BURKHA

Why adolescents health is a concern in Bangladesh?

Risk behaviors are voluntary actions that threaten to harm an individual’s mental or physical health, or increase the likelihood of illnesses, injury, and premature death.

six categories of risk behaviors in today’s adolescent

1. Behaviors that result in unintentional and intentional injuries

2.Tobacco use

3.Alcohol and other drug use

4.Sexual behaviors     

5. Dietary patterns that contribute to disease

6. Insufficient physical activity

Unintentional and Intentional Behaviors

Unintentional injuries are those that occur as a result of accidents where there is no intent to harm.

Examples of accidental injuries include those resulting from:

Being struck by an automobile or being in an automobile crash ,Being injured in a fire ,

Careless play around water .

Tobacco use

Although tobacco use is illegal for individuals under the age of 18 in Bangladesh, there is a high

incidence of use among adolescents. Tobacco use in adolescence is associated with a range of health-compromising behaviors, including being involved in fights, carrying weapons, engaging in high-risk sexual behavior, and using alcohol and other drugs.

Alcohol and Other Drug Use

Alcohol is a psychoactive drug that depresses the central nervous system. Alcohol comes in many forms including clear, absolute liquid diluted and blended as beer, wine, or liquor. Alcohol initially makes individuals feel relaxed and sociable, but with prolonged use, these feelings will be replaced by feelings of depression, anger, loss of control and drowsiness. Alcohol can also cause the following:

• Memory loss

• Addiction

• Liver, kidney, stomach, and intestine damage

• Brain damage               

In Bangladesh There are a high percentage drug addicts amongst adolescents. But they have no place to go for treatment.

Sexual behaviors

That result in human immunodeficiency virus (HIV), other sexually  transmitted diseases (STDs,) and unintended pregnancy. Current trends of sexual behavior among youth are alarming.

In Bangladesh early marriage especially among female ,65% of young female marry before 18 years. 27%  Bangladeshi adolescent already become mother 6% are already become with their first child. 50% of adolescent girls are stunted and 33%  adolescent girls are in rural areas are  wasted. And  43% adolescent girls suffer from iron-deficiency anemia , iodine and vitamin A deficiency.

Insufficient Physical Activity

Another category of risky behavior is insufficient physical activity.

When students are physically active, they are more inclined to be energetic, maintain their ideal weight, and cope with stress. In addition, students are less likely to have chronic diseases. Currently, more than one-third of students do not get enough activity.

All over the situation in Bangladesh on adolescent is in very difficult condition. Its very difficult to develop the country without concerning adolescent health. For the sake of healthy future generation now a  days adolescent health care become  a big issue in Bangladesh.

FARHANA NEWAZ PRIYA

REDUCE BANGLADESH ROAD ACCIDENT

Worldwide, the number of people killed in road traffic crashes is estimated to be 1.3 million, with another 50 million injured each year. More than 85 percent of these casualties and 96 percent of total child deaths, occur in low and middle income countries. There has been an alarming rise in road accidents, significantly highway accidents, in Bangladesh over the past few years. According to a study conducted by the Accident Research Centre (ARC) of BUET, road accidents claim on average 12,000 lives annually and lead to about 35,000 injuries. According to World Bank statistics, annual fatality rate from road accidents is found to be 85.6 fatalities per 10,000 vehicles. Hence, the roads in Bangladesh have become deadly. Road traffic deaths are predicted to increase by 83 percent in low-income and middle-income countries if no major action is taken and to decrease by 27 percent in high-income countries over the next 20 years. Sustained declining trends in road fatalities in developed countries have been attributed to concerted efforts in many areas, including effective coordination, community involvement, research on road safety initiatives, the promotion of good road safety practices and improved targeting of resources.

Road traffic accidents have now become a great social concern in Bangladesh and the situation is deteriorating. The annual economic wastage occasioned by traffic accidents is estimated to be in the order of 2 to 3 percent of the GDP. Each year, there are at least 3,000 fatalities and 3,000 grievous and simple injuries from around 3,500 police reported accidents on Bangladesh roads. Other sources estimated the fatalities as high as from 12,000 to 20,000 per year. Thus, the safety problem is very severe by international standards with some 60 to 150 fatalities per 10,000 motor vehicles in Bangladesh compared to around 25 in  India, 16 in Srilanka,2  in the US and1.4 in UK respectively.

The reported road accident and casualty statistics over the past thirteen (1998-2010) years for Bangladesh have showed significant fluctuations. Such fluctuations usually indicate that the statistics are unreliable  with accidents increasing by some 12 percent between 1998 and 1999 and then peaking in 2003 (4,114 accidents) after dropping quickly in 2001 (decreased by 26 percent compared to year 2000). In 2010 there were about 2,437 reported accidents with 2,443 fatalities and 1,706 injuries.

Accident type analysis showed 'hit pedestrian' as the dominant accident type (45%). Other common accident types are rear-end collision (15%), head-on collision (15%) and overturning (9%). These four accident types account for nearly 84 percent of the total accidents. Current statistics revealed a deteriorating situation in metropolitan Dhaka, with pedestrians as a proportion of road crash deaths increasing from 43 percent in 1986-87 to 74 percent in 1998-2010. In urban areas 50 percent pedestrian casualties occur during crossing the road, but in rural areas 52 percent pedestrian casualties occur while walking along the roadside. On the other hand, grievous and simple injuries are the highest for passengers (63%).

Road accident statistics of Bangladesh revealed a serious threat to children. The incidence of child involvement in road accident casualties and fatalities are around 16 percent and 20 percent respectively. Of this fatality 78 percent represent as child pedestrians. This involvement of children up to15 years of age in road accident fatalities in Bangladesh is much higher than those in other developing countries. Worldwide, road traffic injuries are the second leading cause of death for 5 to 14 years of children. It is important to note that compared with industrialised countries, the proportion of fatalities to under 15 years of age in developing countries is approximately two and a half times higher.

Heavy vehicles (trucks and buses) are major contributors to road traffic accidents accounting for about 58% of vehicular involvement in accidents. Some striking features of heavy vehicles accidents are as follows:

* Involvement in all accidents 71%
* Involvement in fatal accidents 71%
* Involvement in pedestrian accidents 63%
* Involvement in pedestrian fatal accidents 65%
* Involvement in casualties 53%
* Involvement in fatalities 54%
* Involvement in pedestrian casualties 67%
* Involvement in pedestrian fatalities 70%

As citizen, I too have a role to play in ensuring road safety. While travelling in public transports, passengers should protest and stop speeding and reckless driving by bus and taxi drivers. Owners of motor vehicles should ensure that employed drivers have genuine licenses, are properly trained and drive responsibly. Road safety education to pedestrians, especially children, within the communities by community leaders is also a good way to promote road safety.

It is possible to significantly reduce the number of road accidents and casualties by implementing an effective and coordinated safety policy and actions which require significant improvements in the relevant sectors viz. better enforcement, better roads, enhanced vehicle safety standards, improved and extensive public education and safety related programs. There is a need for identification of accident prevention priorities setting realistic problem specific goals and targets. The problem-specific targets (e.g. reduction of pedestrian deaths from pedestrian walking with traffic) are far more important than macro targets (e.g. fatalities per 10,000 registered motor vehicles).

There is specific need and much scope for road environment improvements aimed at correcting the most common deficiencies through wider application of traffic engineering approaches. It is argued that priorities be placed on the principles like traffic segregation to provide facilities and road space for the most vulnerable users particularly pedestrians and non-motorized vehicles, and to force correct road user behavior (self enforcing measures) via channelization, speed reduction measures, etc. To promote enhanced road safety, there should be programs to implement well-known engineering measures, leading to larger and longer lasting effects at less expense, widely and systematically. Measures that would achieve greater road safety (likely to also improve traffic flow) and would also offer cost-effective results are listed below.

Road and road environment improvement measures

Low Cost Short Term Periodic Measures

* Removal of visual obstruction (permanent and temporary)

* Access control (major-minor road connections, frequent median opening)

* Road side hazard and parking management (bazaar, vendors, illegal parking)

* Improving bus-bay, passenger shelter and street lighting

* Road surface improvement

* Traffic sign, signal and marking improvement

* Drainage improvement

* Curve improvement (super-elevation, widening)

* Intersection improvement

* Pedestrian facilities improvement (walking along the road side and crossing)

* Speed management

* Long Term Policy and Capital Intensive Measures

* Planning and guidelines

* Land use control

* Exposure control through transport and land-use policies

* Functional hierarchy of the road system

* Safety audit and assessment

* Access control

* Highway surveillance

* Bridge and bridge approach

* Increase provision of road divider

* Provision of service or frontage roads

* Grade separated intersection

* Grade separated pedestrian facilities

* Additional space for future intersection improvement

Vehicle and traffic operation improvement measures
* Use of seatbelts and helmets
* Setting and enforcing speed limits
* Standard safety features in vehicles
* Improved visibility of non-motorized vehicles (NMV)
* Strict enforcement and random vehicle inspection (light, brake, tyre)
* Control irresponsible overtaking
* Computer based vehicle fitness checking
* Restriction in carrying rooftop passengers and goods
* Control excessive speeding and overloading
* Control non-standard vehicles on roads
* Application of ITS and central traffic control system
* Promoting public transport system
* Development of adequate modern driver training schools

Research, Education and Awareness Development Measures
* Advancing road safety research
* Strengthen accident data reporting and recording system
* Traffic safety education and information for all ages of road users
* Awareness development at different levels
* Mass media campaigns and publicity
* Safety awareness of vehicle owner
* Development of community based road safety program

Post-Crash Care Measures
* Ensure help for road accident patients at every stages
* Improve emergency rescue services
* Emergency units capable of dealing road accident patients
* Trauma care centre
* Rehabilitation

Bangladesh government has taking various kind of action to prevent and reduce road accident. such as formed a accident research centre.

The Accident Research Institute (previously known as Accident Research Centre) of BUET with its own efforts collects Accident Report Forms (ARFs) from four metropolitan offices and six ranges of Bangladesh Police regularly and is maintaining a Microcomputer Accident Analysis Package (MAAP) based database which is substantially important for ARI's research, training and national road traffic accident statistics. In addition to this, ARI conducts in-depth investigations on some major accidents on different national highways. ARI organize various training programs based on database analyses, researches and investigations. For example, Heavy Vehicle Drivers' Training Program on Road Safety and Good Driving Practice (1 day Program, approximately 1,000 drivers), Training Program for Police Officers on Accident Event Recording and Reporting (1 day program, approximately 800 police officers) and Driving Instructors' Training Program (2 weeks program, approximately 80 instructors). Recently, ARI with collaboration of Dhaka Transport Coordination Board (DTCB) has arranged a five-day professional training program on Traffic Safety. ARI has taken the initiatives to upgrade its training manual for drivers, driving instructors and related professionals to Safe Driving Manual and publish it as early as possible. ARI will continue its endeavors regarding trainings and investigations depending on demand and availability of funds. 

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