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Khan MAS, Dalal K, Hasan M, Haque MMA, Nusrat-E-Mozid, Hossian M, Rahman T, Maliha R, Mutsuddi A, Rashid MU, Hossain MA, Nabi MH, Hawlader MDH. The impact of comorbidity on the quality of life of people who recovered from COVID-19 in Bangladesh. IJID REGIONS 2024; 11:100351. [PMID: 38634072 PMCID: PMC11021361 DOI: 10.1016/j.ijregi.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/19/2024]
Abstract
Objectives COVID-19 affects the quality of life (QoL) in a reverse way after recovery, which might be multiplied by the comorbid non-communicable diseases. This study explored the relationship between comorbidities and the QoL of people who recovered from COVID-19 in Bangladesh. Methods The cross-sectional study was conducted among 3244 participants between June 2020 and November 2020 using a pre-tested questionnaire through over-the-phone interviews. The WHOQOL-BREF was used to explore the QoL among the study participants. A multivariable linear regression model was conducted to identify the effects of the number of comorbidities on QoL scores of all four domains. Results Of 3244 patients who recovered from COVID-19, over one-third (39.4%) had one or more chronic diseases, such as hypertension, diabetes mellitus, ischemic heart disease, bronchial asthma/chronic obstructive pulmonary disease, chronic kidney disease, and cancer. Around 46.85% of the participants aged above 40 years presented with one to two chronic diseases, and 16.33% had three or more chronic diseases. Among all comorbidities, the participants with cancer and chronic kidney disease were found to have relatively lower scores in all four domains than other comorbidities. The lowest QoL scores were observed in the psychological domain. Those with three or more simultaneous chronic comorbidities had the lowest QoL score in all four domains: physical, psychological, social relationship, and environmental. Conclusions Persons who recovered from COVID-19 with comorbidities undergo a lower QoL. Therefore, special attention is required to these vulnerable groups to ensure their smooth recuperation.
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Affiliation(s)
| | - Koustuv Dalal
- School of Health Sciences, Division of Public Health Science, Mid Sweden University, Östersund, Sweden
| | - Mehedi Hasan
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh
| | - Miah Md. Akiful Haque
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Nusrat-E-Mozid
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Mosharop Hossian
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh
| | - Tajrin Rahman
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh
| | - Ramisha Maliha
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh
| | - Archi Mutsuddi
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh
| | - Md. Utba Rashid
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Mohammad Ali Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh
- Ibn Sina Medical College Hospital, Dhaka, Bangladesh
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Ahmed S, Saif‐Ur‐Rahman KM, Dhungana RR, Ganbaatar G, Ashraf F, Yano Y, Miura K, Ahmed MSAM. Medication adherence and health-related quality of life among people with diabetes in Bangladesh: A cross-sectional study. Endocrinol Diabetes Metab 2023; 6:e444. [PMID: 37491893 PMCID: PMC10495558 DOI: 10.1002/edm2.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/21/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION Good adherence to anti-diabetic medications is an important protective factor for decreasing diabetes-related complications and disabilities but its association with health-related quality of life (HRQoL) is understudied. The current study aimed to assess an association between medication adherence to anti-diabetic drugs and HRQoL among people with diabetes in Dhaka city, Bangladesh. METHODS We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, who attended a tertiary-level hospital in Dhaka city. We used the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L) to measure HRQoL and Morisky Medication Adherence Scale to assess the level of medication adherence to anti-diabetic drugs. Multivariable logistic regression was performed to assess the significance of relevant factors. RESULTS The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (74%) had a lower level of medication adherence. The mean value of (EQ-5D-5L) was 2.0 (SD, 1.0). The percentage of severe disability in different domains were 6.7% for mobility, 3.5% for self-care, 11.9% for usual daily activities, 11.9% for pain/discomfort and 11.3% for anxiety. After adjusting for age, sex, years of education, household expenditure, hypertension, duration of diabetes, glycemic status and multi-morbidities; low adherence to anti-diabetic medication was inversely associated with pain (OR, 0.26; 95% CI, 0.08-0.80; p = .036), and positively associated with anxiety (OR, 7.18; 95% CI, 1.03-9.59; p = .043). CONCLUSIONS Low medication adherence to anti-diabetic drugs was associated with anxiety and pain among the EQ-5D-5L indexes measured in people with diabetes in Dhaka, Bangladesh.
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Affiliation(s)
- Sabrina Ahmed
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
- NCD Epidemiology Research CenterShiga University of Medical ScienceSeta Tsukinowa‐Cho, OtsuShigaJapan
- Center for Noncommunicable Diseases and Nutrition (CNCDN)James P Grant School of Public Health, BRAC UniversityDhakaBangladesh
| | - K. M. Saif‐Ur‐Rahman
- Health Systems and Population Studies Division, icddr,bDhakaBangladesh
- College of Medicine, Nursing and Health SciencesUniversity of GalwayGalwayIreland
- Evidence Synthesis Ireland and Cochrane IrelandUniversity of GalwayGalwayIreland
| | - Raja Ram Dhungana
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Gantsetseg Ganbaatar
- NCD Epidemiology Research CenterShiga University of Medical ScienceSeta Tsukinowa‐Cho, OtsuShigaJapan
| | - Fatema Ashraf
- Department of Gynaecology and ObstetricsShaheed Suhrawardy Medical CollegeDhakaBangladesh
| | - Yuichiro Yano
- NCD Epidemiology Research CenterShiga University of Medical ScienceSeta Tsukinowa‐Cho, OtsuShigaJapan
| | - Katsuyuki Miura
- NCD Epidemiology Research CenterShiga University of Medical ScienceSeta Tsukinowa‐Cho, OtsuShigaJapan
| | - M. S. A. Mansur Ahmed
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
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Zhai X, Zhou Z, Liu G, Lu J, Zhao Y, Cao D, Zhao D, Lai S, Fan X. Catastrophic health expenditure of households with hypertension: a comparative study in China. Front Public Health 2023; 11:1176170. [PMID: 37361148 PMCID: PMC10285052 DOI: 10.3389/fpubh.2023.1176170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
Objectives The aim of this study was to understand the impact of multimorbidity on catastrophic health expenditures for people with hypertension. Methods Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) in 2018, 8,342 adults were included in our analysis. Propensity score matching method was used to compare the risk of catastrophic health expenditures between the hypertension patients (treatment group) and those without any chronic disease (control group) in middle-aged and older adults. Patients with hypertension were also divided into two groups: only hypertension and multimorbidity. Results Hypertension increased the likelihood of CHE by 11.3% in older adults. Further analysis showed that hypertension alone does not increase the risk of CHE, and the risk of CHE in hypertension patients with multimorbidity was 12.9% higher than those without chronic disease. Conclusion Our study highlights the importance of healthy management of patients with only hypertension and preventing them from developing multimorbidity.
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Affiliation(s)
- Xiaohui Zhai
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Guanping Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Jiao Lu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yaxin Zhao
- School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Dan Cao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Dantong Zhao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Sha Lai
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaojing Fan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Haque MA, Afrin S. Construction of the active aging index in Bangladesh: challenges and opportunities. Heliyon 2022; 8:e10922. [PMID: 36217464 PMCID: PMC9547210 DOI: 10.1016/j.heliyon.2022.e10922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 03/15/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Bangladesh is one of the fastest-growing older populations in the world. However, there has been little initiative in constructing an Active Aging Index (AAI) to monitor the quality of life of senior citizen. Objectives The objective of the study was to construct an AAI to know the active aging scenario of the population in Bangladesh. Methods A cross-sectional study was conducted among 518 respondents aged 60 years or older from six villages and six wards. Three villages and three wards from Rangpur district and three villages and three wards from Dhaka district were selected for the collection of data. A semi-structured questionnaire was used to collect data on the eight indicators of the ‘health dimension’, three indicators of the ‘participation dimension’, and seven indicators of the ‘security dimension’ for the AAI using the World Health Organization (WHO) model. The responses for each of the indicators (ranges from 0, 1, 2, or 3) in each dimension were added to create a composite index (CI) for each of the dimensions. Descriptive statistical methods with significance tests were applied to analyze the data. Results The findings provide opportunities to view the 18 aspects of the quality of life of the older population by sex and place of residence. Among the respondents, the overall AAI score shows that 48.1% of the health, 28.9% of the participation, and 48.5% of the security dimensions score fall in the lower active category. Gender differences were distinct in all three dimensions, where the moderate AAI score for females from both rural (41.5%) and urban areas (62.7%) was lower than for males in rural (73.5 %) and urban areas (76.3%). Conversely, the AAI value for urban older adults was higher in all dimensions in comparison with rural older adults. Overall, 62.7% of the respondents were moderately active (a range within 0.50–0.79), while 34.4% were poorly active (a range within 0.0–0.49) and only 3.9% were highly active (a range within 0.80+). Conclusion Effective initiatives are needed to improve the individual scores of each of the three dimensions of the AAI. Attention should be given to addressing the gender and residential variations in all three dimensions of the AAI. The incorporation of indicator-specific measures is essential to the existing plan of action and programs to improve the situation of the older population that is poorly and moderately active. This result will help policymakers from concerned ministries to focus on specific dimensions to improve the AAI situation in the country. A nationally representative study is needed regularly to monitor the AAI situation.
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Ahmed S, Faruque M, Moniruzzaman M, Roby NU, Ashraf F, Yano Y, Miura K, Ahmed MSAM. The pattern of physical disability and determinants of activities of daily living among people with diabetes in Bangladesh. Endocrinol Diabetes Metab 2022; 5:e365. [PMID: 36102126 PMCID: PMC9471590 DOI: 10.1002/edm2.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Diabetes mellitus itself is a known predictor of physical disability and impairment in activities of daily living (ADL); however, there are existing controversies about the factors explaining the association between diabetes and disability. Therefore, we assessed the possible determinants associated with ADL impairment among people with diabetes in Dhaka city, Bangladesh. METHODS We conducted a cross-sectional study among 480 people with diabetes aged between 50 and 70 years, and attended a tertiary level hospital in Dhaka city. For determining the ADL impairment, we used the Katz Index Scoring (6 = no impairment; <6 = impairment). Age, sex, educational attainment, household expenditure, body mass index, the status of diabetes (controlled or uncontrolled), hypertension and medication adherence to anti-diabetic drugs were included in the statistical models, and we defined any ADL impairment (Katz score <6) as an event. Multivariable logistic regression was performed to assess the significance of relevant factors. RESULTS The mean age of the participants was 59.0 (standard deviation [SD], 7.0) years. The majority of the participants (76.3%) had at least some sort of physical disability. In multivariable logistic regression analysis after adjusting for all covariates simultaneously, age (odds ratio [95% confidence interval]: 1.35 [1.20 to 1.75] per 1-SD increment), BMI (1.32 [1.08 to 1.21] per 1-SD increment), higher educational attainment (0.34 [0.09-0.90]), multi-morbidity (2.79 [1.48-5.25]) and uncontrolled diabetes (1.35 [1.10-1.45]) were independently associated with ADL impairment. CONCLUSIONS Physical disability was common, and ADL impairment was associated with age, educational attainment, BMI, multi-morbidities and uncontrolled diabetes among the people with diabetes in Bangladesh.
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Affiliation(s)
- Sabrina Ahmed
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - Mithila Faruque
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
| | - Mohammad Moniruzzaman
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - Naym Uddin Roby
- School of Rehabilitation ScienceMcMaster UniversityHamiltonOntarioCanada
| | - Fatema Ashraf
- Department of Gynaecology and ObstetricsShaheed Suhrawardy Medical CollegeDhakaBangladesh
| | - Yuichiro Yano
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - Katsuyuki Miura
- NCD Epidemiology Research CenterShiga University of Medical ScienceOtsuJapan
| | - M. S. A. Mansur Ahmed
- Department of Noncommunicable DiseasesBangladesh University of Health SciencesDhakaBangladesh
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The Impact of Multimorbidities on Catastrophic Health Expenditures among Patients Suffering from Hypertension in China: An Analysis of Nationwide Representative Data. SUSTAINABILITY 2022. [DOI: 10.3390/su14137555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Background: Patients with hypertension are sensitive to multimorbidities (i.e., the existence of ≥2 chronic diseases), and the related treatment can create enormous economic burdens. We sought to examine the distribution of multimorbidities, the prevalence and factors of catastrophic health expenditure (CHE), the impact of multimorbidities on CHE, and the variation in this relationship across age groups, work status, and combinations of socioeconomic status and health insurance types. Methods: Socioeconomic-related inequality associated with CHE was estimated by concentration curve and concentration index. We examined the determinants of CHE and the impact of age groups, work status, and combinations of socioeconomic groups and health insurance schemes against the relationship with multimorbidities and CHE using logistic regression. Results: 5693 (83.3%) participants had multimorbidities. In total, 49.8% of families had experienced CHE, and the concentration index was −0.026 (95% confidence interval [CI], −0.032 to −0.020). Multimorbidities were related to the increased odds of CHE (odds ratio [OR], 1.21; 95% CI, 1.18–1.25). The relationship between multimorbidities and CHE persisted across age groups, work status, and combinations of socioeconomic status and health insurance schemes. Conclusions: More than 80% of patients with hypertension had multimorbidities. The protection of health insurance schemes against financial risks is very limited.
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Modifications of Traditional Formulas to Estimate and Project Dependency Ratios and Their Implications in a Developing Country, Bangladesh. POPULATION RESEARCH AND POLICY REVIEW 2022; 41:1931-1949. [PMID: 35572094 PMCID: PMC9090599 DOI: 10.1007/s11113-022-09720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Traditional dependency ratios based on the United Nations’ old age definition (≥ 65 years) appear to be an inappropriate indicator for many developing countries, including Bangladesh. Bangladesh, with a retirement age of 59 in many sectors, defines old age as ≥ 60 years, whereas the United Nations documents 60–64 years as working age. This study offers two modifications to the traditional formulas of dependency ratios and compares the modified measures against the traditional measures from 1975 to 2100. Using data from the United Nations and the World Bank, (i) we moved the cut-off for ‘old age’ to 60 instead of 65 years, considering 15–59 years as ‘potentially working’, and (ii) we used the economically active population instead of the entire working-age population. Using our modified calculations, the growth rate of older adults (≥ 60 years) will be at its peak (4.6%) between 2020 and 2030 and continue to increase until 2085, though we will observe a negative population growth after 2055, and 2020–2040 appears to be the best time for reaping the highest demographic dividend. Compared to our modification, the traditional formula undercounted the older adults substantially, predicting a much lower demographic and financial burden. The modifications and associated estimates are important in advancing our understanding of dependency ratios in Bangladesh and have policy and practical implications in preventing the inaccurate representation of demographic and financial issues, and they are useful for planning for geriatric care, social safety nets, and healthy aging. The modified formulas may also be applicable in other countries which adopt ≥ 60 years as an old-age threshold.
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Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: A New Challenge for Public Health in Low and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312449. [PMID: 34886172 PMCID: PMC8656800 DOI: 10.3390/ijerph182312449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 12/21/2022]
Abstract
Objectives: Low and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.
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Mistry SK, Ali ARMM, Yadav UN, Ghimire S, Hossain MB, Das Shuvo S, Saha M, Sarwar S, Nirob MMH, Sekaran VC, Harris MF. Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study. PLoS One 2021; 16:e0255534. [PMID: 34324556 PMCID: PMC8320993 DOI: 10.1371/journal.pone.0255534] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. MATERIALS AND METHODS The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. RESULTS Most of the participants aged 60-69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33-2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17-7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11-4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03-9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. CONCLUSIONS Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - A. R. M. Mehrab Ali
- ARCED Foundation, Dhaka, Bangladesh
- Innovations for Poverty Action, New Haven, Connecticut, United States of America
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Center for Research Policy and Implementation, Biratnagar, Nepal
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, United States of America
| | - Md. Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Manika Saha
- Action Lab, Department of Human-Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia
| | - Sneha Sarwar
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Md. Mohibur Hossain Nirob
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College (Manipal Campus) MAHE, Manipal, Karnataka, India
| | - Mark F. Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
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Hamiduzzaman M, Torres S, Fletcher A, Islam MR, Siddiquee NA, Greenhill J. Aging, care and dependency in multimorbidity: how do relationships affect older Bangladeshi women's use of homecare and health services? J Women Aging 2021; 34:731-744. [PMID: 34255615 DOI: 10.1080/08952841.2021.1951115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Gender issues can create major barriers to healthcare utilization for older women with multimorbidity, especially in developing countries like Bangladesh. Elderly rural women in Bangladesh, are the poorest of the poor, and the women with multimorbidity live in a regulated family atmosphere. This study explored the relationship dimensions of older women with multimorbidity in homecare and their utilization of health services. To gain a deeper understanding of these complex issues, a qualitative case study was conducted. Semi-structured, in-depth interviews were conducted with 11 health staff and 22 older women with multimorbidity, living in three residential communities of the Sylhet District, Bangladesh. Our analysis used critical thematic discourse, a technique developed from Axel Honneth's recognition-and-misrecognition theory. Seven relationship dimensions have been identified, and grouped under three major themes: intimate affairs [marital marginalization and parent-children-in law dynamics]; alienation in community relationships [patriarchal sibling relationships, neighborhood challenges, and gender inequality in interactions]; and legal disconnections [ignorance of rights and missed communication]. Our findings revealed a lack of understanding of the women's multimorbid care needs and patriarchal marginalization in family. This lack of understanding together with poor peer-supports in healthcare is perpetuated by misrecognition of needs from service providers, resulting in a lack of quality and poor utilization of homecare and health services. Understanding the high needs of multimorbidity and complexities of older women's relationships can assist in policy decisions. This study deepens our understanding of the ways gender inequality intersects with cultural devaluation to reduce the well-being of older women in developing countries.
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Affiliation(s)
- Mohammad Hamiduzzaman
- College of Health, Medicine & Wellbeing, The University of Newcastle, New South Wales, Australia
| | - Stacy Torres
- Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Amber Fletcher
- Department of Sociology & Social Studies, University of Regina, Saskatchewan, Canada
| | - M Rezaul Islam
- Institute of Social Welfare & Research, University of Dhaka, Dhaka, Bangladesh
| | - Noore Alam Siddiquee
- College of Business, Government & Law, Flinders University, South Australia, Australia
| | - Jennene Greenhill
- Faculty of Health and Medical Sciences, UWA Medical School, University of Western Australia, Perth, Australia
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Mistry SK, Ali ARMM, Akther F, Yadav UN, Harris MF. Exploring fear of COVID-19 and its correlates among older adults in Bangladesh. Global Health 2021; 17:47. [PMID: 33853616 PMCID: PMC8045579 DOI: 10.1186/s12992-021-00698-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/08/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study was aimed to assess the perceived fear of COVID-19 and its associated factors among older adults in Bangladesh. METHODS This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged ≥60 years. A semi-structured questionnaire was used to collect information on participants' characteristics and COVID-19 related information. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S), where the cumulative score ranged from 7 to 35. Multiple linear regression was performed to identify factors associated with perceived fear of COVID-19. RESULTS The mean fear score was 19.4. Participants who were concerned about COVID-19 (β: 2.75, 95% CI: 1.71 to 3.78) and overwhelmed by COVID-19 (β: 3.31, 95% CI: 2.33 to 4.29) were significantly more likely to be fearful of COVID-19. Moreover, older adults who felt themselves isolated from others and whose close friends and family members were diagnosed with COVID-19 were more fearful. However, the participants who received COVID-19 related information from the health workers had a lower level of fear (β: -1.90, 95% CI: - 3.06 to - 0.73). CONCLUSIONS The presence of overwhelming fear of COVID-19 among the older adults of Bangladesh underlines the psychological needs of these vulnerable groups. Health workers have a key role in addressing these needs and further research is needed to identify the effective strategies for them to use.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh ,grid.1005.40000 0004 4902 0432Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia ,grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - A. R. M. Mehrab Ali
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh ,grid.479464.c0000 0004 5903 5371Innovations for Poverty Action, New Haven, USA
| | - Farhana Akther
- grid.443019.b0000 0004 0479 1356Mawlana Bhashani Science and Technology University, Tangail, Bangladesh ,grid.10347.310000 0001 2308 5949SPM department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Uday Narayan Yadav
- grid.1005.40000 0004 4902 0432Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Mark F. Harris
- grid.1005.40000 0004 4902 0432Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
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