Nitai Chakraborty

The differentials and determinants of perinatal mortality in rural Bangladesh.

Objective: In Bangladesh, the perinatal mortality is very high. This study examined the differentials and determinants of perinatal mortality in rural Bangladesh. Methods: The study was based on the prospective data on maternal morbidity collected by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT). This prospective study was conducted during the period November 1992 to December 1993. In this study, the factors associated with perinatal deaths were examined, employing differential and multivariate analyses. Results: It was found that assisted delivery caused higher risks of stillbirth and death among live births during the first week of life. It was also observed that five or more pregnancies, prior to the index pregnancy, were positively associated with perinatal death. Conclusion: If the delivery is assisted or there are complications in delivery, then it is likely that the incidence of perinatal mortality will increase sharply. If the newborn baby was given colostrum, then perinatal mortality decreased to a great extent.

Factors associated with delivery complications in rural Bangladesh

Objectives There are only a few studies on maternal morbidity, delivery complications and maternal mortality in Bangladesh. This study analyzes data from a follow-up study conducted by the Bangladesh Institute of Research for Health and Technologies (BIRPERHT) on maternal morbidity in rural Bangladesh in 1993. Methods A total of 1020 pregnant women were interviewed in the follow-up component of the study. The survey collected information on socioeconomic and demographic characteristics, pregnancy-related care and practice, morbidity during the period of follow-up as well as in the past, information concerning complications at the time of delivery and during the postpartum period. For the purpose of this study, we selected 993 pregnant women with at least one antenatal follow-up. Both bivariate and multivariate analyses were conducted to identify the potential risk factors for complication during delivery and duration of labor. Results and conclusions It appears that complications during the antenatal period can result in various complications at the time of delivery. Some of the important findings are: hemorrhage during the antenatal period increases the risk of excessive hemorrhage during delivery, the risk of obstructed labor increases significantly if abdominal pain is observed during the antenatal period, prolonged labor appears to be significantly higher for the first pregnancy, and pregnancies suffering from abdominal pain during pregnancy tend to have a higher risk of prolonged labor during delivery. The duration of labor appears to be negatively associated with the number of previous pregnancies, being longest for the first pregnancies. The duration of labor pain is significantly higher for the respondents who reported the index pregnancy as undesired, and, similarly, the respondents who were reported to be involved with gainful employment would have a shorter duration of labor pain than those having no involvement with gainful employment.

Partitioning the effect of infant and child death on subsequent fertility: An exploration in Bangladesh

The authors propose a method to partition the fertility impact of infant and child death into two components-a physiological and a behavioral effect-by application of the Cox hazards model with three dummy variables that indicate the time of child death and the status of lactation with reference to the return of menstruation. Analysis of results from the 199 1 Bangladesh Contraceptive Prevalence Survey (BCPS) indicates that child death far outweighs any other factor in increasing the likelihood of an additional birth. The physiological effect of a childs death is 90 percent stronger than the behavioral effect and both effects wane quickly over time. It appears that an early cessation of lactation is not the sole cause of the physiological effect at least in Bangladesh. The relative strength of the two effects supports the observation that Bangladesh is in the early stage of fertility transition. This paper was prepared for presentation at the Annual Meeting of the Population Association of America May 1996 New Orleans Louisiana. The research was supported in part by a Cooperative Agreement between the East-West Center and USAID (CCP-3046-A-00-3015-00). (authors)

Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh

BackgroundBangladesh urban population is expected to overtake rural population by 2040, and a significant part of the increase will be in slums. Wide disparities between urban slums and the rest of the country can potentially push country indicators off track unless the specific health and nutrition needs of the expanding slum communities are addressed. The study aims at describing the individual, household and community determinants of undernutrition status among children living in major urban strata, viz. City Corporation slums and non-slums, in order to understand the major drivers of childhood undernutrition in urban slum settings.MethodsData are derived from Bangladesh Urban Health Survey conducted in 2013. This survey is a large-scale, nationally representative of urban areas, household survey designed specifically to provide health and nutrition status of women and children in urban Bangladesh.ResultsData showed that 50% of under-5 children in slums are stunted and 43% are underweight, whereas for non-slums these rates are 33 and 26% respectively. In terms of severity, proportion of under-5 children living in slums severely underweight or stunted are nearly double than the children living in non-slums. Logistic analyses indicate that mother’s education, child’s age, and household’s socio-economic status significantly affects stunting and underweight levels among children living in the urban slums. Logistic models also indicate that all individual-level characteristics, except exposure to mass media and mother’s working outside home, significantly affect undernutrition levels among children living on non-slums. Among the household- and community-level characteristics, only household’s socioeconomic status remains significant for the non-slums.ConclusionsPoor nutritional status is a major concern in slum areas, particularly as this group is expected to grow rapidly in the next few years. The situation calls for specially designed and well targeted interventions that take into account that many of the mothers are poorer and less educated, which affects their ability to provide care to their children.

The use of modern and traditional methods of fertility control in Bangladesh: A multivariate analysis☆

An attempt has been made to study the use pattern of traditional and modern methods of fertility control among currently married women of reproductive ages utilizing the 1989 BFS data. Bivariate analysis has been employed to study the differentials in the use pattern by some selected demographic and socio-economic characteristics. Also, multivariate logistic regression analysis has been used to identify independent contributions of each selected covariate. It has been observed, however, that there is universality of knowledge about contraceptive methods. Of the total 31 percent, about 23 percent were using modern methods and the rest, 8 percent, traditional methods. Analysis using a logistic regression model showed that visits of family planning workers have very strong and positive influence on the current use of modern contraceptives as compared to traditional methods. Duration of effective marriage also emerged as a strong determinant of modern versus traditional methods use but it influenced modern methods use negatively. Also, administrative division is an important variable. Residents of Rajshahi division were significantly more (relative odds of 2.5) likely to be using modern methods than residents of Chittagong division. The likelihood of women having electricity in their household of being a current user of modern contraceptives is almost 2 times higher compared to women without electricity in their households. Education and occupation of husbands also exerts effect on current use of modern contraceptives. The odds of current use of modern methods among women whose husbands have secondary and higher level of education is one-and-a-half times higher than that of women with husbands having no formal education. However, wives of landowners were less (relative odds of 0.72) likely to use these methods as compared to traditional methods than wives of labourers or farmers. The probability of current use of modern contraceptives was higher (relative odds of 1.5) among women who discussed family planning with their husbands than those who did not.

Women's television watching and reproductive health behavior in Bangladesh

Bangladesh has made significant social, economic, and health progress in recent decades, yet many reproductive health indicators remain weak. Access to television (TV) is increasing rapidly and provides a potential mechanism for influencing health behavior. We present a conceptual framework for the influence of different types of TV exposure on individual’s aspirations and health behavior through the mechanisms of observational learning and ideational change. We analyze data from two large national surveys conducted in 2010 and 2011 to examine the association between women’s TV watching and five reproductive health behaviors controlling for the effects of observed confounders. We find that TV watchers are significantly more likely to desire fewer children, are more likely to use contraceptives, and are less likely to have a birth in the two years before the survey. They are more likely to seek at least four antenatal care visits and to utilize a skilled birth attendant. Consequently, continued increase in the reach of TV and associated growth in TV viewing is potentially an important driver of health behaviors in the country.