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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ObjectivesDue to low health literacy and adverse situation in the camps, there are possibilities of misconceptions related to COVID-19 among the older Rohingya (forcefully displaced Myanmar nationals or FDMNs) adults in Bangladesh. The present research aimed to assess the level of misconceptions and the factors associated with it among the older FDMNs in Bangladesh.DesignCross-sectional.SettingA selected Rohingya camp situated in Cox’s Bazar, a southeastern district of Bangladesh.ParticipantsInformation was collected from 416 conveniently selected FDMNs who were aged 60 years and above.Primary and secondary outcome measuresThe primary outcome was misconceptions related to the spread, prevention and treatment of COVID-19. Information on 14 different locally relevant misconceptions was gathered, each was scored as one, and obtained a cumulative score, ranging from 0 to 14, with a higher score indicating a higher level of misconceptions. A multiple linear regression model explored the factors associated with misconceptions.ResultsThe participants had an average of five misconceptions. The most prevalent misconceptions were: everyone should wear personal protective equipment when outside (84.6%) and its prevention by nutritious food (62.5%) and drinking water (59.3%). Other notable misconceptions included the spread of COVID-19 through mosquito bites (42%) and its transmissions only to the non/less religious person (31.4%). In regression analyses, memory or concentration problems, communication frequency with social networks, pre-existing conditions and receiving information from health workers were significantly associated with higher COVID-19 misconceptions. These misconceptions were less likely among those overwhelmed by COVID-19, having COVID-19 diagnosed friends or family members and receiving information from friends and family.ConclusionsOverall, we found that misconceptions were prevalent among the older FDMNs in Bangladesh. The associations have important implications for programmes to prevent and manage COVID-19 in these settings. Health workers need to be adequately trained to provide clear communication and counter misconceptions.

Despite some visible progress in some areas of health sectors, Bangladesh is still struggling to sustain efforts towards decreasing Maternal Mortality Rate (MMR). Evidence shows that there is lower access to skilled birth attendant in Bangladesh. Access to skilled birth attendants (SBAs) during delivery has been identified as an effective mechanism to significantly reducing MMR. Previous studies have focused on socio-demographic characteristics of women including cultural and religious dynamics with communities with limited attention to the health system. Using the World Health Organisation's health system strengthening framework, this paper analyses how health system 'architecture' playing role in create fragile platform for the women to access skilled birth attendants. It draws emphasis on governance and policy, financing, health information, workforce, service delivery, medicines and commodities including infrastructure. As governance is the dominant factor and plays critical role in determining success of all facets of the health system, this paper further proposes a systematic strategy that seeks to mitigate the identified challenges. Lessons from this study are relevant to guiding policy makers in Bangladesh as well as in other resource-constrained settings in making evidencebased decisions regarding strengthening the health system to access a skill birth attendant to make birth safer for both mothers and newborns.

PurposeThe purpose of this paper is to report on the exploration of women farmers' information literacy (IL) in the context of rural Bangladesh within the context of an ICT-based women empowerment project.Design/methodology/approachThis study uses thematic analysis of qualitative data collected during a culturally sensitive workshop on IL with a group of project participants.FindingsThe findings showed that women understood their information needs and where to find information, which indicates that participants had some basic IL skills. However, the online environment presented challenges for them to evaluate the quality of the information and its relevance to their daily activities. The cultural complexity of IL was observed with the rural women’s information practices affected by family patterns, community and religion, amongst other social factors. Collective practices are made highly evident by the women’s natural tendency to share phones and information and by the way information is maintained. While the collective practices are very useful in utilising information for daily needs, the downside is that women are potentially vulnerable to threats in an online environment when sharing confidential information.Originality/valueThis article shows that in the context of rural Bangladesh, women farmers’ information-seeking behaviour and practices of sharing and creating information are influenced by sociocultural characteristics. It describes how the women’s situational context of collectivity and power relations influence their ways of handling information.

The onset of the coronavirus disease (COVID-19) pandemic and its overwhelming physical and mental health burden can result in stigmatization toward the disease and those affected. This study aimed to measure the prevalence of COVID-19-related stigma and its associated factors among older people in Bangladesh. This cross-sectional study was conducted among 1,045 Bangladeshi older adults aged 60 years and above through telephone interviews in September 2021. The outcome was measured using an eight-point Stigma Scale, adapted to the Bengali language. Level of stigma was indicated by the cumulative score of the eight-items, ranging from 0 to 8, with a higher score indicating a higher level of stigma. On average, participants had stigmas on three of the eight items, and 62.6% had a high stigma score. The most prevalent stigmas were as follows: COVID-19 is a punishment from God (79.3%), patients with previous COVID-19 must be isolated (67.3%), and people infected with COVID-19 did not meet hygiene standards (63.9%). Participants who lived in rural areas (β: 0.67, 95% CI: 0.39 to 0.95) and who perceived needing additional care during the pandemic (β: 0.35, 95% CI: 0.09 to 0.60) had a higher average stigma score, whereas stigma scores were lower among unemployed/retired participants (β: −0.22, 95% CI: −0.45 to 0.00). The study findings suggest implementing interventions to raise awareness through appropriate health literacy interventions and mass media campaigns.

Introduction In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea. Methods Nigeria was used as the control country with pre-intervention period of 1990 and 2003 and 1993 and 1998 in Ghana. Post-intervention period was 2008 and 2014 in Ghana and 2008 and 2018 in Nigeria. Data was acquired from demographic health surveys in both countries and propensity score matching was calculated based on background socioeconomic covariates. Following matching, difference in difference analysis was conducted to estimate average treatment on the treated effects. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05. Results After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points). Conclusions Introduction of health financing reforms in Ghana had positive effects on childhood infections (malaria and diarrhoea).

The present study aims to investigate the prevalence of loneliness and its associated factors among older adults during the COVID-19 pandemic in Bangladesh. This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged 60 years and above through telephone interviews. A semi-structured questionnaire was used to collect information on participants’ characteristics and COVID-19-related information. Meanwhile, the level of loneliness was measured using a 3-item UCLA Loneliness scale. More than half (51.5%) of the older adults experienced loneliness. We found that participants formally schooled [adjusted odds ratio (aOR = 0.62, 95% CI 0.43–0.88)] and received COVID-19-related information from health workers (aOR = 0.33, 95% CI 0.22–0.49) had lower odds of being lonely during the pandemic. However, older adults living alone (aOR: 2.57, 95% CI 1.34–4.94), residing distant from a health facility (aOR = 1.46, 95% CI 1.02–2.08) and in rural areas (aOR = 1.53, 95% CI 1.02–2.23) had higher odds of loneliness than their counterparts. Likewise, odds of loneliness were higher among those overwhelmed by COVID-19 (aOR = 1.93, 95% CI 1.29–2.86), who faced difficulty in earning (aOR = 1.77, 95% CI 1.18–2.67) and receiving routine medical care during pandemic (aOR = 2.94, 95% CI 1.78–4.87), and those perceiving requiring additional care during the pandemic (aOR = 6.01, 95% CI 3.80–9.49). The findings suggest that policies and plans should be directed to reduce loneliness among older adults who require additional care.