Comparative analysis of emotional and behavioral problems among adolescent offspring of female sex workers and residents of urban slum, Bangladesh

Afia Mahmuda Khan; Koustuv Dalal; Sumaiya Zabin Eusufzai; Sabrin Shohid; Rinku Das; Sheikh Jamal Hossain; Lameea Shahed; Turia Alam; Kazi Sayma Ferdous; Mohammad Delwer Hossain Hawlader

doi:10.1007/s44192-025-00211-8

Comparative analysis of emotional and behavioral problems among adolescent offspring of female sex workers and residents of urban slum, Bangladesh

Discov Ment Health. 2025 Jul 1;5(1):93. doi: 10.1007/s44192-025-00211-8.

Authors

Afia Mahmuda Khan^{1

2

3}, Koustuv Dalal^{4

5}, Sumaiya Zabin Eusufzai⁶, Sabrin Shohid⁷, Rinku Das¹, Sheikh Jamal Hossain^{6

8}, Lameea Shahed¹, Turia Alam⁹, Kazi Sayma Ferdous¹, Mohammad Delwer Hossain Hawlader^{1

10}

Affiliations

¹ Department of Public Health, North South University, Dhaka, 1229, Bangladesh.
² Maternal and Child Health Division (MCHD), International Centre for Diarrheal Disease Research, Bangladesh, (Icddr,B), Dhaka, 1212, Bangladesh.
³ Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh.
⁴ School of Health Sciences, Division of Public Health Science, Mid Sweden University, 851 70, Sundsvall, Sweden. koustuv.dalal@miun.se.
⁵ University of Johannesburg, Johannesburg, 2902, South Africa. koustuv.dalal@miun.se.
⁶ School of Dental Sciences, University Sains Malaysia, 16150, Kelantan, Malaysia.
⁷ Department of Public Health and Hospital Administration, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212, Bangladesh.
⁸ Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden, 75237.
⁹ University of Wollongong, Wollongong, NSW, Australia, 2522.
¹⁰ NSU Global Health Institute (NGHI), North South University, Dhaka, 1229, Bangladesh.

Abstract

Introduction: The children of female sex workers are the victims of their circumstances from the beginning and are deprived of an environment that encourages optimal physical and psychological development. This study aimed to assess the prevalence of emotional and behavioral problems among adolescent offspring of female sex workers and compare that with adolescent offspring of slum-dwellers in Daulatdia and Dhaka city, Bangladesh.

Methods: A cross-sectional study was conducted with a sample of 394 adolescent children (196 adolescent offspring of sex workers and 198 adolescent offspring of slum dwellers) from March 2024 to May 2024 using a structured questionnaire. The study was conducted through face-to-face interviews where sociodemographic details, along with information regarding emotional and behavioral health problems, were assessed through the Strength and Difficulties Questionnaire (SDQ) scale, and health-related quality of life was assessed through the Kidscreen-10 scale. Descriptive analysis, bivariate analysis, and binary logistic regression analysis were performed.

Results: The prevalence of emotional and behavioral problems was 13% for adolescent offspring of Daulatdia and 15% for Korail slum. Age and gender in brothel settings and HRQoL in both settings were found to be significantly associated with emotional and behavioral difficulties. Adolescent offspring of FSWs with low HRQoL (OR = 4.09, p-value < 0.05, CI 1.579-10.595) were 4.09 times more likely to suffer from abnormal mental disorders than those with average or high HRQoL. While in a slum setting, it is 2.825 times higher (OR = 2.825, p-value < 0.05, CI 1.142-6.987).

Conclusion: The study concluded that the overall prevalence of emotional and behavioral problems for adolescent offspring of FSWs was significantly lower than for adolescent offspring of slum dwellers in the emotional problem subscale. Tailored interventions should be developed to address the specific needs of individuals with emotional and behavioral health problems while minimizing the detrimental impacts of their stigmatized identity.

Keywords: Adolescent; Emotional and behavioral problems; Female sex workers; Psychosocial challenges; Quality of life.