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Inter-Asian Law is starkly absent from constitutional accounts of reproductive rights in Asia. Instead, Asian jurisdictions tend to draw from the Global North, with the United States Supreme Court decision in Roe v Wade occupying norm status. To explicate the potential of Inter-Asian Law in transforming reproductive rights, an act of imagination is required, suspending Roe as the central comparative frame and introducing alternate, hypothetical referents from Asia. This chapter conducts this task at two stages. First, it develops imagination as a method of comparative constitutional law. Second, applying the imaginative method, it hypothesizes what reproductive rights might look like if Nepal served as a referent for India and India as a referent for Bangladesh. In documenting explicit shifts in the constitutional construction of these rights, the chapter cements the place of Inter-Asian Law.
Groundwater iron varies geographically and iron intake through drinking water can minimise iron deficiency (ID). Rice, a major share of daily meals (∼70% of total energy) in Bangladesh, absorbs a substantial amount of water. This study aimed to estimate the contribution of groundwater iron entrapped in cooked rice and its implications on the recommended iron intake. A cross-sectional study was conducted among 25 households, selected by the iron content of their drinking groundwater source in Sirajganj district, Bangladesh. Each household pre-supplied with 600 g of raw rice (300 g for each cooking), was instructed to cook ‘water-draining rice’ (WDR) and ‘water-sitting rice’ (WSR). Using atomic absorption spectrophotometry, iron content in filtered and non-filtered water was measured as 0.4 ± 0.2 mg/L and 6.1 ± 2.0 mg/L, respectively. After adjusting for water filtration, the weighted mean of total iron content in WDR and WSR was 6.18 mg and 5.70 mg, respectively. Assuming the average rice intake, iron content in WDR and WSR fulfilled approximately 98.15% and 90.62% of the average requirement for non-pregnant and non-lactating women (NPNL). The water-entrapped iron in cooked WDR and WSR fulfilled about 23.77% and 20.4% of Recommended Dietary Allowances, and 52.83% and 45.30% of Estimated Average Requirements, respectively in NPNL women, suggesting that groundwater entrapped in cooked rice is an influential dietary iron source. The substantial amount of iron from cooked rice can make an additional layer to the environmental contribution of iron in this setting with the potential to contribute ID prevention.
Mental health symptoms pose a significant vulnerability to stressful life events among currently married women, adversely impacting their overall well-being and quality of life. This study explores the spatial patterns and factors associated with anxiety, depressive symptoms and the co-occurrence of both symptoms among currently married women of reproductive age in Bangladesh. This study utilised data from 13,372 (weighted) currently married women aged 15–49 years in the Bangladesh Demographic and Health Survey (BDHS) 2022, which used a cross-sectional design. Multivariable logistic regression models determined the associated factors. Additionally, spatial distribution and hotspot analysis were conducted using ArcGIS version 10.8. The weighted prevalence of moderate to severe anxiety, depressive symptoms and co-occurrence of anxiety and depressive (CAD) symptoms among currently married women of reproductive age was 4.1% (95% confidence interval [CI]: 3.8%, 4.5%), 4.8% (95% CI: 4.7%, 5.4%) and 2.2% (95% CI: 2.1%, 2.6%), respectively. Clustering of anxiety symptoms (Moran’s I = 0.063, p < 0.001), depressive symptoms (I = 0.091, p < 0.001) and CAD symptoms (I = 0.082, p < 0.001) were observed, with hotspots in Rangpur, Sylhet and Chittagong regions. Logistics regression analysis shows that currently married women who were living in the Barishal, Khulna, Rangpur and Sylhet regions, who belong to households with a higher wealth index, who experienced high levels of intimate partner violence (IPV), have completed high school, who are sexually inactive and whose husbands are unemployed, were more likely to experience CAD symptoms. Additionally, currently married women of reproductive age, whose age was 25–34 years, who are labourers, whose pregnancies are terminated and who have ≥5 children ever born, are at a higher risk of having anxiety symptoms. Besides, currently married women aged 25–34 years and 35–44 years, who are underweight, were more likely to have depressive symptoms. The findings highlight a significant regional disparity in the burden of anxiety, depressive and CAD symptoms among currently married women of reproductive age in Bangladesh. These findings can help design site-specific programmes and actions for women in the hot spot areas of Rangpur, Sylhet and Chittagong.
Rapid population declines of three species of Gyps vultures endemic to Asia were caused by unintentional poisoning by the non-steroidal anti-inflammatory drug (NSAID) diclofenac. Despite a ban on its veterinary use across South Asia, diclofenac has continued to be supplied for this purpose. Here, we report updated results from undercover pharmacy surveys, conducted between 2012 and 2024, in India, Nepal, Bangladesh, and Pakistan to investigate the availability and prevalence of veterinary NSAIDs. The purpose was to establish whether sales of diclofenac had continued and to determine which other veterinary NSAIDs were available. In India, the availability of diclofenac had declined in all Vulture Safe Zones (VSZs), but it was still readily available (up to 25% of sales) in Rajasthan where intensive conservation advocacy had not occurred. Elsewhere in the region, prevalence of diclofenac was low. The vulture-safe meloxicam continued to be the most commonly available veterinary NSAID throughout most of the region, especially in Nepal (85–100%), but still accounted for only 25–45% of products offered in other countries. In Bangladesh, the vulture-toxic ketoprofen was the most prevalent drug overall, but levels declined to a low level (<1% in 2024), following the nationwide ban on veterinary use of the drug in 2023. Fourteen different NSAIDs were recorded in our surveys, several of which are known or suspected to be toxic to vultures. Of special concern is a rapid increase in the prevalence of flunixin in Bangladesh. Flunixin has not been banned in any of the South Asian vulture range states. Conservation priorities should include awareness campaigns, stronger measures to implement current bans, safety-testing of other NSAIDs, especially flunixin, followed by bans on veterinary use of all NSAIDs found to be toxic to vultures. Prior evidence of safety to vultures should be a requirement for the licensing of all new veterinary NSAIDs.
This study aims to systematically identify patient-reported end-of-life (EOL) care needs of patients with incurable illnesses, and advocate for a person-centered approach to care in Bangladesh.
Method
This cross-sectional study was conducted in four tertiary care hospitals across Bangladesh and included 301 adult patients who had at least one of the following serious and complex incurable conditions: stage III or IV cancer, congestive heart failure (NYHA Class IV), end-stage liver disease, chronic renal failure requiring hemodialysis, stroke, oxygen-dependent pulmonary disease, or any type of dementia. Specific domains of EOL care needs were identified in relation to patients’ functional status using multinomial logistic regression. Differences in EOL care needs across socio-demographic and symptom profiles were analyzed using independent t-tests and one-way ANOVA.
Results
All patients had a Needs Near the End-of-Life Care Screening (NEST-13) score ≥30, indicating a high level of EOL care need. High levels of unmet needs were reported in domains such as doctor–patient communication (89.4%), goals of care (78.1%), spiritual needs (77.4%), and caregiving (66.4%). Patients with longer disease duration (>12 months) and higher symptom burden had significantly higher NEST scores (p < 0.001). Functional status strongly influenced care needs. Multinomial regression confirmed physical care needs (OR = 10.59), caregiving (OR = 3.40), and spiritual needs (OR = 2.81) were most strongly associated with terminal status (PPS ≤ 20%).
Significance of the result
This study reveals an overwhelming burden of unmet EOL care needs among patients with incurable diseases in Bangladesh. The findings emphasize the urgent necessity for holistic, culturally sensitive, and person-centered care, alongside the integration of palliative care into mainstream healthcare services.
Despite high rates of intimate partner violence (IPV) among women, research on its mental health consequences, particularly PTSD in slum settings, remains scarce. This study assessed PTSD prevalence and determinants among slum-dwelling women in Bangladesh who experienced IPV during the COVID-19 pandemic. A cross-sectional study was conducted between July and October 2022 among 291 women from 5 urban slums in Dhaka, who reported IPV using the World Health Organisation questionnaire. Face-to-face interviews collected sociodemographic data, pandemic-related challenges, gender roles, health information and PTSD symptoms using the validated Post-Traumatic Stress Disorder Checklist-5. Logistic regression identified PTSD predictors. Most women were married before the age of 18 years (87.9%), unemployed (69.3%), had no formal schooling (38.6%) and lived in overcrowded households (38.6%). Over half of their husbands were daily wage earners (57.9%) and had a history of substance misuse (65.9%). PTSD prevalence was 21.16% and was higher among women with non-communicable diseases (adjusted odds ratio [AOR]: 3.29; 95% confidence interval [CI]: 1.6–6.7), concern about COVID-19 infection (AOR: 3.87; 95% CI: 1.12–13.22) and increased marital arguments (AOR: 3.00; 95% CI: 1.57–5.74). IPV in slum settings imposes a significant PTSD burden, highlighting the need for community-based mental health services to support marginalised women.
While much has been written about urban-educated women’s veiling in recent decades, the proliferation of veiling, or wearing a burqa, among ordinary rural women has received little attention. This paper is an attempt at such an inquiry in the context of Bangladesh. It juxtaposes historical, literary, and theological resources with recently collected ethnographic and interview data to show how the landscape of veiling has radically transformed in rural Bangladesh and suggests that ordinary rural women’s veiling cannot be interpreted as either their choice or an imposition on them. It illustrates how women choose to don a veil in compliance with the community’s expectations while simultaneously resisting its prescription of putting on a specific pattern of burqa. In other words, the paper shows how veiling has become a site for women’s complex negotiations with community norms, liberal women’s rights discourse, and legal regimes. This negotiation process, it argues, constructs women as distinct subjects who are neither liberal nor Islamic but are constantly in the process of self-constitution.
Bangladesh’s handloom weaving industry, a vital cultural and economic asset, employs approximately one million rural workers and generates over 10 billion Bangladeshi taka (~82 million USD) annually. Despite its importance, the mental health of handloom weavers, locally known as Tatis, remains largely unexamined. This perspective article, based on a narrative review of existing literature synthesizing peer-reviewed studies, reports and policy documents on mental health in informal sectors, explores the mental health challenges faced by these workers. Using a syndemics framework, it draws on data on garment workers and the broader informal sector, which indicates heightened risks of stress, anxiety and depression resulting from long working hours, low wages and competition from mechanized looms. These risks are compounded by systemic barriers, including Bangladesh’s allocation of only 0.44% of its health budget to mental health (2021), a severe shortage of professionals (0.16 psychiatrists per 100,000 people and 0.34 psychologist per 100,000 people) and pervasive cultural stigma. Additionally, musculoskeletal pain, which affects 82.4% of weavers, places a particularly heavy burden on women, who constitute half of the workforce, further exacerbating mental health vulnerabilities through syndemic interactions with poverty and gender inequities. To address this neglected crisis, the article proposes a novel intervention framework aligned with the Double Diamond design model. The framework integrates community-based mental health hubs, peer-led support networks and digital platforms tailored to Bangladesh’s collectivist culture. It calls for increased funding, workplace reforms, stigma reduction campaigns and targeted research, highlighting the dual benefit of improving weavers’ well-being and sustaining the long-term future of the industry.
In an effort to “reform” and fundamentally redefine who gets to call themselves a rights-bearing citizen of India, the BJP government introduced the National Registry of Citizens (NRC) and Citizenship Amendment Act (CAA). January and February of 2020 saw riots across India over the issue of NRC and CAA. The Indian government made a decision by passing CAA, which stated that Muslims from Afghanistan, Pakistan, and Bangladesh could not become citizens of India. The decision also resulted in the Shaheen Bagh protests where Muslim women organized a dharna, “sit in,” for weeks to protest this draconian decision. NRC/CAA meant that many Muslims who were born in India but could not produce proper documents of being from India would not be regarded as lawful citizens of India. Many Indians below the poverty line have limited access to resources such as literacy that safeguard documentation. These Indians are not limited to their religious backgrounds yet NRC/CAA targets only Muslim citizens. NRC/CAA has led to widespread debate about how citizenship is framed and the legality of the law itself. Leaders of the BJP made several speeches where they framed Muslims as outsiders and “takers” who drain Indian society.
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.
Edited by
Lisa Vanhala, University College London,Elisa Calliari, International Institute for Applied Systems Analysis, Vienna and Euro-Mediterranean Centre on Climate Change, Venice
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.