Aim: This study aims to systematically identify and review the most significant risk factors and the trends that follow acute respiratory infection (ARI) among children under five in Bangladesh. Methods:A total of 6863 under-five children were eligible for our analysis, retrieved from Bangladesh Demographic and Health Survey (BDHS), 2014. ARI cases were defined if a child experienced coughing with short and rapid breathing at the chest that occurred during 2 weeks prior to the study. Logistic regression and systematic review methods were appraised to explore the various risk factors involving ARI in Bangladesh. Furthermore, a trend analysis was performed to overlook the historical trend of ARI prevalence and affiliated determinants from 1996/97 to 2017/18 in Bangladesh.Results: Over the past two decades, Bangladesh experienced a significant drop in ARI prevalence from 12.8% in 1996 to only 3.0% in 2018. The cross-sectional findings revealed that boys (OR = 1.35, 95% CI: 1.03-1.78), stunted children (OR = 1.35, 95% CI:1.03-1.78) and mothers with primary or no education (OR = 2.53, 95% CI: 1.43-4.90) and secondary education (OR = 1.77, 95% CI: 1.00-3.44) have the higher odds of ARI than their counterparts. Conclusion:Acute respiratory infection prevalence significantly declined in Bangladesh, while boys, stunted children and uneducated or primary educated mothers were identified as potential risk factors.

IntroductionMaternal undernutrition is highly prevalent in most of the developing countries. Prevalence of both extremes of maternal malnutrition (undernutrition and overweight/obesity) are common in those countries. For Bangladesh, the scenario is not different. The Government of Bangladesh recognises maternal nutrition as a public health priority and addresses the issue in its policies and programmes. We identified and analysed the existing maternal nutrition programmes and determined the bottlenecks in implementing the programmes in Bangladesh using qualitative approach.MethodsWe followed a qualitative research approach and conducted 25 key informant interviews with the programme managers and policymakers, 10 in-depth interviews with the service providers and six focus group discussions with the pregnant women to identify the constraints of programme implementation. We analysed data using thematic and inductive approaches of qualitative research methods.ResultsWe have found that successful implementation of maternal nutrition intervention was being hampered by both the demand and supply side issues. On the demand side, major constraints were financial inability of the families to avail maternal nutrition-related services, ignorance of the family members and cultural barriers of using maternal nutrition-related services. Lack of priority and heavy workload of the service providers, lack of human resources, poor monitoring system, lack of medicine to supply and incoordination have been identified as major supply-side constraints in providing maternal nutrition-related interventions in Bangladesh.ConclusionBoth supply side and demand side issues are responsible for the existing bottlenecks in implementing maternal nutrition-related programmes in Bangladesh. Findings of this study will help the policymakers to learn about the programmatic constraints regarding maternal nutrition services in Bangladesh.