Levels, trends and socio-demographic determinants of infant and under-five mortalities in and around slum areas of Dhaka city, Bangladesh

Ayenew

et al. 2022

Sci Rep

The infant mortality rate remains unacceptably high in sub-Saharan African countries. Ethiopia has one of the highest rates of infant death. This study aimed to identify individual-and community-level factors associated with infant death in the rural part of Ethiopia. The data for the study was obtained from the 2016 Ethiopian Demographic and Health Survey. A total of 8667 newborn children were included in the analysis. The multilevel logistic regression model was considered to identify the individual and community-level factors associated with new born mortality. The random effect model found that 87.68% of the variation in infant mortality was accounted for by individual and community level variables. Multiple births (AOR = 4.35; 95%CI: 2.18, 8.69), small birth size (AOR = 1.29; 95%CI: 1.10, 1.52), unvaccinated infants (AOR = 2.03; 95%CI: 1.75, 2.37), unprotected source of water (AOR = 1.40; 95%CI: 1.09, 1.80), and non-latrine facilities (AOR = 1.62; 95%CI: 1.20) were associated with a higher risk of infant mortality. While delivery in a health facility (AOR = 0.25; 95%CI: 0.19, 0.32), maternal age 35–49 years (AOR = 0.65; 95%CI: 0.49, 0.86), mothers receiving four or more TT injections during pregnancy (AOR = 0.043, 95% CI: 0.026, 0.071), and current breast feeders (AOR = 0.33; 95% CI: 0.26, 0.42) were associated with a lower risk of infant mortality. Furthermore, Infant mortality rates were also higher in Afar, Amhara, Oromia, Somalia, and Harari than in Tigray. Infant mortality in rural Ethiopia is higher than the national average. The government and other concerned bodies should mainly focus on multiple births, unimproved breastfeeding culture, and the spacing between the orders of birth to reduce infant mortality. Furthermore, community-based outreach activities and public health interventions focused on improving the latrine facility and source of drinking water as well as the importance of health facility delivery and received TT injections during the pregnancy.

Section: Discussionsupporting

confidence: 93%

Community and individual level determinants of infant mortality in rural Ethiopia using data from 2016 Ethiopian demographic and health survey

Ayenew

et al. 2022

Sci Rep

“…Although a large number of studies have examined socio-demographic differentials of infant and under-five mortality in Bangladesh [35][36][37], none of these studies have specifically examined mortality differentials among slum dwellers. Recently Razzaque et al ( 2022) examined under-five mortality using the same data (HDSS) and found that it varied by the mother's working status, sex of the child, size of the baby, delivery type, presence of complication (s) during delivery, and birth interval [38]. Our current study found almost similar results while pre-term birth was included in the model.…”

Section: Discussionsupporting

confidence: 77%

Preterm Birth and Neonatal Mortality in Selected Slums in and around Dhaka City of Bangladesh: A Cohort Study

Razzaque

Rahman

Chowdhury

et al. 2023

Preprint

Self Cite

Background: Although under-five mortality declined appreciably in Bangladesh over the last few decades, neonatal mortality still remains high. The objective of the study is to assess the level and determinants of preterm birth and the contribution of preterm birth to neonatal mortality. Methods: Data for this study came from selected slums in and around Dhaka city, where; since 2015, icddr,b has been maintaining the Health and Demographic Surveillance System (HDSS). The HDSS data were collected by female Field Workers by visiting each household every three months; however, during the visit, data on Last Menstrual Period (LMP) were also collected by asking each eligible woman to ascertain the date of conception. Gestational age was estimated in complete weeks by subtracting LMP from the date of pregnancy outcome. In this study, 6,989 livebirths were recorded by HDSS during 2016-2018, and these births were followed for neonatal survival; both bivariate and multivariate analyses were performed. Results: Out of total births, 21.7% were born preterm (before 37 weeks of gestation), and sub-categories were: 2.19% for very preterm (28 to 31 weeks), 3.81% for moderate preterm (32 to 33 weeks), and 15.71% for late preterm (34 to 36 weeks). The study revealed that preterm babies contributed to 39.6% of neonatal deaths; however, the probability of death was very high on the 1st day of birth (0.124 for very preterm, 0.048 for moderate preterm, 0.024 for late preterm, and 0.013 for term birth), and continued until the 3rd day. In the regression analysis, compared to the term neonates, the odds of neonatal mortality were 8.74 (CI: 5.68, 13.45, p<0.01), 4.05 (CI: 2.64, 6.22, p<0.01) and 1.48 (CI: 1.05, 2.08, p<0.05) respectively for very, moderate, and late preterm birth categories. The population attributable fraction for neonatal mortality was 23%, and sub-categories were 14% for very preterm, 10% for moderate preterm, and 6% for late preterm. Conclusions: Although urban slums are in proximity to many health facilities, a substantial proportion of preterm birth contributed to neonatal deaths. So, pregnant women should be targeted, to ensure timely care during pregnancy, delivery, and post-partum periods to improve the survival of new-borns in general and preterm birth in particular.

“…The scenario is comparably worsened for the urban poor women than the rural side of Bangladesh. These settings were characterized by a place of congested with overcrowded people, high fertility rate, unwanted pregnancies and unplanned births, limited access of healthcare services and many more health deprivations [10][11][12]. In Bangladesh, apart from the adolescents living in poor settlements, signi cant gaps remain in obtaining SRH information from migrants and internally displaced persons [13] and nearly 52% of the migrated women living in the urban poor and informal settings [14].…”

Section: Introductionmentioning

confidence: 99%

“…SRH knowledge among reproductive-age women in urban slums is barely studied in Bangladesh [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Sexual and Reproductive Health (SRH) Knowledge of Women: A Cross- Sectional Study among the women experienced abortion in urban slums, Dhaka, Bangladesh

Billah,

Koly,

Begum

et al. 2023

Preprint

Self Cite

Background: Women in urban slums were particularly susceptible due to a lack of knowledge about sexual and reproductive health (SRH), and abortion was frequently performed. In this study, reproductive-aged women who have had abortions and lived in urban slums in Dhaka, Bangladesh, are evaluated for their level of SRHR knowledge and its predictors. Methods: We adopted a cross-sectional survey among the reproductive aged women experienced any sorts of abortion from July 2020 to January 2022 living in the UHDSS sites, applying a predefined interviewer assisted survey questionnaire. Data were analyzed using descriptive statistics (i.e., mean, standard error, and 95% confidence interval (CI)) for continuous and percentage distribution for categorical variables. Bi-variate analysis was used to look for associations. After checking the assumptions, multinomial regression analysis was used to confirm the determinants with 95% CIs. Results: Total of 338 women were participated (221 spontaneous abortion and 117 induced abortion) with average age of 26.59 ±0.355, first age at marriage 16.69 ±0.173, and marital length of 9.45 ±0.386. Except for the use of emergency contraceptives (32%), many women correctly identified condom effectiveness for preventing pregnancy (89%), STDs and HIV/AIDS prevention (79-80%), and abortion (98%). 34 to 64% of them experienced stigmas attached to sexually explicit items. Few of them knew about abortion complications (9 to 57%), with the exception of bleeding associated with abortion (91.7%). Overall, ¾ women lacked sufficient SRH knowledge, with a mean score of 58.28 (95% CI: 56.70, 59.87), which was slightly higher for women who had spontaneous abortions 58.90 (95% CI: 57.02, 60.78) and lower for women who had induced abortions 57.69 (95% CI: 54.94, 60.45). Women who were older (p <0.05), had a higher education (p <0.01), and received post-abortion family planning counseling (p< 0.001) had adequate SRH knowledge. Conclusion: Our findings can be used in the abortion policies and strategies for vulnerable women and we recommend an intervention of increase awareness and knowledge on SRH is essential for those women to achieve the maternal reproductive health parameters.