PRO4 Cost-Effectiveness Analysis of an Integrated Extracorporeal Photopheresis System Versus Selected Treatments for Refractory Chronic Graft Versus Host Disease

Milk production in Bangladesh has been increasing despite farmers being resource-poor. The expansion of commercial milk collection centers has promoted market-oriented production; however, poor food safety practices (FSPs) have resulted in disease transmission among cattle and also milk contamination, restricting market access. Therefore, this study examined farm-level FSPs among 498 market-oriented dairy farmers operating across diverse agro-climatic zones. Employing partial least square structural equation modeling (PLS-SEM) within an integrated theoretical framework, the relationships between farmers' knowledge and attitudes, institutional inspections, constraints and farm resources, with FSPs as the primary outcome, were analyzed. The results indicate that knowledge, attitudes and resources significantly enhance the implementation of FSPs, although the effect size of farm resources is small. However, constraints related to FSPs, such as poor market conditions, uniform pricing policies and additional safety costs, have negatively impacted. These constraints also diminish the overall effectiveness of positive attitudes and knowledge. Trained farmers could utilize resources to improve FSPs, while untrained suffer severely from the negative effects of constraints. Surprisingly, institutional inspections have an insignificant influence on the adoption of FSPs. The study recommends targeted training, price incentives, enhanced resources and the establishment of safety inspection bodies, as well as structural changes to commercial milk collection procedures, to improve food safety and hygiene standards in the Bangladeshi dairy sector.