Background Although the perinatal mortality rate (PNMR) has been reduced over time in Bangladesh, the rate is still very high. Only a few studies explored the determinants of high PNMR in Bangladesh, yet most of them were small-scale or conducted for stillbirths and early neonatal deaths separately. The objective of this study was to explore the trends in and determinants of perinatal deaths in Bangladesh which would be an advanced step in effective policies to tackle the issue. Methods The data used for this study was extracted from four rounds of Bangladesh Demographic and Health Surveys (BDHSs) 2004, 2007, 2011 and 2014. We considered the outcome of the 26604 pregnancies reaching seven months of their gestation. The trends of perinatal mortality was assessed using the Cochran–Armitage test, while the logistic regression with generalized estimating equation (GEE) to account for the clustering effect was implemented to explore the association between perinatal mortality and its risk factors. Results The PNMR was significantly reduced from 64 (95% CI: 57–73) to 41 (95% CI: 35–48) per 1000 pregnancies between 2004 and 2014 (stillbirths: 34 to 19 and early neonatal deaths: 30 to 22). After adjusting for potential covariates in the model, we found that administrative division, type of cooking fuel, child’s gender, maternal occupation, body mass index, birth interval, history of miscarriage, previous deaths of children, total number of under 5 children, mode of delivery, type of delivery, access to participation in decision making, paternal education and occupation were significantly associated with perinatal deaths. Conclusion The study highlights the importance of strengthening proper postnatal care services in the healthcare facilities. Alongside this, effort should also be stressed to ensure proper pregnancy care and to improve the socio-economic condition of the households to address the issue.
Background: Low birth weight (< 2.5 kg) is an important indicator of health and development of infants throughout their life. Aims: This study aimed to determine the prevalence and risk factors for low birth weight in Jordan and its association with under-5 mortality. Methods: In this secondary analysis, data were extracted from the 2012 Jordan Population and Family Health Survey for 9734 live births born in the 5 years preceding the survey and for which birth weight was reported. Data were collected on child and maternal characteristics. Multivariable regression analysis was used to determine the significant risk factors for low birth weight and mortality. Results: Of the 9734 births analysed, 13.8% were low birth weight and 1.3% were very low birth weight. Mother's age (< 30 and ≥ 35 years), education (less than higher education), birth interval (< 24 months and first birth), unplanned pregnancy, household wealth status (poorest and richest), consanguinity, residence (central and south regions of Jordan), female sex, birth order (1 and ≥ 6), twin birth and maternal smoking during pregnancy were significant risk factors for low birth weight. The risk of death under 5 years of age was 4.8 times higher in children with low birth weight than children with normal birth weight. Conclusions: The high rate of low birth weight and its increasing rate in Jordan is a challenge for public health. Preventing low birth weight neonates and increasing their survival need to be prioritized in the national health strategy. Special care needs to be taken for the high-risk groups identified in this study.
South Asian countries have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures. This review aims to describe the epidemiological features and shortcomings in public health preparedness to tackle COVID-19 as well as derive lessons from these events in the context of Bangladesh. We have shown that an increase in human mobility was evident throughout the lockdown period. Over 20,000 frontline health workers were affected, and more than 2100 unofficial deaths possibly linked with COVID-19 diagnosis were reported. Males were disproportionately affected in terms of infection (71%) and death (77%) than females. Over 50% of infected cases were reported among young adults (20-40-year age group). After seven months into the pandemic, a downward trend in laboratory test positive percentage was seen, although the number of new deaths per day remained largely unchanged. We believe our findings, observations and recommendations will remain as a valuable resource to facilitate better public health practice and policy for managing current and future infectious disease like COVID-19 in resource-poor developing countries.
SummaryThis study examined the recent level, trends and determinants of consanguineous marriage in Jordan using time-series data from the Jordan Population and Family Health Surveys (JPFHSs). According to the 2012 JPFHS, 35% of all marriages were consanguineous in Jordan in 2012. There has been a declining trend in consanguinity in the country, with the rate decreasing from a level of 57% in 1990. Most consanguineous marriage in 2012 were first cousin marriages, constituting 23% of all marriages and 66% of all consanguineous marriages. The data show that women with a lower age at marriage, older marriage cohort, larger family size, less than secondary level of education, rural place of residence, no employment, no exposure to mass media, a monogamous marriage, a husband with less than higher level of education and lower economic status, and those from the Badia region, were more likely to have a consanguineous marriage. Increasing age at marriage, level of education, urbanization and knowledge about the health consequences of consanguinity, and the ongoing socioeconomic and demographic transition in the country, will be the driving forces for further decline in consanguinity in Jordan.
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