Characteristics of Child Labour and Their Health Problems: Findings from Rural Community of India

Background: Child labour is a big problem. Studies have indicated several problems of child labour. However, few studies have indicated the characteristics of child labour rural India. Objectives: This study has explored characteristics of child labour and their families in the rural community of eastern India and also identified their health problems. Methods: A cross-sectional study was designed to explore their characteristics in purposively selected areas in rural Howrah, India. Frequency table and bar-diagrams were used. Results: The study identified 72% boys and 28% girls as child labour. Majority of the children (67.9%) were labour because they wanted to help their parents. In 8.9% cases, they were forced to work by their parents. In 5.4% cases, they were orphans. Majority of the children were not satisfied (78.6%) with their job place and job status. Conclusions: Child labourers are not satisfied with their job. Their money is used in family. Parents are illiterate. Lack of effective education system and availability of functional schools are both causes and consequences of child labour. Due to illiteracy, working conditions for these children get worse as they are not even aware of the occupational benefits.

Response to an Earthquake in Bangladesh: Experiences and Lesson Learnt

A powerful earthquake occurred in Nepal on 25th April 2015 where the highest measure of the tremor was 7.9 on the Richter scale with a minimum of 6.6. The death toll was around 3000 and thousands were injured in the devastation of the disaster. The earthquake and subsequent earth tremors were also felt in other South East Asian countries including Bangladesh, India and China. Bangladesh was jolted twice by tremors and, although the tremor was not as severe, it was reported to be between 4 and 5 on the Richter scale. Aftershocks over the next few days were also experienced and these ranged around 5 on the Richter scale. In Bangladesh, six lives were lost, and more than 200 people were injured and were taken to hospital. There were also many buildings that collapsed in the mega city Dhaka and its surrounding areas. This study describes the country’s response to the earthquake. This experience and the lessons learnt highlight the importance for national earthquake-proof building regulations and systems to lessen the damage and devastation of any future earthquake.

Socioeconomic inequalities in the use of delivery care services in Bangladesh: a comparative study between 2004 and 2007

The study explores inequalities in the utilization of delivery care services in different administrative divisions in Bangladesh, by key socioeconomic factors. It estimates the extent of the relationship between women’s socioeconomic inequalities and their place of delivery during 2004 and 2007. Trends in relation to place of delivery in relation to residency and education over a period of thirteen years (1993-2007) have also been measured. The study analyzed the trends and patterns in utilization of institutional delivery care among mothers, using data from the Bangladesh Demographic Health Survey (BDHS) conducted during 1993-2007. The data was disaggregated by area of residence in different divisions in Bangladesh. Bi-variate analyses, concentration curves and multivariate logistic regression were employed in the analysis of the data. The study indicated slow progress in the utilization of institutional delivery care among mothers in Bangladesh between 1993 and 2007. Large variations in outcome measures were observed among the different divisions. Multivariate analyses suggested growing inequalities in utilization of delivery care services between different economic groups and parents with different educational levels. The use of institutional delivery care remains substantially lower among poor and less educated rural mothers in Bangladesh, irrespective of age and employment. Further studies are recommended to explore the specific causes relating to the non-utilization of institutional delivery care.

Maternal and Neonatal Death Review (MNDR): A Useful Approach to Identifying Appropriate and Effective Maternal and Neonatal Health Initiatives in Bangladesh

Objectives: To identify the effects of Maternal and Neonatal Death Review (MNDR) in terms of improving maternal and neonatal health at the community level in Bangladesh. Methods: Both quantitative and qualitative methods were undertaken for collecting data in Kashipur Union, Bangladesh. Death notifications from households, subsequent data collections from a focus-group discussion (FGD), a group discussion (GD) and in-depth interviews (IDIs) were obtained using structured tools and guidelines. Results: A total of four maternal deaths, 21 neonatal deaths and 15 still births were reported in the MNDR death notification system at Kashipur Union in 2010. Data were presented to local programme managers, who took various initiatives including awareness programmes, pregnancy registration, antenatal care, birth planning, and also the revitalization of a community clinic. The coverage of antenatal care, delivery in clinics, postnatal care and referral of complications increased through the active participation of the community. Community healthcare providers, care recipients and members of the community expressed satisfaction with the quality of maternal and neonatal services. In the preceding two years, maternal and neonatal deaths substantially reduced in Kashipur (in 2011 maternal death = 1, neonatal death = 20, still birth = 8;in 2012 maternal death = 1, neonatal death = 8, still birth = 13). Conclusions: The MNDR system successfully delivered notification of all maternal and neonatal deaths in the defined area and collected information for the formulation and implementation of specific interventions, which resulted in visible and tangible changes in care-seeking and client satisfaction.

Community Notification of Maternal, Neonatal Deaths and Still Births in Maternal and Neonatal Death Review (MNDR) System: Experiences in Bangladesh

Objectives: The aim of the study was to examine the process of community maternal, neonatal deaths and still births notification within the Bangladesh government health structure using the Maternal and Neonatal Death Review (MNDR) system. The study also explored the feasibility and acceptance of community death notification in the MNDR system. Methods: The study was under-taken in the Thakurgaon district of Bangladesh during 2010. During the study a mix of both qualitative and quantitative information was collected. A review of the documentation process of community death notification was undertaken and focus group discussions (FGDs) with community members, health care providers and managers in a sub-district were conducted, with in-depth interviews (IDIs) with district heath and family planning managers. Quantitative data were collected from community death notifications in the district during January to December 2010. Results: The death notification process was implemented by the government health care system within the Thakurgaon district. Field level health and family planning staff collected maternal and neonatal death information, recorded the death on the notification form and reported back to the Upazila (sub-district of the district) focal point at the Upazila health complex (primary health care centre). Community people were encouraged to share their death information to field level health staff. The health and family planning managers in the district periodically discussed the maternal and neonatal deaths and prepared remedial action plans in high death notified areas. In 2010, 59 maternal deaths, 739 neonatal deaths and 633 still births were reported in Thakurgaon district. District health and family planning departments performed community death notification as part of their routine daily work and integrated these procedures with other field level activities. Conclusion: Community death notification under the MNDR system was found to be achievable and acceptable at the district level using the existing government health system. The simple death notification process used to capture community level maternal, neonatal deaths and still births provides a guide for planning corrective actions for better health outcomes for the community.

Economic Burden of Disability Adjusted Life Years(DALYs)of Injuries

Economic burdens of injuries at the country level are unknown. In the current study we tried to explore the economic burden of DALYs loss due to injuries at the country level, then distributed according to the World Bank’s income groups. Methods: Data from the World Bank and the World Health Organization websites were used. Disability adjusted life year (DALY) and gross domestic product (GDP) per capita were used to estimate the economic loss for RTIs. Estimates of economic burdens were presented in tables and figures. Results: The total economic loss of the world during 2004 by means of DALYs due to injuries was 613. 144 billion USD, corresponding value of 848.205 billion USD in 2014. DALYs burden of injuries were concentrated (almost 75%) among low and lower middle income countries. Economic burdens of injuries were concentrated (over 80%) among higher middle and high income countries. Iraq had lost almost one-fifth of its GDP due to injuries. The USA had the highest amount of economic loss for injuries (169.136 billion USD) among all countries. Conclusion: Injuries are highly expensive and they account for heavy losses to GDP. Injury prevention should be prioritized in order to save such losses to life and economies.

Economic Cost of Pedestrian Injuries in Stockholm City

Objective: To conduct a cost analysis of pedestrian injuries at zebra crossings (marked lines only) in Stockholm city during 2008, and propose an intervention for reducing these incidents. Cost savings for the intervention are calculated and presented. Method: A Cost of Illness (COI) method was used to calculate the cost for pedestrian injuries at zebra crossings. Cost of Illness included direct and indirect costs and excluded intangible costs due to lack of data. Data and statistics from STRADA, PAR and calculations from MSB were used to perform the COI. Results: During 2008, 73 pedestrians were injured at zebra crossings in Stockholm city, amounting an estimated social cost of 10.8 million Swedish Krona (SEK) (severe injuries 9.2 million SEK, minor injuries 1.6 million SEK). The costs for reducing pedestrian injuries and related social burden via the proposed intervention (zebra crossings constructed alongside asphalt speed bumps with adjacent lights on both sides of the crossing) were estimated to be 250,000 SEK at roads without intersections, and 1.6 million SEK at roads with an intersection. Conclusion: Pedestrian injuries place a large financial burden on society each year. It is recommended to add speed bumps and adjacent lights to zebra crossings where most pedestrian injuries occur. The intervention would reduce pedestrian injuries and also decrease the cost for the society due to these injuries. Cost savings for the intervention depend on the kind of injury avoided and what kind of road the intervention is built on.

Do Functional Problems and Neighborhood Disturbances in and around the Home Trigger Injuries?

The study has tried to identify whether poor self-rated health and home and neighbourhood environmental problems trigger injuries. The study used data from the Life & Health year 2008 survey, a postal questionnaire administered by Statistics Sweden in five administrative regions in central Sweden (Uppsala, S?dermanland, ?rebro, Varmland and V?stmanland). A random sample of 1,060,032 respondents aged 18 - 79 years had participated in the study. ?rebro and Varmland region had the highest proportions of injuries. People at their age between 18 to 24 years—males—tobacco and alcohol addicted had the highest proportions of injuries. Environmental factors such as disturbances in and around home had emerged as major triggering factors for injuries. Physical functional problems such as problem of buying own food, cooking, dressing-up and walking had been emerged as very strong predicting factors of injuries. Policy makers in Sweden could identify the poor neighborhood, disturb living condition through the housing companies and the cooperative housing societies to control injuries and promote safety.

Two NGO-Run Youth-Centers in Multicultural, Socially Deprived Suburbs in Sweden—Who Are the Participants?

Objective: Leisure-time is an important part of young people’s lives. One way to reduce social differences in health is to improve adolescents’ living conditions, for example by enhancing the quality of after-school activities. Multicultural, socially deprived suburbs have less youth participation in organized leisure-time activities. This study explores who the participants are at two NGO-run youth-centers in multicultural, socially deprived suburbs in Sweden and whether socio-demographic, health-related, and leisure-time factors affect the targeted participation. Methods: The study can be seen as an explanatory mixed-methods study where qualitative data help explain initial quantitative results. The included data are a survey with youth (n = 207), seven individual interviews with staff, and six focus-groups interviews with young people at two youth-centers in two different cities. Results and Conclusions: The participants in the youth-centers are Swedish born youths having foreign-born parents who live with both parents, often in crowded apartments with many siblings. Moreover they feel healthy, enjoy school and have good contact with their parents. It seems that strategies for recruiting youths to youth-centers have a large impact on who participates. One way to succeed in having a more equal gender and ethnicity distribution is to offer youth activities that are a natural step forward from children’s activities. The youth-centers’ proximity is also of importance for participation, in these types of neighborhoods.

Impact of social standing on traffic injury prevention in a WHO safe community

The objective of the current study was to evaluate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experimental design was used, with pre- and post-implementation registrations in the program implementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in ?sterg?tland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self-employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active category displayed a decreasing trend in the intervention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the intervention area between 1983 and 1989 was likely to be attributable to the success of safety promotion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

Influencing factors on time of breastfeeding initiation among a national representative sample of women in India

Breastfeeding is seen as vital for mother and child and therefore is of great public health concern. Early initiation of breastfeeding within one hour of delivery is important as it reduces neonatal mortality. Increasing our understanding of barriers and reasons for not commencing early breastfeeding is important to improve strategies and conditions to overcome such barriers. Hence, the present study aimed to investigate factors influencing time of breastfeeding among women in India, focusing on health care utilisation related issues and partner behaviour. Data from the Ministry of Health and Family Welfare of the Government of India’s National Family Health Survey (NFHS) from 2005-2006 (NFHS-3) have been used in this study. Breastfeeding for the latest child was considered in the study. A total of 35,795 female respondents are included in this study. Chi square test and adjusted logistic regression analysis were used. Among all 35,795 women in the study, a total of 31.1% initiated breastfeeding within one hour and 68.6% initiated breastfeeding within the first week. Educational level, economic status and women’s caste or tribe, place of delivery, prenatal visits to health care facilities and assistance during delivery as well as partner’s controlling and violent behavior are important factors influencing time of initiation of breastfeeding. It is evident that policy makers need to ensure that all health professionals support and promote early breastfeeding initiation. It is also important to promote deliveries in hospitals and other healthcare facilities as they may increase early initiation. Furthermore, it is fundamental that efforts are intensified for girls and women to obtain education to increase women’s empowerment and improved gender equality.

Identifying households with low immunisation completion in Bangladesh

The objective of this study was to investigate if the mothers’ demographics and household characteristics—including type of use of cooking fuel, energy and toilet facilities—have any implication for complete immunisation rates among their children. A cross-sectional data analysis of a nationally representative sample of 4925 women with at least one child was performed. Chisquared tests and multivariate logistic regression analyses were used. Immunisation coverage was positively associated with the mother’s education and with household characteristics such as toilet facility, electricity and involvement in a microfinance group. These findings indicate the need for further advocacy for increased knowledge on the importance of vaccination and affordable public immunisation programs focusing on higher risk households such as those with pit facilities, lack of electricity and no participation in a microfinance group. Such households warrant further attention and can be targeted for immunisation coverage.

Quality of life of COVID-19 recovered patients:a 1-year follow-up study from Bangladesh

BackgroundThe COVID-19 pandemic posed a danger to global public health because of the unprecedented physical,mental,social,and environmental impact affecting quality of life(QoL).The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings.MethodsCOVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice,once immediately after recovery and again 1 year after the first follow-up.The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version(WHOQOL-BREF).After excluding 48 deaths,95 were rejected to participate,618 were inaccessible,and there were 45 cases of incomplete data.Descriptive statistics,paired-sample analyses,generalized estimating equation(GEE)analysis,and multivariable logistic regression analyses were performed to test the mean difference in participants’QoL scores between the two interviews.ResultsMost participants(n=1710,70.1%)were male,and one-fourth(24.4%)were older than 46.The average physical domain score decreased significantly from baseline to follow-up,and the average scores in psychological,social,and environmental domains increased significantly at follow-up(P<0.05).By the GEE equation approach,after adjusting for other factors,we found that older age groups(P<0.001),being female(P<0.001),having hospital admission during COVID-19 illness(P<0.001),and having three or more chronic diseases(P<0.001),were significantly associated with lower physical and psychological QoL scores.Higher age and female sex[adjusted odd ratio(aOR)=1.3,95%confidence interval(CI)1.0–1.6]were associated with reduced social domain scores on multivariable logistic regression analysis.Urban or semi-urban people were 49%less likely(aOR=0.5,95%CI 0.4–0.7)and 32%less likely(aOR=0.7,95%CI 0.5–0.9)to have a reduced QoL score in the psychological domain and the social domain respectively,than rural people.Higher-income people were more likely to experience a decrease in QoL scores in physical,psychological,social,and environmental domains.Married people were 1.8 times more likely(aOR=1.8,95%CI 1.3–2.4)to have a decreased social QoL score.In the second interview,people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance(aOR=1.3,95%CI 1.1–1.6)of a decreased environmental QoL score.Almost 13%of participants developed one or more chronic diseases between the first and second interviews.Moreover,7.9%suffered from reinfection by COVID-19 during this 1-year time.ConclusionsThe present study found that the QoL of COVID-19 recovered people improved 1 year after recovery,particularly in psychological,social,and environmental domains.However,age,sex,the severity of COVID-19,smoking habits,and comorbidities were significantly negatively associated with QoL.Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological,social,and physical domains,respectively.Strong policies to prevent and minimize smoking must be implemented in Bangladesh,and we must monitor and manage chronic diseases in people who have recovered from COVID-19.