Background Diabetes is one of the leading non-communicable diseases globally, particularly affecting low- and middle-income countries. Among marginalized populations such as tea garden workers in Sylhet, Bangladesh, limited healthcare access and education contribute to gaps in understanding and managing diabetes. This study aimed to assess the knowledge, attitudes, and practices (KAP) related to diabetes in this vulnerable group. Methods A cross-sectional study was conducted from August 2023 to March 2024 among 320 adult tea garden workers in Sylhet. Participants were selected using cluster random sampling, and data were collected through face-to-face interviews using a structured questionnaire. Descriptive statistics were used to summarize KAP levels among participants. Results The study found that 88.1% of participants had heard of diabetes, but only 5.3% were aware of its types, and 65.6% did not know about treatment options. While 71.9% believed in the importance of dietary changes for diabetes management, only 3.8% reported monitoring their blood sugar regularly. Additionally, 40.3% believed diabetes could be prevented, while 57.2% were unaware that children could also be affected by the condition. Conclusion Despite some positive attitudes, significant gaps in knowledge and practice remain among tea garden workers in Sylhet. The findings highlight the need for targeted, community-based health education programs and improved healthcare access to promote better diabetes prevention and management in this underserved population.

Abstract

Background: Late postpartum depression (LPPD), occurring after the first year post-delivery, is a significant but neglected public health issue in low-income countries like Bangladesh. In rural areas like Chattogram, where access to healthcare is scarce and parental responsibilities are heavily governed by traditional gender roles, LPPD remains undetected and untreated. This neglect affects not only the mental well-being of the mother but also the child's development and the long-term stability of the family. Women in these communities are even more vulnerable due to a combination of social expectations for maternal sacrifice, social isolation, unstable economic circumstances, and inadequate mental health responses. Therefore, the purpose of this research is to evaluate the prevalence and sociodemographic status of LPPD and its impact on women's daily life and mental health in rural Chattogram. Methodology: In this cross-sectional study, 272 postpartum women from rural area of Chattogram were selected and recruited using simple random sampling; these women were having children aged between 1 to 5 years. A cross-sectional study, 272 postpartum mothers in rural Chattogram with children ages 1 to 5 were selected by simple random sampling. The PHQ-9 was used to measure the severity of depression (mild, moderate, moderately severe, and severe), and the EQ-5D was used to assess quality of life (QOL) in five dimensions: mobility, self-care, typical activities, pain/discomfort, and anxiety/depression. The data were gathered using structured interviews and questionnaires both online and offline. Descriptive statistics were used to contextualize QOL issues, and logistic regression was used to find determinants. Results: The majority of research participants were housewives (88.2%), married (97.1%), and Muslim (98.5%). There was variation in income levels, with smaller percentages in both lower and higher income bands and 20.6% earning between 15,000 and 28,000 BDT. According to the study, the prevalence of LPPD was startling: 19.9% of participants had severe depression (PHQ-9 scores 20–27), 39.7% had moderately severe symptoms (15–19), and 36.8% had moderate symptoms (10–14). With the highest occurrence (20.6%) in the 15,000–28,000 BDT income range, financial hardship was evident. Moreover, over one-third (35.3%) gave birth at home, which is associated with less access to postnatal care. High functioning in mobility (95.6%), self-care (97.8%), and routine tasks (91.9%) were noted by the EQ-5D; nevertheless, 42.7% of respondents experienced moderate-to-extreme pain, and 25% did not have social support. Cultural resilience was highlighted by universal mother-infant connection (100%) and social involvement (100%) in spite of these difficulties.

Conclusion: This study demonstrates a significant prevalence of late postpartum depression among women in rural Chattogram, with the majority reporting moderate to severe symptoms. Financial difficulty, a large number of deliveries at home, and restricted access to mental health treatments are also contributing factors. The issue is made worse by cultural norms that place an emphasis on maternal sacrifice and prohibit open discussions about mental suffering. Despite strong mother-infant ties and active social participation, many women suffer in silence due to inadequate support systems and health infrastructure. These findings highlight the critical need for integrated, culturally sensitive mental health care in the community. Policy should focus on improving access to healthcare, empowering women economically to reduce their dependence and increase their well-being, and increasing support from husbands and family. Addressing these issues is essential to stop this pattern of poor maternal mental health and ensure a healthy future for both mother and children.