Antenatal care and skilled birth attendance in Bangladesh are influenced by female education and family affordability: BDHS 2014 (original) (raw)
Related papers
2021
Objectives: The study aims to identify the associated factors with antenatal care (ANC) service utilization by pregnant women in Bangladesh. Methods: Using Bangladesh Demographic and Health Survey, 2014, Chi-square association test detected significant explanatory variables for the number of ANC visits. For adjusted effects estimation, the study considered multinomial logistic regression (MLR) with relative risk ratio (RRR) and proportional odds model (POM). Akaike Information Criterion (AIC) compared and selected a better-fitted model. Results: This study included 4488 responses who are women aged from 15-49 years. From MLR, primary educated women (RRR=1.344, 95% CI=1.253-1.747, p<0.001) with highly educated partners (RRR=1.478, 95% CI=1.255-1.908, p<0.001) were more likely to use ANC services. Besides, women belonging to the middle (RRR=1.209, 95% CI=1.114-1.644, p<0.001) and rich (RRR=1.506, 95% CI=1.307-1.970, p<0.001) wealth index had more chances of utilizing ANC services. However, ANC attendance decreased significantly with the increment in birth order (p<0.001). ANC visits was also lower for rural women (RRR=0.711, 95% CI=0.555-0.891, p<0.001), Dhaka (RRR=0.623, 95% CI=0.493-0.955, p<0.001), Khulna (RRR=0.457, 95% CI=0.388-0.687, p<0.001), and Rangpur (RRR=0.579, 95% CI=0.484-0.780, p<0.001) divisions. Conclusion: To increase the ANC attendance, improvement of maternal education in rural areas is highly recommended. Dhaka, Khulna, and Rangpur divisions also need special focus.
Factors affecting deliveries attended by skilled birth attendants in Bangladesh
Background: The presence of skilled birth attendants (SBAs) is crucial in childbirth to reduce the maternal mortality ratio (MMR) and to achieve the maternal mortality target of the United Nations' Sustainable Development Goals (SDGs). The aim of this study was to investigate the factors related to childbirths attended by SBAs in Bangladesh. Methods: Data from the Bangladesh Demographic and Health Survey (2014 BDHS) were analyzed. Logistic regression was applied to calculate crude odds ratios (CORs), adjusted odds ratios (AORs), 95% confidence intervals (CIs), and p-values. Results: In Bangladesh, 35.9% of deliveries were attended by SBAs, and 44.2% of those women received at least one antenatal checkup by a skilled provider. The deliveries by SBAs were less than 50% of the total deliveries in all divisions, excluding Khulna. Known pregnancy complications (AOR: 1.2; 95% CI: 1.1–1.4), higher level of education in both women (AOR: 1.7; 95% CI: 1.2–2.3) and their husbands (AOR: 1.8; 95% CI: 1.3–2.4), receiving antenatal care (ANC) by a skilled provider during the pregnancy period (AOR: 1.5; 95% CI: 1.1–2.1), and higher wealth quintiles (AOR: 3.4; 95% CI: 2.5–4.7) were all significantly associated with an increased likelihood of a delivery by SBAs (p <0.05). In contrast, women living in rural areas (AOR: 0.7; 95% CI: 0.6–0.8) and the Sylhet Division (AOR: 0.4; 95% CI: 0.3–0.5) were less likely to be delivered by SBAs.
Concise title: Maternal health service utilization
Clinical Epidemiology and Global Health, 2020
Abstract Objectives The objective of this study is to identify the determinants and measure the trends in maternal health-facility based utilization in Bangladesh. This research shows the importance of each variable and their role in utilizing maternity care in Bangladesh. Materials and methods In our study, we have analysed BDHS 2004, 2007, 2011 and 2014 data to measure the determinants and trends in maternal health services in Bangladesh, using the binary logistic regression model. Results Our study revealed that the variable education of women, place of residence, wealth index, and husband's education have a significant association with the maternal health services utilization. Women who completed higher education were more likely to use antenatal care (AOR = 3.76, CI = 2.07–6.52), skilled birth attendants (AOR = 2.82, CI = 1.96–1.4.08) and postnatal care (AOR = 1.87, CI = 1.31–2.68). Women from urban areas were more likely to use ANC (AOR = 1.30, CI = 1.05–1.60), SBAs (AOR = 1.64, 9 CI = 1.40–1.92) and PNC services (AOR = 1.45, CI = 1.23–1.70) than women from rural areas. Women from the richest households were more likely to use ANC (AOR = 2.30, CI = 1.80–2.95), SBAs (AOR = 2.23, CI = 1.83–2.71) and PNC (AOR = 1.78, CI = 1.47–2.16) than poor women. Conclusion Maternal health service utilization should be more targeted towards the rural women in Bangladesh as there seems a high inconsistency in service utilization among urban and rural mothers. ANC is an essential entry point for the ensuing application of delivery and PNC services. So, it is recommended to promote women's education and empowerment with improved geographical access and strong ANC policies.
PLOS global public health, 2022
Identifying high-risk pregnancies through antenatal care (ANC) is considered the cornerstone to eliminating child deaths and improving maternal health globally. Understanding the factors that influence a healthcare facility's (HCF) preparedness to provide ANC service is essential for assisting maternal and newborn health system progress. We aimed to evaluate the preparedness of HCFs to offer ANC services among childbearing women in Bangladesh and investigate the facility characteristics linked to the preparedness. The data for this study came from two waves of the Bangladesh Health Facilities Survey (BHFS), conducted in 2014 and 2017 using a stratified random sample of facilities. The study samples were 1,508 and 1,506 HCFs from the 2014 and 2017 BHFS, respectively. The outcome variable "ANC services preparedness" was calculated as an index score using a group of tracer indicators. Multinomial logistic regression models were used to identify the significant correlates of ANC service preparedness. We found that private hospitals had a lower chance of having high preparedness than district and upazila public facilities in 2014 (RRR = 0.04, 95% CI: 0.01-0.22, p-value = <0.001) and 2017 (RRR = 0.23, 95% CI: 0.07-0.74, p-value = 0.01), respectively. HCFs from the Khulna division had a 2.84 (RRR = 2.84, CI: 1.25-6.43, p-value = 0.01) and 3.51 (RRR = 3.51, CI: 1.49-8.27, p-value = <0.001) higher likelihood of having medium and high preparedness, respectively, for ANC service compared to the facilities in the Dhaka division in 2017. The facilities that had a medium infection prevention score were 3.10 times (RRR = 3.10, 95% CI: 1.65-5.82; p-value = <0.001) and 1.89 times (RRR = 1.89, 95% CI: 1.09-3.26, p-value = 0.02) more likely to have high preparedness compared to those facilities that had a low infection prevention score in 2014 and 2017 respectively. Facilities without visual aids for client education on pregnancy and ANC were less likely to have high (RRR = 0.29, 95% CI: 0.16-0.53, p-value = <0.001) and (RRR = 0.55, 95% CI: 0.30-0.99, p-value = 0.04) preparedness, respectively, than those with visual aids for client education on pregnancy and ANC in both the surveys. At all two survey time points, facilities that did not maintain individual client cards or records for ANC clients were less likely to
Multidisciplinary Science Journal
Maternal mortality and morbidity reduction constitute policy priorities, facilitated by prenatal care and World Health Organization (WHO)-endorsed antenatal care (ANC) utilization during pregnancy. Progress in Bangladesh is hindered as only 47% of expectant women participated in a minimum of four ANC sessions according to the latest maternal mortality survey. This study, utilizing 2018 Bangladesh Demographic and Health Survey (BDHS) data, undertakes an assessment of the socioeconomic determinants influencing the utilization or non-utilization of ANC services. Additionally, the study investigates socioeconomic factors significantly impacting the attainment of the WHO-recommended four or more ANC sessions. A Hurdle Negative Binomial Model is employed to ascertain ANC risk variables and their frequency, while the utilization characteristics of WHO ANC services are discerned through the Binary Logistic Regression Model. Noteworthy among the statistically significant determinants influen...
PLOS ONE, 2021
Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are pre...
Clinical Epidemiology and Global Health
Improving maternal health and reducing maternal mortality rate (MMR) are major challenges for Bangladesh. Utilization of antenatal care (ANC) services from skilled professionals and deliveries in health facilities are therefore important to tackle MMR and socioeconomic differences play a major part for these service utilization. The purpose of the current study was to identify the level and determinants of ANC and health facility delivery care utilization in Subornochor upazila (a rural sub-district), Noakhali, Bangladesh. The study was a community based cross sectional study. A total of 360 women (15-49 years) who had a child in the last five years preceding the survey were interviewed and studied. The results of overall analysis showed that only 34.6% women received ANC from health professionals, whereas mere 5.3% deliveries were taken place at health facilities. Mother's education, partner's occupation, family income and area of residence were significant predictors of these services utilization. Place of receiving ANC was an influencing factor of health facility delivery. Women who didn't receive ANC in health facilities were almost three times (OR: 2.95, 95% CI: 1.06-7.9) less likely to deliver in health facilities compared to the women who received ANC. The study underscores the urgent need of addressing socioeconomic differences and targeted interventions might help the women who need to utilize these services more often. The study also pointed out huge differences of these services utilization with national average. Though further investigation is necessary but emphasis should be given more to address the barriers of maternal health service.
Utilization of antenatal care services in a selected rural area in Bangladesh
Northern International Medical College Journal, 2015
Background : Antenatal care, the care that a woman receives during pregnancy, helps to ensure healthy outcomes for mother and newborns. Utilization of antenatal care services is the basic component of maternal care on which the life of mothers and babies depend. Objectives : To find out the utilization of antenatal care services in a selected rural area in Bangladesh. Methodology : Descriptive cross-sectional study was conducted between January to June 2014' A total 199 married women of reproductive age who had a live baby below 5years of age, were selected purposively from village Islampur in Dhamrai Upzilla under Dhaka district. Data were collected by face to face interview using a pre-tested structured questionnaire. Result : The study revealed that 94.97% utilized ANC services among them 44.72% visited for ANC more than 4 times, 20.10% for 4 times and 30.15% less than 4 times during pregnancy. Health care centre was within walking distance. Most of them were young women aged between 23-27 years (45.72%) and 18-22 years (36.18%). Majority (33.16%) was educated up to secondary level but 83.42% were house wife. Economic status was lower economic group. Half of the respondents (52%) took ANC on their own and permission of husband and 95.97% received special care from their family during pregnancy. For birth planning 86.83% planned health provider to conduct delivery and 71.36% wanted hospital delivery. Majority (97.98%) took birth preparedness during pregnancy and 55% received antenatal care from qualified doctor. About 87% found them available on duty and good behavior was found by 70.90% respondents. Information about danger signs during pregnancy were received by 77.89% of the respondents. Conclusion : Utilization of Antenatal care service was higher in the study area. Most of the mothers had idea about benefit of ANC. Mother's education, family support, behaviour, availability of health care service provider and distance of health centre influence higher utilization. Therefore, to strengthen and intensify the ANC service at all level of health care delivery throughout the country is necessary for sustainability and targeting suboptimum ANC utilization group.
2021
ObjectiveTo assess whether health facilities in Bangladesh are prepared to provide ANC services and to investigate facility characteristics that are linked to preparedness.Methods This cross-sectional analysis used publicly available data from two waves of Bangladesh Health Facilities Survey (BHFS) that was conducted in 2014 and 2017 using stratified random sample of facilities. 1508 and 1506 health facilities were included as study samples from the 2014 and 2017 BHFS respectively. The outcome variable ‘ANC services preparedness’ was calculated as an index score using a group of tracer indicators. Multivariable logistic regression models were used to identify the important correlates of ANC service preparednessResultsThe percentage of facilities providing ANC services has increased slightly from 97.4% in 2014 to 98.8% in 2017. Union level public facilities were less likely to be prepared for providing ANC service than district level public facilities in 2014 (Odds ratio (OR): 0.20, ...