Key PointsQuestionIs it feasible to develop a systematic model of fundus photograph–based eye screening for patients living with diabetes in Bangladesh?FindingsIn this cross-sectional study, 49 264 patients underwent fundus photograph–based eye screening during a 7-year period at 3 centers in Bangladesh. The primary prevalence rate of diabetic retinopathy was 33%.MeaningGiven the very high prevalence of diabetes, there is an urgent need to scale up diabetic eye screening services in resource-poor countries to prevent retinopathy complications and vision loss.

Improved agricultural practices that increase yields and preserve soils are critical to addressing food insecurity and undernutrition among smallholder farmer families. Urine-enriched biochar has been shown to be an accessible and effective fertilization option in various subtropical countries; however, it is new to Bangladesh. To better understand attitudes and experiences preparing and using urine-enriched biochar fertilizer, mixed-methods research was undertaken among smallholder farmers in northeastern Bangladesh in 2016/2017. In-depth interviews were conducted with 25 respondents who had compared the production of crops grown with biochar-based fertilizer to usual practice. In addition, in areas where trainings on biochar-based fertilization had been offered, 845 farmers were asked about their experience through a quantitative survey. Interview results indicated that cow urine-enriched biochar was favored over human urine because cow urine was perceived as clean and socially acceptable, whereas human urine was considered impure and disgusting. Respondents praised biochar-based fertilizer because it increased yields, cost little, was convenient to prepare with readily available natural materials, produced tastier crops, and allowed families to share their larger yields which in turn enhanced social and financial capital. Comparative field trials indicated a 60% yield benefit in both cabbage and kohlrabi crops. Challenges included uneven access to ingredients, with some respondents having difficulty procuring cow urine and biomass feedstock. The low social, health, and financial risk of adoption and the perceived benefits motivated farmers to produce and apply biochar-based fertilizer in their gardens, demonstrating strong potential for scale-up of this technology in Bangladesh.

Inadequate diet quality is a cause of undernutrition among children 6-23 months of age in Bangladesh, particularly in remote and isolated areas such as Bandarban District. Feeding animal source foods can help to combat stunting and wasting problems among children, but it may not be accessible or acceptable. A barrier analysis using the Designing for Behavior Change Framework was conducted in Bandarban district with participants from 4 ethnic groups, to explore potential barriers and key motivators by examining 12 behavioural determinants of consumption of animal-source food in complementary feeding for children 8-23 months. Data were collected from 45 mothers of children 8-23 months, who provided animal-source foods to their children (doers), and from 45 mothers who did not (non-doers), for a total of 90 interviews. Nine determinants were statistically significantly different between doers and non-doers as follows: self-efficacy, positive consequences, negative consequences, social norms, access, reminders, perceived risk, perceived severity and perceived action efficacy. Nearby access to purchase animal-source foods, rearing poultry or livestock at home and the support of household and community members are enablers to feeding animal-source food. In contrast, these same factors are barriers for non-doers. The lack of money to spend on animal-source foods is also a barrier. An integrated nutrition-sensitive and gender-transformative animal-based food production, and inclusive market programme could increase access to meat and eggs at the household level, increase opportunities to earn income and support gender-equitable household workloads and decision-making for optimal child feeding.