ObjectivesTo assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents.DesignIntervention study.SettingAraihazar area, Bangladesh.Participants416 adolescent female students aged 11–16 years, in grade 6–8, and living with their parents.InterventionsA school-based health education study conducted from April 2012 to April 2013.Primary and secondary outcome measuresWe randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments.ResultsAfter health education, participants reported a significant improvement (p<0.001) in ‘high knowledge and beliefs’ scores compared to baseline (51% vs 82.4%). Significant improvement was also observed in overall good menstrual practices (28.8% vs 88.9%), including improvements in using sanitary pads (22.4% change after the intervention), frequency of changing pads/cloths per day (68.8%), drying the used absorbent (77.6%), methods of disposing of the used absorbent (25.5%), and cleaning of genitalia (19.2%). During the follow-up, the participants reported significant improvements in the regularity of their menstrual cycle (94.5% vs 99.5%) and fewer complications during menstruation (78.6% vs 59.6%).ConclusionsThe programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh.

BackgroundThere is a dearth of published literature that demonstrates the impact and effectiveness of school-based oral health education (OHE) program in Bangladesh and it is one of the most neglected activities in the field of public health. Keeping this in mind, the objectives of this study were to assess the effectiveness of OHE program in: 1) increasing oral health knowledge, attitude, and practices and 2) decreasing the prevalence of untreated dental caries among 6–8 grade school students in Bangladesh.MethodsThis intervention study was conducted in Araihazar Thana, Narayanganj district, Bangladesh during April 2012 to March 2013. The total participants were 944 students from three local schools. At baseline, students were assessed for oral health knowledge, attitude and practices using a self-administered structured questionnaire and untreated dental caries was assessed using clinical examination. Follow up study was done after 6 months from baseline. McNemar’s chi-square analysis was used to evaluate the impact of OHE program on four recurrent themes of oral health between the baseline and follow-up. Multiple logistic regression analyses were used to determine the impact of the intervention group on our outcome variables.ResultsSignificant improvement was observed regarding school aged adolescents’ self-reported higher knowledge, attitude and practices scores (p < 0.001) at follow-up compared with baseline. The prevalence of untreated dental caries of the study population after the OHE program was significantly (p < 0.01) reduced to 42.5 %. Multiple logistic regression analyses showed that the OHE intervention remained a significant predictor in reducing the risk of untreated dental caries (adjusted odds ratio [AOR] =0.51; 95 % confidence interval [CI] = 0.37, 0.81). In the follow-up period participants were 2.21 times (95 % CI = 1.87, 3.45) more likely to have higher level of knowledge regarding oral health compared to baseline. Compared with baseline participants in the follow-up were 1.89 times (95 % CI = 1.44–2.87) more likely to have higher attitude towards oral health. In addition, OHE intervention was found to be significantly associated with higher level of practices toward oral health (AOR = 1.64; 95 % CI = 1.12, 3.38).ConclusionsThis study indicated that OHE intervention was effective in increasing i) knowledge, ii) attitude, and iii) practices towards oral health; it also significantly reduced the prevalence of untreated dental caries among school aged adolescents from grade 6–8 in a deprived rural area of Bangladesh.

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This article analyzes the history and dynamics of conflict and cooperation in a local and regional delta management system focusing on tidal river management (TRM).TRM was formally implemented through a participatory approach since early 2000 to address waterlogging problems in the southwest delta of Bangladesh. There have been, and still are, serious difficulties in achieving the full potential of TRM because multistakeholder processes (MSPs) are not effectively sustained. One major cause of ineffective MSPs is incompetent dealing with conflict and cooperation among stakeholders. Our research was a participatory assessment of water management events focusing on the causes, intensity, and trend of conflict and cooperation in TRM practices over the last 30 years. The results show that the history of TRM appeared more conflictive than cooperative, and also the cooperations between major stakeholders were rarely sustained in TRM practices. To that effect, we applied an adapted "Transboundary Water Interaction Nexus (TWINs)" model to this local water management context, which explores the interrelatedness of conflict and cooperation for learning to deal with MSPs in local delta water management. The research findings should be helpful for improving participation policy in water management in Bangladesh and also facilitate MSPs in delta water governance elsewhere.

This study reviews the current situation of medical waste management (MWM) and practices in Dhaka, Bangladesh, and examines possible solutions for further study. We collected existing information through an Internet survey using the keywords “Medical Waste Management,” “Health Hazards,” and “Bangladesh.” Medical wastes that are disposed in open places in the city are hazardous and toxics. Moreover, waste management and practices were found to be quite unsafe. Poor people collect the waste and sell it for recycling. Almost 85.0% of sharp injuries are caused between their usage and subsequent disposal. More than 20.0% of those who handle them encounter “stick” injuries. Another study showed that people use an average of 3.4 injections per year, in which 39.3% were administered with reused equipment for low level of management. There is no initiative for present MWM system by government or INGOs, and no concrete regulation has been established yet. Few researchers and INGOs have done little. Women and children are more vulnerable because they handle the waste with bare hands; exposing them to contamination with HIV or hepatitis B and other diseases. Therefore, it is essential to follow sound medical waste management system and take actions for this public health problem.