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With over 17 million children learning English, Bangladesh has one of the world’s largest English-learning populations. However, despite this, the country faces challenges in achieving the optimal level of English proficiency. English language teaching (ELT) initiatives in Bangladesh, which have evolved over time, can be broadly classified based on the Grammar-Translation Method, Communicative Language Teaching, and the English in Action project. These approaches predominantly reinforced traditional monolingual and bilingual frameworks while overlooking the rich metalinguistic, cultural, and intellectual resources that students bring to English classrooms. This article critically examines past ELT efforts, policies and their outcomes through a translanguaging lens, which challenges the rigid language separation ideology in traditional models and encourages the use of all linguistic repertoires in learning English as a target language. This article provides fresh perspectives on the strengths and weaknesses of past initiatives, as well as suggestions for developing linguistically and culturally sustainable ELT models based on translanguaging scholarship.
This chapter focuses on how Bangladesh, a country with extensive experience of climate-related disasters, has dealt with loss and damage in its national policymaking. In response to its high vulnerability, Bangladesh is – among the countries studied in this book – a role model in disaster reduction and preparedness. However, the government’s efforts do not meet the scope of needs connected to climate impacts on the ground. Drawing on a review of relevant policy documents and semi-structured interviews with key public and civil society actors, the chapter analyzes national-level engagement with loss and damage from climate change in Bangladesh. It demonstrates that while fundamentally all ministries in Bangladesh are involved in averting, minimizing, or addressing loss and damage, the concept is yet to be fully integrated in national policy. The chapter also finds that existing policies tend to focus on addressing economic losses and overlook the significant noneconomic losses from climate change. It is argued that integrating loss and damage into national policies, establishing a fair national mechanism, and creating a comprehensive database of loss and damage data would strengthen Bangladesh’s role as both an advocate for loss and damage governance and a leader in climate response.
Suicide prevention is an under-prioritised public health issue in Bangladesh. Recently, it has received academic attention substantiated by an increasing number of publications. Along with that, the Mental Health Act (2018), National Mental Health Policy (2022) and National Mental Health Strategic Plan (2020–2030) have come out. There are many challenges facing suicide prevention efforts in the country, such as suicide’s criminal legal status and associated stigma, lack of a national suicide prevention programme, inadequate clinical services, and most important, the absence of a national database on suicide. This paper analyses documents critically considering initiatives for suicide prevention, highlights the urgent necessity for suicide prevention strategies in the country and identifies prominent stakeholders. A national suicide database in which law enforcement agencies have a prominent stake is urgently needed. In the long term, suicide prevention should be considered in the lens of public health.
The objective of this study was to explore the knowledge and attitudes regarding seafood safety and consumption, along with preferences and environmental issues in coastal Bangladesh. A cross-sectional, consumer-based survey was conducted in Bangladesh from September to November 2023, targeting 1100 participants aged 18 years and older across seven coastal districts. Convenience sampling and in-person interviews were used for the data collection. The average knowledge and attitude scores toward seafood safety and consumption were 48.2% and 63.5%, respectively. Several factors influenced seafood safety and consumption knowledge, including age, education level, family size, religion, and residence in coastal areas (all P < 0.05). In contrast, attitudes toward seafood safety and consumption were shaped by education level, family size, employment status, seafood allergies, and history of seafood poisoning (all P < 0.05). The most commonly consumed seafood was rupchanda, followed by shrimp. Most participants consumed seafood for its health benefits, with no significant seasonal impact on seafood consumption. Overfishing and climate change were recognised as the most alarming environmental dangers identified by the participants. Coastal communities in Bangladesh have demonstrated moderate attitudes, but relatively low knowledge of seafood safety and consumption. Targeted educational programmes, including community workshops on safe handling and storage, school-based programmes on marine conservation, and digital campaigns via SMS/social media, are needed to improve seafood safety knowledge, while promoting sustainable consumption practices is crucial for addressing environmental concerns like overfishing. Additionally, improving market accessibility and highlighting the health advantages of seafood can drive more informed and healthier consumption choices.
In this chapter, we review the physical processes that affect the elevation of coastal settlements relative to the sea, and identify current and projected rates of change, describe the impacts of MSLR on coastal settlements and on small island states, provide rough estimates of the number of people exposed, identify options for in situ adaptation, describe common challenges in implementing planned relocations of communities at risk, with case studies from the Carteret Islands and Fiji, and conclude by reviewing the cascading risks faced in Bangladesh.
This study aimed to explore situations where caregivers and patients are likely to collude, from the perspective of caregivers of advanced cancer patients in Bangladesh.
Methods
This study took place in 2 different tertiary care hospitals in Bangladesh. The study design included both quantitative and qualitative components. In this study, we focused on situations in which caregivers choose not to disclose the truth, regardless of their patients’ desire to know it. This may include instances of mutual withholding or cases of deliberate withholding by caregivers, even when patients express a desire to know the truth. While collusion may occur in some instances, not all situations qualify as collusion; nonetheless, all of these situations were broadly considered as collusion-prone. The intensity of enactment was assessed using the “Caregiver Collusion Questionnaire,” and in-depth exploration of collusion-prone situations was conducted through key person interviews with the caregivers.
Results
The intensity of enactment was medium to high among two-thirds (83.1%) of caregivers. This intensity was significantly associated with the caregivers’ relationship with the patients and their intention to disclose the truth (p < 0.01). Higher intensity of enactment has been observed among the children who are tending to their terminally ill parents. Four major themes regarding collusion-prone situation were generated by the qualitative analysis: (1) Reasons for nondisclosure; (2) Time of disclosure; (3) Selective disclosure; and (4) Discloser of truth.
Significance of Results
The nature of collusion-prone situations is shaped by culture and social values. By gradually and indirectly addressing these situations, healthcare professionals can assist families in navigating through difficult conversations and ensure that the patient’s wishes and values are respected.
Animal source foods (ASF) are nutrient-dense and essential for the growth and development of children. The Bangladesh Demographic and Health Survey (BDHS) 2022 reported that approximately two-thirds of children aged 6–23 months consumed eggs/flesh foods. However, overall consumption patterns, trends, and factors influencing ASF intake among children in Bangladesh were not well-documented. Therefore, the study aimed to assess the trends and associated factors of ASF consumption among children aged 6–23 months in Bangladesh. A total of 9401 children were extracted from four consecutive BDHS (2011, 2014, 2017/18, and 2022). The Cochran-Armitage test was conducted to assess the trends in ASF consumption, while a two-stage multilevel mixed-effects logistic regression was performed to identify the associated factors. The consumption of ASF significantly increased to 79.1% in 2017/18 from 67% in 2011 but decreased to 73.3% in 2022. ASF consumption was found to be higher among children whose mothers were educated (AOR = 1.60, 95% CI = 1.30–1.98), employed in either agricultural (AOR = 1.27, 95% CI = 1.04–1.54) or non-agricultural (AOR = 1.36, 95% CI = 1.07–1.72) activities, pregnant (AOR = 2.54, 95% CI = 1.66–3.87), had received ANC 1–3 times (AOR = 1.43, 95% CI = 1.20–1.72) or ≥4 times (AOR = 1.59, 95% CI = 1.29–1.95), and was exposed to media (AOR = 1.21, 95% CI = 1.04–1.39). Furthermore, consumption increased with increasing the age of children, and the wealth of their families. However, children who experienced illness were less likely to consume ASF (AOR = 0.76, 95% CI = 0.68–0.86). The recent declines in ASF consumption emphasize the need for targeted interventions to increase ASF consumption among children in Bangladesh.
Adolescence is a critical period marked by significant physical and psychological changes, yet there is limited understanding of suicidal behaviors among adolescents in Bangladesh. To address this gap, the MeLiSA study utilizing a two-stage stratified cluster sampling approach was conducted to investigate the prevalence and associated factors of suicidal ideation, plans and attempts among adolescents. A total of 1,496 participants were recruited from urban and rural areas, and their socio-demographic characteristics and data on smoking, alcohol use, depression, anxiety and insomnia were obtained. Chi-square and Fisher’s exact tests were used for univariate analyses, followed by multivariable logistic regression to identify factors associated with suicidal behaviors. The findings revealed that 6.8% reported experiencing lifetime suicidal ideation, with 2.3% suicide plans and 0.8% suicide attempts. The 12-month prevalence rates were 3.2% for suicidal ideation, 1.5% for suicide plans and 0.6% for suicide attempts. Smoking emerged as a significant predictor of suicidal ideation, plans and attempts, while alcohol use was strongly linked to past-year suicide attempts. Depression was associated with lifetime suicidal ideation, whereas anxiety significantly influenced both lifetime and past-year suicide plans. These results provide valuable insights that could inform evidence-based interventions and policies to address prevalent mental disorders and suicidal behaviors among adolescents in Bangladesh.
The current study is an attempt to explore under-five child malnutrition in a low-income population setting using the Extended Composite Index of Anthropometric Failure (ECIAF).
Design:
Data from the Bangladesh Demographic and Health Survey 2017–2018 were analysed. Malnutrition using ECIAF was estimated using stunting, wasting underweight and overweight. Multilevel logistic regression models identified factors associated with malnutrition. Geospatial analysis was conducted using R programming.
Setting:
Bangladesh.
Participants:
Children under 5 years of age.
Results:
In Bangladesh, as indicated by the ECIAF, approximately 40·8 % (95 % CI: 39·7, 41·9) of children under five experience malnutrition, whereas about 3·3 % (95 % CI: 2·9, 3·7) were overweight. Children of parents with no formal education (56·3 %, 95 % CI: 50·8, 61·8), underweight mothers (53·4 %, 95 % CI: 50·4, 56·3), belonging to the lowest socio-economic strata (50·6 %, 95 % CI: 48·3, 53·0), residing in rural areas (43·3 %, 95 % CI: 41·9, 44·6) and aged below 3 years (47·7 %, 95 % CI: 45·2, 50·2) demonstrated a greater age- and sex-adjusted prevalence of malnutrition. The Sylhet division (Eastern region) exhibited a higher prevalence of malnutrition (> 55·0 %). Mothers with no formal education (adjusted OR (AOR): 1·51, 95 % CI: 1·08, 2·10), underweight mother (AOR: 1·54, 95 % CI: 1·03, 1·83), poorest socio-economic status (AOR: 2·14, 95 % CI: 1·64, 2·81), children aged 24–35 months (AOR: 2·37, 95 % CI: 1·97, 2·85) and fourth and above birth order children (AOR: 1·41, 95 % CI: 1·16, 1·72) were identified key factors associated with childhood malnutrition while adjusting community- and household-level variations.
Conclusions:
In Bangladesh, two out of five children were malnourished, and one in thirty-five children was overweight. Continuous monitoring of the ECIAF over time would facilitate tracking changes in the prevalence of different forms of malnutrition, helping to plan interventions and assess the effectiveness of interventions aimed at addressing both undernutrition and overweight.
This chapter investigates the impact of anti-sweatshop activism on garment industry employment and the number of firms in Bangladesh following the 2013 Rana Plaza factory disaster. The disaster led to activism that created two major brand-enforced factory fire and safety agreements. The chapter uses a synthetic control methodology to investigate the trade-offs associated with the reaction to the disaster and finds that they led to 33.3 percent fewer garment factories in Bangladesh by 2016 and 28.3 percent fewer people employed in Bangladesh’s garment industry by 2017. Given the importance of the garment industry in Bangladesh’s development in providing a pathway out of extreme property, this finding raises important questions about the efficacy of anti-sweatshop activism.
In 2023, Bangladesh experienced its largest and deadliest outbreak of the Dengue virus (DENV), reporting the highest-ever recorded annual cases and deaths. Historically, most of the cases were recorded in the capital city, Dhaka. We aimed to characterize the geographical transmission of DENV in Bangladesh. From 1 January–31 December 2023, we extracted and analyzed daily data on dengue cases and deaths from the Management Information System of the Ministry of Health and Family Welfare. We performed a generalized linear mixed model to identify the associations between division-wise daily dengue counts and various geographical and meteorological covariates. The number of dengue cases reported in 2023 was 1.3 times higher than the total number recorded in the past 23 years (321,179 vs. 244,246), with twice as many deaths than the total fatalities recorded over the past 23 years (1705 vs. 849). Of the 1,705 deaths in 2023, 67.4% (n = 1,015) died within one day after hospital admission. The divisions southern to Dhaka had a higher dengue incidence/1000 population (2.30 vs. 0.50, p <0.01) than the northern divisions. Festival-related travel along with meteorological factors and urbanization are likely to have contributed to the shift of dengue from Dhaka to different districts in Bangladesh.
We use childhood exposure to disasters as a natural experiment inducing variations in adulthood outcomes. Following the fetal origin hypothesis, we hypothesize that children from households with greater famine exposure will have poorer health outcomes. Employing a unique dataset from Bangladesh, we test this hypothesis for the 1974–75 famine that was largely caused by increased differences between the price of coarse rice and agricultural wages, together with the lack of entitlement to foodgrains for daily wage earners. People from northern regions of Bangladesh were unequally affected by this famine that spanned several months in 1974 and 1975. We find that children surviving the 1974–75 famine have lower health outcomes during their adulthood. Due to the long-lasting effects of such adverse events and their apparent human capital and growth implications, it is important to enact and enforce public policies aimed at ameliorating the immediate harms of such events through helping the poor.
South of 25°N, the rugged, riparian, mixed evergreen forests of eastern Bangladesh mark the western edge of the ranges of the globally Vulnerable Asiatic black bear Ursus thibetanus and sun bear Helarctos malayanus. According to the IUCN Red List, the distribution of bears in Bangladesh is unclear: black bears are described as ‘scattered’ and ‘likely to be very low in number’ and sun bears as ‘vagrants’ entering from the adjoining north-east Indian forests. These statements are not based on any population or habitat assessments, impeding focused research and conservation investment. We compiled recent evidence of bear presence in Bangladesh based on camera trapping, literature reviews and analysis of media reports. From peer-reviewed and grey literature published during 2010–2022 we traced 43 verifiable accounts of black bears in the country. Our camera-trap survey in Rajkandi Reserve Forest produced the first ever evidence of a small population of black bears in north-eastern Bangladesh. Two field studies (in 2016 and 2021) reported camera-trap observations and multiple incidents of poaching of sun bears in Kassalong Reserve Forest and Sangu-Matamuhuri Reserve Forest in south-eastern Bangladesh. Media reports on conflict incidents presented 83 human casualties (80 injured, three dead) and 13 bear casualties (six dead, seven rescued) during 2003–2023. The incidents peaked in the summer (17); 79% were reported during 2018–2023. Cognizant of the fact that the absence of evidence is not evidence of absence, our study calls for systematic conservation measures for both of these bear species in unprotected hill forests in eastern Bangladesh.
The objective of this study was to explore the burden of disasters and adverse health outcomes during and following disasters in Bangladesh.
Methods
We analyzed 6 788 947 respondents’ data from a cross-sectional and nationally representative 2021 Bangladesh Disaster-related Statistics (BDRS). The key explanatory variables were the types of disasters respondents faced, while the outcome variables were the disease burden during and following disasters. Descriptive statistics were used to determine disease burden. A multilevel mixed-effects logistic regression model assessed the association between disease burden and disaster types, along with socio-demographic characteristics of respondents.
Results
Nearly 50% of respondents experienced diseases during disasters, rising to 53.4% afterward. Fever, cough and diarrhea were prevalent during and after disasters, with increases in skin diseases, malnutrition, and asthma post-disaster. Vulnerable groups, such as children aged 0–4, hijra individuals, those with lower education, people with disabilities, and rural residents, especially in Chattogram, Rangpur, and Sylhet divisions, were most affected. Floods, cyclones, thunderstorms, and hailstorms significantly increased disease likelihood during and after disasters.
Conclusions
The study underscores the complex relationship between disasters and health outcomes in Bangladesh, stressing the need for targeted public health interventions, improved health care infrastructure, and evidence-based policies to mitigate disaster-related health risks.
Undernutrition among children under the age of five years is a prevalent global issue, especially in Bangladesh. This study aimed to explore the relationships of household environmental conditions (HECs) with child undernutrition in Bangladesh, with a specific focus on rural–urban variations.
Design:
We analysed children’s data from the 2017/18 Bangladesh Demographic Health Survey. The outcome variable considered were measures of child undernutrition, including stunting, wasting and underweight. The primary exposure variables considered were indicators of HEC. We used a hierarchical multilevel mixed-effect generalized linear models (GLM) modified with a Poisson regression to explore the association between outcomes and exposures, adjusting for potential confounders.
Setting:
Nationally representative cross-sectional survey.
Participants:
8,057 under-5 children.
Results:
The prevalence of stunting, wasting and underweight in Bangladesh was 31%, 8%, and 22%, respectively, with notable urban–rural variations. Under-5 children who lived in houses constructed with unimproved materials (aRR: 1·17), exposed to household air pollution (aPR: 1·37), had unimproved drinking water sources (aPR: 1·28) or had poor handwashing facilities (aPR: 1·24) had a greater likelihood of stunting compared to their counterparts. Similar associations were observed for underweight. The likelihood of stunting and underweight increased with increasing scores of poor HECs, with variations in the effect size across urban–rural areas.
Conclusion:
The high prevalence of stunting and underweight in Bangladesh is linked to poor HECs, therefore, integrated approaches should be adopted to address these environmental factors collectively. Policies and programmes should prioritse enhancing housing quality to achieve sustainable improvements in child nutritional outcomes.
This study investigates the stigma against people with mental illness in Bangladesh through in-depth interviews with 14 patients and 9 healthcare professionals, and 33 focus group discussions with people without mental illness. The research has delved into the understanding of different types of stigma against mental illness in the context of Bangladesh. The findings revealed four types of stigma which were categorized into four themes namely self-stigma, public stigma, professional, and institutional stigma. Patients had internalized negative attitudes, thereby discriminated toward themselves. The public discriminated against patients because of believing in prejudices against them. Other health professionals had negative conceptions toward patients, and they devalued mental health professionals (MHPs). A culture of negative attitude and belief had emerged in institutional settings which encouraged discrimination. Policymakers and healthcare professionals can use the findings to develop a mental health service by addressing the stigma. Mental health practitioners can assess the impact of stigma to improve the mental well-being of their patients. Students and workplace staff will benefit from intentional or unintentional discrimination in educational institutions and workplace settings by addressing the effects of stigma. Importantly, other health care providers will be aware of their thoughts against patients and MHPs.
Toxocara vitulorum is one of the deadliest parasite of buffalo calves in Bangladesh. This study was conducted to explore genetic variability within and among the T. vitulorum populations in buffalo calves of Bangladesh. Genomic DNA was extracted, ITS2, COX1 and NAD1 gene were amplified and sequenced. Distinct 29 ITS2, 21 unique NAD1 and 24 COX1 genotypes were detected among the T. vitulorum of different geographic regions. These three gene genotypes similarities ranged from 97 to 99%, when these were compared to best hit scoring T. vitulorum sequences retrieved from GenBank. A total of 12 and 6 unique haplotypes were detected for COX1 and NAD1 gene sequences. The average nucleotide and haplotype diversity for COX1 and NAD1 were 0.0931 & 0.89493 and 0.00658 & 0.77895 respectively and the recorded values were more dispersed than previously published values. The pairwise Nst values ranged from −0.050 to 0.602 and Fst from −0.050 to 0.600 between all the T. vitulorum genotypes indicated huge genetic differentiation which were reportedly higher than other published reports Fst values. This is the first report of T. vitulorum on the basis of COX1 gene in Bangladesh. The study findings will be helpful for further extensive epidemiological studies regarding anthelmintic resistance, control and prevention of T. vitulorum infection in buffalo calves.
Bangladesh is experiencing a rapid increase in hypertension prevalence, particularly in socio-economically disadvantaged communities. The higher use of solid fuel in these communities could be one of the significant factors contributing to this trend, but evidence supporting this hypothesis is limited in Bangladesh. Therefore, this study aims to investigate the associations of household solid fuel use and its exposure level with systolic and diastolic blood pressure (DBP) and hypertension. We analysed 7,320 women’s data from 2017/18 Bangladesh Demographic and Health Survey. We considered three outcome variables: (i) systolic blood pressure (BP) (continuous response), (ii) DBP (continuous response), and (iii) hypertension status (yes, no). Our primary exposures of interest were fuel type (clean vs solid) and the potential level of household air pollution exposure through solid fuel use (unexposed, moderately exposed, and highly exposed). We used a multilevel mixed-effects Poisson regression model with robust variance to determine association between exposure and outcome variables while adjusting for confounders. Of the total respondents analysed, approximately 82% used solid fuel for cooking. The age-standardised prevalence of hypertension was 28%. Respondents using solid fuel were found to be 1.44 times (95% confidence interval [CI], 1.04–1.89) more likely to develop hypertension compared to clean fuel users. Compared to women using clean fuel, the likelihood of hypertension was found to be 1.61 times (95% CI, 1.07–2.20) higher among the moderately exposed group and 1.80 times (95% CI, 1.27–2.32) higher among the highly exposed group. Similar associations were reported for systolic and DBP. The use of solid fuel increases the risk of becoming hypertensive and elevates systolic and DBP. Policies and programmes are necessary to increase awareness of the adverse effects of solid fuel use on health, including hypertension. Efforts should be made to reduce solid fuel use and ensure proper ventilation systems in households where solid fuel is used.