Diabetic Association of Bangladesh is a non-profit organization medical organization and is located in Dhaka, Bangladesh. Professor AK Azad Khan is the present president of the association.
Introduction Bangladesh has a high burden of type two diabetes mellitus (T2DM) and hypertension. To better target non-communicable disease (NCD) programmes, populations with unmet care needs must be identified. We describe the unmet care needs for people living with T2DM and hypertension in rural Bangladesh at a subregional level.Methods We conducted a secondary analysis of cross-sectional surveys conducted in 2021 and 2022 in Alfadanga Upazila, Faridpur District. Surveys were conducted among random samples of non-pregnant adults aged >30 years, including questions about demographics, NCD diagnoses, care-seeking and treatment. Study staff conducted blood pressure measurements to determine hypertension and 2-hour oral glucose tolerance tests to determine T2DM status. We calculated the prevalence of T2DM and hypertension and the unmet need for care, defined as the prevalence minus the proportion screened (T2DM only), diagnosed, treated and controlled, following the cascade of care (COC). We present the COC for 12 subregional geographical clusters and sex.Results 1982 participants (62.9% women) were analysed. The prevalence of T2DM was 19.0%, and the unmet need for care was 90.7%. The prevalence of hypertension was 37.9%, and the unmet need for care was 81.4%. For both T2DM and hypertension, women had a higher prevalence of disease, but there was a wider gap in the COC for hypertension, with 22.4% of women achieving good control compared with 10.9% of men. At the subregional level, the prevalence of T2DM ranged from 12.4% to 26.5%, and the unmet need for care from 85.0% to 95.6%. Variations in the prevalence and unmet need for care were also seen for hypertension but with different subregional distribution patterns.Conclusions In this rural Bangladesh setting, the unmet care need was high for T2DM and hypertension, with subregional and sex differences. Understanding hyper-local factors driving NCD risks and access to care could support more effective programme delivery.
Background Community mobilisation through participatory women's groups (PWGs) has been shown to be an effective intervention to improve maternal and neonatal survival in low-income settings, including Bangladesh. Despite WHO recommendations and scale-up in some contexts, the intervention has not been widely scaled-up in Bangladesh. To add to the existing evidence-base for PWGs and to renew calls for effective, scalable interventions to improve neonatal outcomes in the post-Sustainable Development Goals era, we report the design, implementation and evaluation of a volunteer-led model for PWGs delivered in rural Bangladesh in 2014/15. Methods Working in three rural unions in Faridpur, Bangladesh, we applied a volunteer-led, lower coverage and shorter duration PWG intervention. Mixed methods evaluation monitored key indicators of intervention delivery, uptake and receipt. Prospective quantitative surveys gathered data on birth outcomes, health care utilisation and essential newborn care practices. Data from before and after the implementation period were compared and interpreted in relation to historical trends in the study area and other rural areas of Bangladesh. Results 180 PWGs facilitated by 45 volunteer facilitators over a period of 15 months were successfully implemented giving a population coverage of one group per 500 population. An average of 32 (min.=18, max.=64) participants attended each PWG meeting, 42% of participants attended meetings on a monthly basis and 11% reported that they actively shared information from the PWGs with non-attenders. 30% of women of reproductive age and 54% of pregnant women participated in the. Focus group discussions with participants and community members revealed positive attitudes towards the groups. A change in trend in extended perinatal mortality rates was observed during the intervention period, corresponding temporally with indicators of improved rates of service utilisation and essential newborn care practices relative to the pre-implementation period. Conclusion The modified PWG intervention likely contributed to positive changes in delivery and neonatal care practices similar to previous studies in Bangladesh. The PWG model remains an important approach to community empowerment that could contribute to enhanced efforts to end preventable neonatal deaths as we move towards the end of the Sustainable Development Goal era and beyond.
Urbanisation has contributed to increased sedentary behaviour, which is a major risk factor for non-communicable diseases. In South Asia, the type 2 diabetes burden is rapidly increasing, and there is a need to understand the effect of different social categories, such as gender, socio-economic status, and diabetes status, in shaping opportunities to participate in physical activity. We used a rapid participatory qualitative research methodology and intersectional analysis in urban Faridpur, Bangladesh, to analyse the feasibility of promoting recreational physical activity to manage and prevent type 2 diabetes. Diabetes was defined as an individual as opposed to a community health issue in Faridpur. Narratives about the causes of diabetes blamed the individual, which prevented the development of a positive diabetes identity and resulted in intersectional stigma. Women, and poorer women in particular, felt disempowered by their diabetes and therefore hid this from others. There was a collective lack of awareness about community barriers to physical activity for women, and a need to create a safe and empowering space for women, while working at the community level to address these barriers. Cross-sectoral complex, community-engaged interventions that consider intersectional experiences are needed to increase physical activity in urban areas of South Asia.
