Journal of Preventive Medicine and Public Health

Original Articles

The Impact of COVID-19 on Healthcare Services in Bangladesh: A Qualitative Study on Healthcare Providers’ Perspectives: Sharmin Parveen, Md. Shahriar Mahbub, Nasreen Nahar, K. A. M. Morshed, Nourin Rahman, Ezzat Tanzila Evana, Nazia Islam, Abu Said Md. Juel Miah; J Prev Med Public Health. 2024;57(4):356-369. Published online June 9, 2024; DOI: https://doi.org/10.3961/jpmph.24.081

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Abstract Summary PDF: Objectives
The objective of this study was to explore healthcare providers’ experiences in managing the coronavirus disease 2019 (COVID-19) pandemic and its impact on healthcare services.
Methods
A qualitative study was conducted with 34 healthcare professionals across 15 districts in Bangladesh. Among the participants, 24 were health managers or administrators stationed at the district or upazila (sub-district) level, and 10 were clinicians providing care to patients with COVID-19. The telephone interviews were conducted in Bangla, audio-recorded, transcribed, and then translated into English. Data were analyzed thematically.
Results
Most interviewees identified a range of issues within the health system. These included unpreparedness, challenges in segregating COVID-19 patients, maintaining isolation and home quarantine, a scarcity of intensive care unit beds, and ensuring continuity of service for non-COVID-19 patients. The limited availability of personal protective equipment, a shortage of human resources, and logistical challenges, such as obtaining COVID-19 tests, were frequently cited as barriers to managing the pandemic. Additionally, changes in the behavior of health service seekers, particularly increased aggression, were reported. The primary motivating factor for healthcare providers was the willingness to continue providing health services, rather than financial incentives.
Conclusions
The COVID-19 pandemic presented a unique set of challenges for health systems, while also providing valuable lessons in managing a public health crisis. To effectively address future health crises, it is crucial to resolve a myriad of issues within the health system, including the inequitable distribution of human resources and logistical challenges.; Summary

Key Message
This qualitative study explored healthcare providers' perspectives on the impact of the COVID-19 pandemic on healthcare services. Issues within the health system, such as a lack of skilled human resources, insufficient critical care facilities, low coverage of COVID-19 tests, inadequate logistical support, poor health behaviors and practices among health service seekers posed barriers to managing the pandemic at different healthcare levels. Ensuring personal protection for health professionals in the face of a novel disease presented a significant challenge. Increasing resource allocation and developing the capacity of healthcare providers were identified as potential solutions.

Individual and Occupational Factors Associated With Low Back Pain: The First-ever Occupational Health Study Among Bangladeshi Online Professionals: Mosharop Hossian, Mohammad Hayatun Nabi, Ahmed Hossain, Mohammad Delwer Hossain Hawlader, Nadira Sultana Kakoly; J Prev Med Public Health. 2022;55(1):98-105. Published online January 12, 2022; DOI: https://doi.org/10.3961/jpmph.21.565

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Objectives
Low back pain (LBP) is a common chronic condition among sedentary workers that causes long-term productivity loss. This study aimed to identify the relationships of individual and occupational factors with LBP among Bangladeshi online professionals.
Methods
We conducted a cross-sectional study involving 468 full-time online professionals who usually worked in a sitting position. One-month LBP complaints were assessed using a musculoskeletal subscale of subjective health complaints. The chi-square test was used to measure associations between categorical predictors and LBP, and multivariable logistic regression was conducted to identify the variables significantly associated with LBP.
Results
LBP within the last month was reported by 65.6% of participants. Multivariable logistic regression analysis indicated that age >30 years (adjusted odds ratio [aOR], 0.40; 95% confidence interval [CI], 0.23 to 0.70) and being married (aOR, 0.59; 95% CI, 0.36 to 0.97) had significant negative associations with LBP. Significant positive associations were found for spending >50 hours weekly on average working in a sitting position (aOR, 1.61; 95% CI, 1.05 to 2.49), being overweight and obese (aOR, 1.87; 95% CI, 1.16 to 2.99), sleeping on a soft mattress (aOR, 2.01; 95% CI, 1.06 to 3.80), and ex-smoking status (aOR, 3.33; 95% CI, 1.41 to 7.87).
Conclusions
A high prevalence of LBP was found among full-time online professionals. Long working hours in a sitting position showed a significant association with developing LBP. Smoking history, body mass index, and sleeping arrangements should also be considered while considering solutions for LBP prevalence among online professionals.

Summary

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Effects of mattress firmness and usage duration on low back pain: a hospital-based study from Lahore
Alveena Mobeen, Hafiz Muhammad Kazim, Nimra Ijaz
Journal of Social & Health Sciences.2024; 2: 34. CrossRef
Pay-for-performance and low back pain with interaction of overwork: findings from the cross-sectional Korean working conditions survey
Julia D. Hur, Jongin Lee
Frontiers in Public Health.2024;[Epub] CrossRef

Adverse Birth Outcomes Among Pregnant Women With and Without COVID-19: A Comparative Study From Bangladesh: Sumaya Binte Masud, Faiza Zebeen, Dil Ware Alam, Mosharap Hossian, Sanjana Zaman, Rowshan Ara Begum, Mohammad Hayatun Nabi, Mohammad Delwer Hossain Hawlader; J Prev Med Public Health. 2021;54(6):422-430. Published online October 21, 2021; DOI: https://doi.org/10.3961/jpmph.21.432

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Abstract PDF

Objectives
Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19.
Methods
The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression.
Results
Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative.
Conclusions
Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

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SARS-CoV-2 infection by trimester of pregnancy and adverse perinatal outcomes: a Mexican retrospective cohort study
Rakesh Ghosh, Juan Pablo Gutierrez, Iván de Jesús Ascencio-Montiel, Arturo Juárez-Flores, Stefano M Bertozzi
BMJ Open.2024; 14(4): e075928. CrossRef
The impact of COVID-19 infections on pregnancy outcomes in women
Ke Xu, Wen Sun, Shuangshuang Yang, Tianqi Liu, Ning Hou
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
COVID-19 vaccine decision-making among pregnant and lactating women in Bangladesh
Rupali J. Limaye, Prachi Singh, Alicia Paul, Berhaun Fesshaye, Clarice Lee, Eleonor Zavala, Sydney Wade, Hasmot Ali, Hafizur Rahman, Shirina Akter, Ruth Karron, Towfida Jahan Siddiqua
Vaccine.2023; 41(26): 3885. CrossRef
The coronavirus disease 2019 infection in pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis
Yeonsong Jeong, Min-A Kim
Obstetrics & Gynecology Science.2023; 66(4): 270. CrossRef
Sources of COVID-19 Vaccine Promotion for Pregnant and Lactating Women in Bangladesh
Berhaun Fesshaye, Sydney A. Wade, Clarice Lee, Prachi Singh, Eleonor Zavala, Hasmot Ali, Hafizur Rahman, Towfida Jahan Siddiqua, Shirina Atker, Ruth A. Karron, Rupali J. Limaye
Vaccines.2023; 11(8): 1387. CrossRef
Impact of SARS-CoV-2 infection in pregnant women and their babies: clinical and epidemiological features
María José Vidal, Èrica Martínez-Solanas, Sergi Mendoza, Núria Sala, Mireia Jané, Jacobo Mendioroz, Pilar Ciruela
Gaceta Sanitaria.2023; 37: 102332. CrossRef
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Firdose Lambey Nakwa, Reenu Thomas, Alison van Kwawegen, Nandi Ntuli, Karabo Seake, Samantha Jane Kesting, Noela Holo Bertha Kamanga, Dikeledi Maureen Kgwadi, Neema Chami, Tshiamo Mogajane, Claude Ondongo-Ezhet, Thulisile Nelly Maphosa, Stephanie Jones, V
Frontiers in Pediatrics.2022;[Epub] CrossRef

Peer Smoking and Smoking-related Beliefs Among College Students in Bangladesh: Akiko Kamimura, Zobayer Ahmmad, Mu Pye, Bethany Gull; J Prev Med Public Health. 2018;51(1):51-58. Published online January 22, 2018; DOI: https://doi.org/10.3961/jpmph.17.146

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Abstract PDF

Objectives
Smoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh.
Methods
College students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017.
Results
First, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking.
Conclusions
Smoking-related beliefs and perceived norms in individuals’ social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals’ social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions.

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Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh: Rashidul Alam Mahumud, Abdur Razzaque Sarker, Marufa Sultana, Ziaul Islam, Jahangir Khan, Alec Morton; J Prev Med Public Health. 2017;50(2):91-99. Published online February 7, 2017; DOI: https://doi.org/10.3961/jpmph.16.089

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Abstract PDF

Objectives
As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh.
Methods
A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method.
Results
The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures.
Conclusions
The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

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