Utilisation of health services is a complex behavioural phenomenon. Empirical studies of preventive and curative services in Bangladesh have often showed that the use of health services is related to the availability, quality and cost of services, as well as to social structure, health beliefs and personal characteristics of the users. The present paper attempts to examine factors associated with the utilisation of healthcare services during the postnatal period in Bangladesh by using prospective data from a survey on maternal morbidity in Bangladesh, conducted by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERT). Both bivariate and multivariate analyses of the data confirmed that the mother's age at marriage had a significant and positive impact on the utilisation of quality healthcare services. The husband's occupation also showed a strong impact on healthcare utilisation, indicating higher use of quality care for postpartum morbidity by wives of business and service workers. The bivariate analysis showed that the number of pregnancies prior to the index pregnancy and desired pregnancies are significantly associated with the utilisation of postpartum healthcare. However, the results of this study were inconclusive on the influence of other predisposing and enabling factors, such as maternal education, the number of previous pregnancies, the occupation of the husband, antenatal care visits during pregnancy and access to health facilities. Multivariate logistic regression estimates did not show any significant impact of these factors on the use of maternal healthcare.
Maternal health services have a potentially critical role in the improvement of reproductive health. The use of health services is related to the availability, quality and cost of the services, as well as to social structure, health beliefs and the personal characteristics of the users. The present paper examined the factors that influence the use of maternal health services for some selected pregnancy-related complications (e.g. prolonged labour, excessive bleeding, high fever/discharge and convulsions) in Bangladesh by using data from the Bangladesh Demographic Health Survey, 1999-2000. It was found that younger mothers were significantly less likely to seek professional healthcare at the time of birth. The odds for rural women seeking healthcare services from a doctor, nurse and/or midwife were half those of urban women. The strong influence of the mothers' education and parity on the utilisation of healthcare services is consistent with findings from other studies. The possession of assets emerged as an important predictor of seeking care from health professionals at the time of birth. Another factor, i.e. a husband's concern about pregnancy complications, showed a significant and positive impact on the utilisation of healthcare services, which is very important for rural women when they are dependent on their spouses. It was observed that the respondents living in urban areas, who had higher levels of education and lower parity, and more assets (used as a proxy for income), visited trained healthcare providers more often and were more likely to use healthcare facilities provided by trained personnel at the time of delivery. This is a reflection of the fact that, irrespective of their needs, only people from higher economic or educational groups can afford to seek healthcare from trained personnel in Bangladesh. In other words, predisposing and enabling factors appear to have a strong association with women's healthcare utilisation during pregnancy.
The combination of founder events, random drift and new selective forces experienced by introduced species typically lowers genetic variation and induces differentiation from the ancestral population. Here, we investigate microsatellite differentiation between introduced and native populations of the small Indian mongoose (Herpestes auropunctatus). Many expectations based on introduction history, such as loss of alleles and relationships among populations, are confirmed. Nevertheless, when applying population assignment methods to our data, we observe a few specimens that are incorrectly assigned and/or appear to have a mixed ancestry, despite estimates of substantial population differentiation. Thus, we suggest that population assignments of individuals should be viewed as tentative and that there should be agreement among different algorithms before assignments are applied in conservation or management. Further, we find no congruence between previously reported morphological differentiation and the sorting of microsatellite variation. Some introduced populations have retained much genetic variation while others have not, irrespective of morphology. Finally, we find alleles from the sympatric grey mongoose (Herpestes edwardsii) in one small Indian mongoose within the native range, suggesting an alternative explanation for morphological differentiation involving a shift in female preferences in allopatry.
Background Bangladesh is facing a higher maternal mortality and morbidity than many other developing countries in the world. The majority of these maternal deaths occur due to pregnancy related complications. Although health facilities in urban areas in Bangladesh are widely available, women living in underprivileged urban areas are least likely to receive the maternal health services and as a result, they face more pregnancy related complications. Unfortunately, there are only a few studies on complications during maternal and delivery period in these areas. We aim to investigate the factors responsible for pregnancy related complications in urban slum and non-slum areas. Methods Data from the Urban Health Survey (UHS), 2013 were analyzed applying mixed logistic regression model. The response variable was complications during pregnancy, during/after delivery at the last birth and the total sample size was 6137. The adjusted odds ratios (AORs) along with their 95% confidence intervals (CIs) were also calculated to compare the magnitude of different risk factors for the pregnancy related complications. Results Younger mothers (age < 18 years) at the birth of their children had 24% (OR = 1.24, 95% CI: 1.01, 1.54) more odds to experience complications during pregnancy/delivery or after delivery compared to older mothers aged 18 to 35 years. The increased risk of complications was found among primiparous women. Women living in urban slum areas had higher pregnancy related complications than women living elsewhere. Migrant mothers faced more complications than women-who were not migrants. Women had greater pregnancy related complications when they delivered boy child than girl child, presumably from an increased size of the baby and resultant birth obstruction, assisted delivery and post partum haemorrhage. Moreover, a wanted pregnancy had fewer significant complications during pregnancy/delivery or after delivery than an unwanted pregnancy. Conclusions The study associates early maternal age, primiparity, unwanted pregnancy, women living in slum areas, women migrating from other cities or non-urban areas and NGO membership with increased risk of pregnancy related complications among urban women in Bangladesh. It is likely that addressing these risk factors for complications to the policymakers may help to reduce the maternal mortality and morbidity in Bangladesh.
Bangladesh has been a signatory to the Convention on Biological Diversity (CBD) although implementation of the convention has been poor. We independently assessed the extent to which the program of work (POW) of the CBD has been implemented in Bangladesh by carrying out workshops involving local communities, conservation organizations, universities, and government departments involved in forest conservation. Our analyses indicate that there is little or no understanding of the
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