:Unmet need for family planning is the key indicator to achieve Millennium Development Goal by the year 2015. Bangladesh Government has a great success in family planning sector but population has almost doubled in recent years. This study was carried out among married women to compare the determinants of unmet need for family planning among rural and urban communities during the period from July 2010 to June 2011. Unmet need for family planning in rural community was found 18(12%) and in urban community it was 38(25.3%). Among rural women unmet need for limiter was 13(8.6%) and spacer was 5(3.4%) while limiter 29(19.4%) and spacer 9(5.9%) found among urban women. Mean age at marriage was found 17.97(SD±2.66) years and mean age at first child birth was 19.91(SD±2.71) years among rural women. Among urban women mean age at marriage was found 20.43(SD±4.08) years and mean age at first child birth was 22.55(SD±4.3) years. Current contraceptive users among rural women was 79(52.7%) while it was 61(40.7%) among urban women. In this study, association between unmet need for family planning and freedom of choice of contraceptives was highly significant (p=0.001). To increase contraceptive prevalence rate and reduction of unplanned pregnancy, more emphasis should be given on unmet need for family planning.

BackgroundWell-functioning patient feedback systems can contribute to improved quality of healthcare and systems accountability. We used realist evaluation to examine patient feedback systems at health facilities in Bangladesh, informed by theories of citizenship and principal–agent relationships.MethodsWe collected and analysed data in two stages, using: document review; secondary analysis of data from publicly available web-portals; in-depth interviews with patients, health workers and managers; non-participant observations of feedback environments; and stakeholder workshops. Stage 1 focused on identifying and articulating the initial programme theory (PT) of patient feedback systems. In stage 2, we iteratively tested and refined this initial theory, through analysing data and grounding emerging findings within substantive theories and empirical literature, to arrive at a refined PT.ResultsMultiple patient feedback systems operate in Bangladesh, essentially comprising stages of collection, analysis and actions on feedback. Key contextual enablers include political commitment to accountability, whereas key constraints include limited patient awareness of feedback channels, lack of guidelines and documented processes, local political dynamics and priorities, institutional hierarchies and accountability relationships. Findings highlight that relational trust may be important for many people to exercise citizenship and providing feedback, and that appropriate policy and regulatory frameworks with clear lines of accountability are critical for ensuring effective patient feedback management within frontline healthcare facilities.ConclusionTheories of citizenship and principal–agent relationships can help understand how feedback systems work through spotlighting the citizenship identity and agency, shared or competing interests, and information asymmetries. We extend the understanding of these theories by highlighting how patients, health workers and managers act as both principals and agents, and how information asymmetry and possible agency loss can be addressed. We highlight the importance of awareness raising and non-threatening environment to provide feedback, adequate support to staff to document and analyse feedback and timely actions on the information.

Background: Involvement of autonomic and motor nervous system are very crucial for the patients suffering from prolapse lumbar intervertebral disc. Objective: The purpose of the present study was to see the involvement of autonomic and motor nervous system of the patients suffering from prolapse lumbar intervertebral disc. Methodology: This cross-sectional study was carried out in the department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2006 to October 2007 for a period of one and half year. Prolapse lumbar intervertebral disc (PLID) patients who were admitted in the Department Neurosurgery at BSMMU, Dhaka, Bangladesh after clinical and radiological evaluation were selected as study population. The involvement of autonomic and motor nervous system were examined among the patients suffering from prolapse lumbar intervertebral disc. Result: A total of 59 hospital-admitted cases of PLID were included in the study. The mean age of the patients was 40.8±11.9 years and the lowest and highest ages were 21 and 65 years respectively. Majority of the patients had intact bladder function which was 57(94.9%) cases and the remaining 2(3.4%) cases had incontinence of urine. More than half (54.2%) of the subjects exhibited weak extensor hallucis longus test, while 30.5% had weak flexor digitalis longus test. Conclusion: In conclusion motor dysfunction is very high, but low rate of autonomic abnormalities are found among the patients suffering from prolapse lumbar intervertebral disc. Journal of Science Foundation, January 2020;18(1):3-6

Background Well-functioning patient feedback systems can contribute to improved quality of healthcare and ultimately make health systems more accountable. We used realist evaluation to understand the functioning of patient feedback systems at frontline health facilities in Bangladesh. Methods We collected and analysed data in two stages using: document review; secondary analysis of data from publicly-available web-portals; in-depth interviews with patients, health workers and managers; non-participant observations of feedback environments; and stakeholder workshops. Stage 1 focused on identifying and articulating the initial program theory of patient feedback systems. In Stage 2, we iteratively tested and refined this initial theory, through analysing data and grounding emerging findings within substantive theories and empirical literature, to arrive at a refined program theory. Results Multiple patient feedback systems operate in Bangladesh, essentially comprising stages of collection, analysis and actions on feedback. Key contextual enablers include political commitment to accountability, whereas key constraints include limited patient awareness of feedback channels, lack of guidelines and documented processes, local political dynamics and priorities, institutional hierarchies and accountability relationships. Findings highlight that relational trust may be important for many people to exercise citizenship and providing feedback, and that appropriate policy and regulatory frameworks with clear lines of accountability are critical for ensuring effective patient feedback management within frontline healthcare facilities. Conclusion Tolib Information, Mirzoev*, Sumit Kanea, Bassey Ebenso1,b

The authors have withdrawn this preprint due to author disagreement.