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The Institute for Global Health and Development

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    Users' Perceived Service Quality of National Telemedicine Services During the COVID-19 Pandemic in Bangladesh: Cross-Sectional Study.
    (2024-12-23) Khatun, Fatema; Das, Novel Chandra; Hoque, Md Rakibul; Saqeeb, Kazi Nazmus; Rahman, Monjur; Park, Kyung Ryul; Rasheed, Sabrina; Reidpath, Daniel
    COVID-19 created an opportunity for using teleconsultation as an alternative way of accessing expert medical advice. Bangladesh has seen a 20-fold increase in the use of teleconsultation during the pandemic. The aim of our study was to assess the influence of service quality and user satisfaction on the intention to use teleconsultation in the future among users of national teleconsultation services during the pandemic. A cross-sectional survey was conducted in 2020 among users of the national teleconsultation service-Shastho Batayon for acute respiratory infection. A validated mobile health service quality model based on structural equation modeling and confirmatory factor analysis was used to analyze the data with SmartPLS (version 3.0). Among the 2097 study participants, 1646 (78.5%) were male, 1416 (67.5%) were aged 18-39 years, 1588 (75.7%) were urban residents, 1348 (64.2%) had more than 10 years of schooling, and 1657 (79%) were from middle-income households. From a consumer perspective, the quality of the service platform (β=.946), service interaction (β=.974), and outcome (β=.955) contributed to service quality. Service quality was positively associated with user satisfaction (β=.327; P<.001) and intention to use teleconsultation services (β=.102; P<.001). User satisfaction was positively associated with the intention to use teleconsultation services (β=.311; P<.001). The increase in the use of teleconsultation during the pandemic indicated that such services were potentially used for emergencies. However, the future use of teleconsultation will be dependent on the quality of service and user satisfaction. Our findings are relevant for low-income contexts where teleconsultation services are used to address gaps in service delivery. [Abstract copyright: © Fatema Khatun, Novel Chandra Das, Md Rakibul Hoque, Kazi Nazmus Saqeeb, Monjur Rahman, Kyung Ryul Park, Sabrina Rasheed, Daniel D Reidpath. Originally published in JMIR Human Factors (https://humanfactors.jmir.org).]
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    Anxiety and Insomnia Among Urban Slum Dwellers in Bangladesh: The Role of COVID-19 and Its Associated Factors
    (Frontiers Media, 2021-12-03) Koly, Kamrun Nahar; Khanam, Mosammat Ivylata; Islam, Md. Saiful; Mahmood, Shehrin Shaila; Hanifi, Sayed Manzoor Ahmed; Reidpath, Daniel; Khatun, Fatema; Rasheed, Sabrina
    Background: Although mental health is an important part of health and wellbeing, very little is known about the impact of the COVID-19 pandemic on the mental health of marginalized communities like urban slum dwellers. Our study estimated the prevalence of generalized anxiety disorder and insomnia among the residents of the informal settlements of Dhaka, Bangladesh, during the COVID-19 pandemic. Methods: A cross-sectional phone-based survey was conducted from October to November 2020 among adult residents of five informal settlements of Dhaka city randomly chosen from an existing Urban Health and Demographic Surveillance Systems (UHDSS) run by icddr,b. Data on Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were collected. A multinomial logistic regression was performed to assess the associated factors of anxiety and insomnia. Results: Of the total 586 participants, the prevalence of mild to severe anxiety and insomnia were 53% and 43%, respectively. As per the multinomial regression analysis, participants with mild anxiety were significantly more likely to be older (>50 years) and afraid of COVID-19 infection. Likewise, participants with moderate/severe anxiety were significantly more likely to share less household facilities (e.g., toilet, kitchen, water) (OR: 2.23; 95% CI: 1.31–3.79), to have difficulties in food availability (OR: 2.76; 95% CI: 1.10–6.93), to be afraid of self (OR: 5.27; 95% CI: 2.82–9.88), and to worry about the family members (OR: 2.26; 95% CI: 1.23–4.17) getting infected. Participants with mild insomnia were significantly more likely to share fewer household facilities and be afraid of being infected with COVID-19 infection. Moreover, participants with moderate/severe insomnia were significantly more likely to be female (OR: 1.90; 95% CI: 1.02–3.56), to receive food aid (OR: 0.50; 95% CI: 0.29–0.88), to be afraid of self (OR: 3.85; 95% CI: 1.81–8.19), and to worry about someone like friends or neighbors (OR: 2.45; 95% CI: 1.07–5.58) getting infected with COVID-19. Conclusions: We found elevated prevalence of both anxiety and insomnia among the urban poor of Bangladesh in the context of COVID-19. This indicates the importance of integrating mental health in the mitigation and recovery efforts related to similar crises for the urban poor in the future.