Zarina Nahar Kabir
My research encompasses community care in the context of ageing, intimate partner violence and maternal mental health from a public health perspective . My current project is an intervention study using mobile technology to provide support by health professionals to family caregivers of persons with dementia to reduce stress and improve quality of life.
My research focuses on two specific areas: i) Ageing and health from a global perspective; and ii) Maternal mental health and its impact on childbirth and infant development in Bangladesh.
I) Ageing and health from a global perspective
Past & CURRENT research: An intervention study Primary Health-Care Services in Later Life: Improving Services in Bangladesh and Vietnam (PHILL), financed by the European Commission (2002-2005), assessed the impact of primary health care (PHC) interventions to improve health and quality of life of older people in rural Vietnam and Bangladesh. The project assessed health needs of elderly people and the effectiveness of PHC services in meeting these needs. A sustainable intervention package was developed to improve delivery of health-care services for older people. It also addressed measures that could be adopted at younger ages to prepare for healthy future in later life. The package targeted PHC providers, local communities, informal carers and older people. The study assessed the impact of these interventions using quantitative and qualitative techniques. The intervention has improved awareness of different stakeholders, including health care providers, elderly individuals and their caregivers, on health of older persons in the study areas. The older people received improved services from the local authorities. In Vietnam, these intervention models were replicated by the local authorities themselves. By providing knowledge on preventive and managing skills of health and health care of elderly persons, specific health conditions and quality of life of the elderly persons and healthcare services for the elderly persons had improved in two rural areas in Bangladesh and Vietnam. Older people reported improved quality of life after the implementation of intervention in both the countries. Research capacity of researchers in partner institutions has been improved by learning experiences from this project. Three PhD dissertations and one Master’s thesis were produced through the project.
Poverty and Health in Ageing (PHA): This multi-dimensional cross-sectional study aims to explore how biological, environmental, and societal factors are interrelated and how they affect aging. PHA includes survey methods, clinical investigations, cognitive testing, and laboratory analyses involving a sample of 850 participants aged ≥60 years in a rural area of Bangladesh. PHA is the result of a collaboration between ICDDR,B: Knowledge for Global Lifesaving Solutions, Bangladesh and KI. Main findings of the study so far reveal 26% prevalence of undernourishment and 62% at risk of malnutrition. The association between nutritional status and cognitive function involves general and specific cognitive abilities, with fluid ability seeming to be affected but crystalized functions being relatively spared. There were significant associations between better nutritional status and better cognitive performance tests of general ability and processing speed, whereas semantic memory appeared to be less affected. In studying the association between nutritional status and physical function, more undernourished participants than well-nourished participants reported limited mobility, impaired activities of daily living (ADL) and difficulties in performance tests. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, better nutritional status were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socioeconomic and health status differences.
International Network on Public Health and Aging (INOPA): INOPA is a network of researchers from 11 academic, government and non-government organizations representing databases (1 intervention, 2 cross-sectional and 8 longitudinal) on older persons from eight countries located in Asia, Australia, Europe and North America. The network was financed by the Swedish Council for Working Life and Social Research (2005-2008). The network aims at the coordination of ageing research in high- and low-income regions of the world. Aging is a complex interaction among biological, genetic, psychological and social influences and keeping ‘interaction’ as the central theme, INOPA, a cross-contextual initiative, was founded in 2005. The focus of the network is the need for integration of knowledge about ageing across diverse geographical contexts (e.g., high-income vs. low-income countries).
II) Maternal mental health and its impact on childbirth and infant development
CURRENT RESEARCH IN BANGLADESH: Results from our most recent publication shows that perinatal depressive and anxiety symptoms lead to low birth weight of the newborn child (Nasreen et al. 2010). These results emanate from a prospective cohort study on maternal mental health related to childbirth and its impact on infant development in rural Bangladesh. The study was conducted in collaboration between Karolinska Institutet (KI), and BRAC University and BRAC in Bangladesh. BRAC is a non-government development organisation, which provides health care to the poor in rural Bangladesh.
Data was collected during 2007 – 2009 using mixed methods. Seven hundred and twenty women were followed from the third trimester of pregnancy until their infants were 6-8 months. Data was collected at four occasions. The rates of depressive- and anxiety symptoms were found to be high among the Bangladeshi women, both during pregnancy, 22% and 38%, respectively, and 2-3 months postpartum, 18% and 38%, respectively. Risk factors for depressive symptoms were previous depression in life, anxiety during pregnancy, poor relationship with the husband and intimate partner violence. The study will also investigate the impact of maternal perinatal depressive- and anxiety symptoms on the infants’ growth, development and health, and on mother‘s emotional bonding to the infant and mother-infant interactions.
Kabir Z.N., Nasreen H-E, Edhborg M. Intimate partner violence and association with maternal depressive symptoms 6-8 months after childbirth in rural Bangladesh. Glob Health Action 2014, 7: 24725 - http://dx.doi.org/10.3402/gha.v7.24725 Palmer K, Kabir ZN, Ahmed T, Hamadani JD, Cornelius C, Kivipelto M, Wahlin Å. Prevalence of dementia and factors associated with dementia in rural Bangladesh: data from a cross-sectional, population-based study. International Psychogeriatrics / IPA 07/2014; DOI: 10.1017/S1041610214001392. Tavallali A.G., Kabir Z.N., Jirwe M. Ethnic Swedish parents’ experiences of minority ethnic nurses’ cultural competence in Swedish pediatric care. Scandinavian Journal of Caring Sciences, 2013, doi: 10.1111/scs.12051. Fattah K.N. and Kabir Z.N. No Place is Safe: Child sexual abuse in Rural Bangladesh. Journal of Child Sexual Abuse. 2013, 22: 901-914. Edhborg M., Hogg B., Nasreen H-E., Kabir Z.N. Impact of perinatal depressive symptoms and infant’s sex on mother-infant interaction among rural Bangladeshi women. Health. 5 (2): Feb 2013, DOI: 10.4236/health.2013.52032. Nasreen H-E., Kabir Z.N., Forsell Y., Edhborg M. Impact of maternal depressive symptoms and infant temperament on early infant growth and motor development: Results from a population based study in Bangladesh. Journal of Affective Disorders. 2013, 146: 254-261. Sternäng O., Hamadani, J., Nilsson L-G., Kabir, Z.N. and Wahlin, Å. A cross-cultural perspective on aging and memory: Comparisons between Bangladesh and Sweden. GERONTOLOGIST, 2012, 52, p. 518. Khanam M.A., Chengxuan Qiu, Streatfield P.K., Lindeboom, W, Kabir Z.N. and Wahlin Å. The Metabolic Syndrome: Prevalence, Associated Factors, and Impact on Survival among the Elderly in Rural Bangladesh. PLoS One (Open Access), 2011, 6(6). Edhborg M, Nasreen H-E, Kabir Z.N. Impact of postpartum depressive – and anxiety symptoms on mothers’ emotional tie to their infants 2-3 months postpartum: a population based study from rural Bangladesh. Archives of Women’s Mental Health, 2011, DOI 10.1007/s00737-011-0221-7. Nasreen H-E., Kabir Z.N., Forsell Y., Edhborg M. Depressive and anxiety symptoms during pregnancy: prevalence and associated factors among rural women in Bangladesh. BMC Women’s Health, 2011, 11: 22 (Open Access). Khanam M.A., Kabir Z.N., Streatfield P.K., Chengxuan Qiu, Cornellius C. and Wahlin Å. Prevalence and patterns of multimorbidity among elderly people in rural Bangladesh: a cross sectional study. Journal of Health, Population and Nutrition, 2011, Aug 29(4). Nilsson J., Rana M., Luong D., Winblad B. and Kabir Z.N. Health-related quality of life in old age: A comparison between rural areas in Bangladesh and Vietnam. Asia-Pacific Journal of Public Health, 2012, 24: 610-619. Rana A.K.M., Wahlin Å., Lundborg C.S. and Kabir Z.N. Health education improves both arthritis-related illness and self-rated health: an intervention study among older people in rural Bangladesh. Public Health, 2010, Dec; 124(12):705-12. Nasreen H-E., Kabir Z.N., Forsell Y. and Edhborg M. Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: Results from a population based study in Bangladesh. BMC Public Health, 2010, Aug 26, 10:515. Doi: 10.1186/1471-2458-10-515. Cameron LJH, Kabir Z.N., Khanam M.A., Wahlin Å and Streatfield P.K. Earning their keep: The productivity of older women and men in rural Bangladesh. Journal of Cross-Cultural Gerontology, 2010, 25(1):87-103. Ferdous T., Cederholm T, Kabir Z.N., Hamadani J.D. and Wahlin Å. Nutritional status and cognitive function in community living rural Bangladeshi older adults: Data from the Poverty and Health in Ageing project. Journal of American Geriatrics Society, 2010, 58:919–924. Rana A.K.M., Wahlin Å., Streatfield P.K. and Kabir Z.N. Association of bone and joint diseases with health-related quality of life among older people: a population-based cross-sectional study in rural Bangladesh. Ageing and Society, 2009; 29:723-747. Ferdous T., Kabir Z.N., Wahlin Å., Streatfield P.K. and Cederholm T. The multidimensional background of malnutrition among rural older individuals in Bangladesh - a challenge for the Millennium Development Goal. Public Health Nutrition, 2009, 12: 2270-2278. Ferdous T., Cederholm T., Wahlin Å., Razzak A. and Kabir Z.N. Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh. Scandinavian Journal of Public Health, 2009; 37:518-524. Rana A.K.M., Wahlin Å., Lundborg C.S. and Kabir Z.N. Impact of health education on health-related quality of life among elderly persons: results from a community-based intervention study in rural Bangladesh. Health Promotion International, 2009; 24: 36-45. Wahlin Å., Anstey K.J. , McDonald S.W.S. , Ahmed S.M., Kivipelto M., Kunnukattil K.S.S., Mai T.T., Nilsson L-G., Streatfield P.K. , vanBoxtel M.P.J. , Kabir Z.N. The International Network on Public Health and Aging (INOPA): Introducing a Life Course Perspective to the Public Health Agenda. Journal of Cross-Cultural Gerontology, 2008; 23:1, 97 – 105. Rana A.K.M., Lundborg C.S., Wahlin Å., Ahmed S.M. and Kabir Z.N. The Impact of Health Education in Managing Self-reported Arthritis-related Illness among Elderly Persons in Rural Bangladesh. Health Education Research, 2008; 23:94-105. Kabir Z.N., Ferdous T., Cederholm T., Khanam M.A., Streatfield P.K. and Wahlin Å. Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors. Public Health Nutrition, 2006; 9:968-974 Biswas P., Kabir Z.N., Nilsson J. and Zaman S.: Illness, Coping, and Healthcare Seeking by the Elderly in Rural Bangladesh. International Journal of Ageing and Later Life, 2006; 1: 69-89. Ahmed SM, Petzold M, Kabir ZN and Tomson G. Targeted intervention for the ultra-poor: Does it make any difference in their health-seeking behaviour? Social Science and Medicine. 2006; 63: 2899-911. Nilsson J., Rana M., Kabir Z.N.: Association of social capital and quality of life among elderly people in rural Bangladesh. Journal of Aging and Health. 2006;18: 419-434. Herlitz A. and Kabir Z.N.: Sex differences in cognition in illiterate Bangladeshis: A comparison with literate Bangladeshis and Swedes. Scandinavian Journal of Psychology. 2006; 47: 441- 447. Nilsson J., Graftström M., Shahaduzzaman and Kabir, Z.N.: Role and function- Aspects of quality of life of older people in rural Bangladesh. Journal of Aging Studies, 2005; 19: 363-374. Ahmed S.M., Tomson G., Petzold M., Kabir, Z.N.: Socioeconomic status overrides age and gender in determining health-seeking behaviour in rural Bangladesh. Bulletin of the World Health Organisation, 2005; 83: 109-117. Nilsson J., Parker M. and Kabir Z.N.: Assessing Health-related Quality of Life Instrument Appropriate for Older People in Asian Countries. J. Transcultural Nursing. 2004; 15:4, 298-307. Kabir, Z.N., Tishelman C., Agüero-Torres H., Chowdhury A. M. R., Winblad B., Höjer B.: Gender and Rural-Urban Differences in Reported Health Status by Older People in Bangladesh. Archives of Gerontology and Geriatrics, 2003; 37: 77-91. Kabir, Z.N., Szebehely M., Tishelman C.: Support in old age in the changing society of Bangladesh. Ageing and Society; 2002, 22: 615-636. Kabir, Z.N., Parker M.G., Szebehely M., Tishelman C.: Influence of socio-cultural and structural factors on functional ability: The case of elderly people in Bangladesh. Journal of Aging and Health, 2001; 13 (3): 355-378. Kabir, Z.N. and Herlitz A.: The Bangla Adaptation of Mini-Mental State Examination (BAMSE): An Instrument to Assess Cognitive Function in Illiterate and Literate Individuals. International Journal of Geriatric Psychiatry, 2000; 15: 441-450. Kabir, Z.N., Szebehely M., Tishelman C., Chowdhury A.M.R., Höjer B., Winblad B.: Aging trends -- Making an invisible population visible: The elderly in Bangladesh. Journal of Cross-Cultural Gerontology, 1998; 13 (4): 361-378. Torres H.A., Kabir, Z.N., Winblad B. Distribution of home help services in an elderly urban population: Data from the Kungsholmen Project. Scandinavian Journal of Social Welfare 1995; 4: 274-279. Chowdhury A.M.R. and Kabir, Z.N. Folk Terminology for Diarrhoea in Rural Bangladesh in Review of Infectious Diseases. 1991; Vol-13 (Suppl.4). Chowdhury A.M.R. and Kabir, Z.N. Prevention of Night-Blindness in Rural Bangladesh, World Health Forum. 1989; Vol-10.
1983-86, B.A. Honours (Economics), University of Delhi, India
1989-90, M.A. (Gender & Development), Institute of Development Studies, University of Sussex, UK
1995-2001, PhD (Epidemiologic Ageing Research/Public Health), Karolinska Institutet, Sweden
Academic honours, awards and prizes
Associate Professor, Public Health at Karolinska Institutet, Stockholm, Sweden.
Adjunct Professor (2014-16), School of Public Health, Brac University, Dhaka, Bangladesh.