities and lack of a social security system. This paper examines how many years older people expect to be in good health, and what are the correlates of self-rated health (SRH). The data used in this study come from 896 older people aged 60 years and above from Rajshahi district in Bangladesh and from United Nations’ projected population figures. Results show that individuals at age 60 expected about 41 per cent of their remaining life to be in good health, while individuals at age 80 expected only 21 per cent of their remaining life to be in good health. Having exercised during the six months prior to the survey was the single most important correlate of SRH (odds ratio=5.49; confidence interval 4.03–7.47; without any adjustment). While rural–urban differentials and some health decline in old age are inevitable, four factors (exercise behaviour, sufficiency of income, physical limitations and facing abusive behaviour) are to a certain extent modifiable and therefore provide the potential for improving SRH and healthy life expectancy in Rajshahi district, Bangladesh.

Correlates of intimate partner violence against women in Bangladesh

This study uses the Bangladesh Demographic and Health Survey-2007 to identify factors associated with Intimate Partner Violence (IPV) for currently married Bangladeshi women. Twenty five percent of women reported experiencing at least one form of IPV. The most prevalent form of IPV is slapping; and, according to respondents, the main reason given for IPV is without any reason. However, results show that women who think their husbands are justified in beating them, and who witnessed their fathers hit or beat their mothers, are more likely to experience IPV. Results revealed that such women are, respectively, 1.21 and 2.37 times more likely to experience violence than their counterparts. Therefore, these two important factors need urgent attention to reduce IPV against women in Bangladesh.

Can an active aging index (AAI) provide insight into reducing elder abuse? A case study in Rajshahi District, Bangladesh.

We use data from respondents aged 60 years and above, collected during April 2009 in the Rajshahi district of Bangladesh, to examine whether high activeness, as captured by an AAI or in sub-domains, can help reduce the risk of elder abuse. The findings suggest that more than half of rural elderly and 14 percent of urban elderly were at some point abused. High activeness in health and security dimensions lowers the risk of being abused while those who are low active in community participation have the lowest risk of being abused in both rural and urban areas. Being literate (elderly with primary/secondary education) is revealed to be a significant factor that lowers the risk of abuse in both rural and urban areas. These results imply a need for educational programs that bolster positive and proper community interaction, in turn promoting a secure later life for elders, and reducing burden for families and society. High activeness in health and security dimensions should also be promoted to keep the elderly healthy and protect from abusive behavior.

Application of Health Expectancy Research on Working Male Population in Bangladesh

Lower quality of life and more work-loss days for the workforce are barriers for economic development in Bangladesh. Using nationally representative data—the Bangladesh Demographic and Health Surveys for the 2004–2007 period, we examined the prevalence of diseases (asthma, diabetes, heart problems, high blood pressure, jaundice/hepatitis, malaria/fever, tuberculosis, and other) that prevented ever-married male workers from doing their regular activities in Bangladesh, and we examined changes in partial work-loss free life expectancy (WLFLE). The study found improvements in the mean number of work-loss days as well as in WLFLE; male workers at age 30 in 2007 expected 212 days more WLFLE than male workers of the same age in 2004. Other diseases prevented 17.8 per cent of male workers in 2004 and 9.1 per cent of male workers in 2007 from doing their normal work. Malaria/fever prevented 14.4 per cent and 11.5 per cent of male workers in 2004 and 2007, respectively, from doing their normal work. In both years, of all the diseases, the other diseases category and malaria/fever were found to be the major causes preventing Bangladeshi male workers from doing their normal work. This study recommends taking action against malaria/fever so that people can continue working without health problems or illness, and it recommends identifying other diseases which cause work-loss days. It suggests collecting data for both the males and females in a consistent manner by keeping the same questions with the same wording, order, and age groups consistent over time.