Health research is a moral duty because it is the foundation for evidence-based care by all health care practitioners. Hence, paediatric research is essential for improving health outcomes of children. Waiting for adult studies before conducting paediatric studies may prolong the denial of effective treatment for children. The CIOMS and other guidelines clearly allow research procedures that involve a low degree of risk. However, the critical need for pediatric research on drugs and biological products underscores the responsibility to ensure that children are enrolled in clinical research that is both scientifically necessary and ethically sound. Even in a resource poor setting of a developing country like Bangladesh, the things that should be taken under considerations are the status of children as a vulnerable population; the appropriate balance of risk and potential benefit in research; ethical considerations underlying study design, including clinical equipoise, placebo controls, and non-inferiority designs; the use of data; compensation; and parental permission and child assent where applicable to participate in research. Such ethical dilemmas are more evident in paediatric research especially when a collaborative research is done by a developed country in a developing country setting. It is the role of the health policy makers, and community of paediatric physicians, nurses, and caregivers to advocate not only for more research for children but also to ensure that the research conducted is of the highest quality from ethical viewpoint. CBMJ 2020 July: Vol. 09 No. 02 P: 54-58
As COVID-19 cases were in rise all over the world and the World Health Organization declared a pandemic, there was an increasing focus on availability of new vaccines and drugs against the virus. Meanwhile, we already have several vaccines in COVID-19 vaccination programmes across the globe. During the process of development and clinical trials of the vaccines, several questions were popped up by multiple stakeholders about child vaccination against COVID-19. Most of the queries focused on safety of COVID-19 vaccines, the clinical trial process, priority criteria of getting a vaccine, why and why not children be included in the vaccination programme. In adult population of the country, COVID-19 vaccination programme is being carried out in an unequalled state; the focus is now on paeditric population, as some countries have already started to vaccinate children. At the time of writing this paper when Government of Bangladesh has not yet decided to vaccinate children in the country but initiatives has been taken by health department for above 12 years children vaccination. However, this paper aims to discuss potential ethical dilemmas related to COVID-19 vaccination in children especially in low-resource settings and dig into effective strategies to implement COVID-19 vaccination programme properly in the field of public health. Bangladesh Med J. 2021 Sept; 50(3): 44-48
Bangladesh made significant improvements in child healthcare and achieved its Millennium Development Goal (MDG) 4 (to reduce child mortality). In 2010, the United Nations recognized Bangladesh for its exceptional progress towards MDG 4 to reduce child and maternal mortality in the face of many socioeconomic challenges. We are also committed to achieve our Sustainable Development Goal (SDG) by 2030. Health education department of Government of Bangladesh prioritized several essential health interventions over the past decades. There were focuses on expanding immunization, tackling diarrhoea and pneumonia, vitamin A campaign, prevention of blindness, iodine deficiency, and improving adolescent health. These programmes and strategies were scaled-up nationwide. The government along with its stakeholders promoted widespread availability and affordability of those health literacy interventions with an emphasis on community-based approaches. As a result, inequities in coverage of specific interventions declined; this may explain the improvements seen amongst even the most disadvantaged populations of the country. Media campaigns played a great role, which were undertaken in Bangladesh for decades and involved a nationally broadcast television supported by radio, television, newspaper, and billboard advertisements and local promotion activities. We expect that ongoing public private partnerships (PPPs) in which the government contracts NGOs and the private sector will enable us greater success and coverage of health information and literacy services throughout the country. CBMJ 2023 January: Vol. 12 No. 01 P: 124-128
A prospective, observational study was conducted in the Department of Obstetrics & Gynaecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, between July 2008 and January 2009 to compare position and attachment of the babies during breastfeeding before and after counselling the mothers. Our study samples include 100 healthy mothers and 100 term healthy babies. Initially, all the mothers and babies were observed for their position and attachment during breastfeeding within 24 hours of the delivery and documented in a standard data sheet. Then the mothers were shown the wall chart of nursing mothers and breastfeeding manual and taught practically by the investigators. Mothers were requested to come after 15 days for follow-up visit so that they become physically fit by that time and improve their skills. At follow-up visit, documentation of the position and attachment during breastfeeding was done in the data sheet. Comparison of each of the components of positioning and attachment was done with first observation (i.e., within 24 hours of the birth of the baby) and follow-up observation (i.e., after 15 days). The mean age of the mothers was 29.40±4.71 years. In all components of the position and attachment of the babies, the difference between before and after counselling the mothers was statistically significant (P<0.05). Similarly, in all signs of effective sucking, the difference was also statistically significant between before and after counselling (P<0.05) except for the sign of oxytocin reflex noticed by the mother (P>0.05). CBMJ 2022 July: vol. 11 no. 02 P: 102-107
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