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Increasing the availability and readiness of basic emergency obstetric and newborn care (BEmONC) services is essential for improving maternal and neonatal health. However, little is known about any progress made in the availability and readiness of BEmONC services in Bangladesh. Using nationally representative data from the Bangladesh Health Facility Survey conducted between 2014 and 2017, we measured changes in the availability and readiness of BEmONC services in health facilities in Bangladesh, calculating the BEmONC service availability and readiness scores according to the World Health Organization Service Availability and Readiness Assessment guideline. The percentage of health facilities performing all seven basic signal functions declined slightly from 13% in 2014 to 11% in 2017. The decline was largely noticed in Maternal and Child Welfare Centers, Upazila Health Complexes, and Union Subcenter/Rural Dispensaries, as well as in all divisions except Rangpur. No remarkable changes in overall readiness of health facilities across location, division and facility type were observed between 2014 and 2017. However, significant reductions in availability and readiness were noticed when item-specific assessment was made. Type of health facility was significantly associated with both availability and readiness scores in adjusted regression models. Appropriate strategies and efforts could improve the availability and readiness of BEmONC services in health facilities in Bangladesh.

Increasing the availability and readiness of basic emergency obstetric and newborn care (BEmONC) services is essential for improving maternal and neonatal health. However, little is known about any progress made in the availability and readiness of BEmONC services in Bangladesh. Using nationally representative data from the Bangladesh Health Facility Survey conducted between 2014 and 2017, we measured changes in the availability and readiness of BEmONC services in health facilities in Bangladesh, calculating the BEmONC service availability and readiness scores according to the World Health Organization Service Availability and Readiness Assessment guideline. The percentage of health facilities performing all seven basic signal functions declined slightly from 13% in 2014 to 11% in 2017. The decline was largely noticed in Maternal and Child Welfare Centers, Upazila Health Complexes, and Union Subcenter/Rural Dispensaries, as well as in all divisions except Rangpur. No remarkable changes in overall readiness of health facilities across location, division and facility type were observed between 2014 and 2017. However, significant reductions in availability and readiness were noticed when item-specific assessment was made. Type of health facility was significantly associated with both availability and readiness scores in adjusted regression models. Appropriate strategies and efforts could improve the availability and readiness of BEmONC services in health facilities in Bangladesh.

Background: The adaptive immune response is a crucial component of the protective immunity against SARS-CoV-2, generated after infection or vaccination. Methods: We studied antibody titers, neutralizing antibodies and cellular immune responses to four different COVID-19 vaccines, namely Pfizer-BioNTech, Moderna Spikevax, AstraZeneca and Sinopharm vaccines in the Bangladeshi population (n = 1780). Results: mRNA vaccines Moderna (14,655 ± 11.3) and Pfizer (13,772 ± 11.5) elicited significantly higher anti-Spike (S) antibody titers compared to the Adenovector vaccine AstraZeneca (2443 ± 12.8) and inactivated vaccine Sinopharm (1150 ± 11.2). SARS-CoV-2-specific neutralizing antibodies as well as IFN-γ-secreting lymphocytes were more abundant in Pfizer and Moderna vaccine recipients compared to AstraZeneca and Sinopharm vaccine recipients. Participants previously infected with SARS-CoV-2 exhibited higher post-vaccine immune responses (S-specific and neutralizing antibodies, IFN-γ-secreting cells) compared to uninfected participants. Memory B (BMEM), total CD8+T, CD4+ central memory (CD4+CM) and T-regulatory (TREG) cells were more numerous in AstraZeneca vaccine recipients compared to other vaccine recipients. Plasmablasts, B-regulatory (BREG) and CD4+ effector (CD4+EFF) cells were more numerous in mRNA vaccine recipients. Conclusions: mRNA vaccines generated a higher antibody response, while a differential cellular response was observed for different vaccine types, suggesting that both cellular and humoral responses are important in immune monitoring of different types of vaccines.