Socio-demographic Factors Associated with Home Delivery Assisted by Untrained Traditional Birth Attendant in Rural Bangladesh (original) (raw)
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Social Science & Medicine, 2002
The majority of births in rural Bangladesh are carried out in unhygienic conditions by relatives and traditional birth attendants (TBAs). This results in a high incidence of maternal and infant mortality that could be reduced if childbirth were to occur in health centers or under the supervision of trained TBAs (TTBAs). In this paper, we examined factors associated with utilization of modern health resources for childbirth in 39 villages of Bangladesh. We followed a retrospective survey research design to collect relevant information from couples who experienced childbirth during a two-year period from July 1, 1995 to June 1997. The data indicate that slightly over 11% of the deliveries were performed by trained personnel with the rest attended by TBAs. Multivariate analysis clearly shows that delivery complications was the most significant factor determining the use of modern health care resources for childbirth, followed by parental education, and pre-natal care. We conclude that quick response to delivery complications and improved access to hospitals and TTBAs can reduce the risk of infant and maternal mortality and morbidity in rural Bangladesh.
PLOS ONE, 2022
Background Skilled birth attendants (SBAs) play a crucial role in reducing infant and maternal mortality. Although the ratio of skilled assistance at birth has increased in Bangladesh, factors associated with SBA use are unknown. The main goal of our study was to reveal the individualand community-level factors associated with SBA use during childbirth in Bangladesh. We also showed the prevalence and trend of SBA use and related independent variables in Bangladesh over the past decade. Methods This study utilized the Bangladesh Health and Demographic Survey (BDHS) 2017-2018, a cross-sectional study. We used binary logistic regression to examine the extent of variation in SBA use attributable to the individual-and community-level variables. Results Overall, 53.35% of women received assistance from SBAs during childbirth. The average annual rate of increase (AARI) in the number of SBA-assisted births over the past 10 years was 8.88%. Respondents who gave birth at or above 19 years had 1.40 times (AOR = 1.40; 95% CI: 1.21-1.62) greater odds of having skilled delivery assistance than respondents aged 18 years old or less. Women and their husband's education levels were significantly associated with using skilled assistance during delivery, with odds of 1.60 (AOR = 1.60; 95% CI: 1.45-2.01) and 1.41 (AOR = 1.41; 95% CI: 1.21-1.66), respectively compared to those with education up to primary level. Women from rich families and those receiving better antenatal care (ANC) visits were more likely to have professional delivery assistance. Community-level factors also showed significance towards having professional assistance while giving birth. Women from urban communities and those who utilized more than four
PloS one, 2016
Although Bangladesh has made significant progress in reducing maternal and child mortality in the last decade, childbirth assisted by skilled attendants has not increased as much as expected. An objective of the Bangladesh National Strategy for Maternal Health 2014-2024 is to reduce maternal mortality to 50/100,000 live births. It also aims to increase deliveries with skilled birth attendants to more than 80% which remains a great challenge, especially in rural areas. This study explores the underlying factors for the major reliance on home delivery with Traditional Birth Attendants (TBA) in rural areas of Bangladesh. This was a qualitative cross-sectional study. Data were collected between December 2012 and February 2013 in Sunamganj district of Sylhet division and data collection methods included key informant interviews (KII) with stakeholders; formal and informal health service providers and health managers; and in-depth interviews (IDI) with community women to capture a range o...
Journal of Health Research, 2021
PurposeThe aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice of delivery place in rural Bangladesh.Design/methodology/approachThe data for the study come from a community-based cross-sectional study conducted among 464 mothers in a rural sub-district of Bangladesh in 2019. Respondents were selected randomly from the frame listing all mothers with inclusion criteria, using a two-stage cluster sampling design. Data were collected through a face-to-face interview. Both descriptive and inferential statistics and logistic regression models were used for data analysis.FindingsThe results indicate a very high rate (58%) of home delivery. About 20% mothers never received ANC visit. Preference for home delivery was high (63%). Mothers with no education, aged 30 and above, multi-parity, low wealth status, lack of knowledge about institutional delivery, no or <4 ANC visits, r...
International Journal of Clinical Practice
Background. SBAs (skilled birth attendants) play a crucial role in reducing maternal mortality. The proportion of maternal healthcare in Bangladesh that receives quality care at birth has increased; the reasons for this are unknown. The purpose of this study is to see if there has been a change in the use of specific maternal healthcare indicators in urban and rural areas, as well as significant risk factors. Materials and Methods. The data set was extracted from a nationally representative survey based on a cross-sectional study, the Bangladesh Health and Demographic Survey (BDHS) 2017-18. The frequency distribution reveals the general state of SBAs. To identify the association, we performed the chi-square test. Finally, multiple logistic regression was used to analyse the factors associated with SBAs and determine the degree of SBAs disparity between urban and rural areas. Results. In Bangladesh, 53% of women received SBAs during childbirth, with urban and rural areas receiving 68...
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.
Utilization of Antenatal Care, Skilled Birth Assistant and Institutional Delivery in Bangladesh
Dhaka University Journal of Science, 2018
Maternal mortality is an important phenomenon to assess the overall health status of a society. To reduce maternal mortality the worldwide recognized vital three factors are: antenatal care, presence of skilled birth assistance and selection of place of delivery. This study made an initiative to identify potential risk factors which can influence the three factors employing the Bangladesh D emographic and Health Survey (BDHS), 2014 data. The parameters are estimated using Poisson count model and Logistic regression model. The estimation results indicate that mother's education level, place of residence, mother's age at birth, wealth index, husband's education level, media exposure and region are significant factors for antenatal care visits. The significant factors for skilled birth assistance are mother's education level, place of residence, wealth index, media exposure and husband's education level where as place of residence, mother's education level, wealth index, media exposure and husband's education level are significant factors for selection of place of delivery. These results may help the policy makers to develop policies that may facilitate the reduction of maternal mortality in Bangladesh.
Practices and determinants of delivery by skilled birth attendants in Bangladesh
Reproductive Health, 2014
Introduction: Utilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh. Birth attendance by SBAs is considered as the "single most important factor in preventing maternal deaths". This paper examined the practices and determinants of delivery by SBAs in rural Bangladesh. Methods: The data come from the post-intervention survey of a cluster-randomized community controlled trial conducted to evaluate the impact of limited post-natal care (PNC) services on healthcare seeking behavior of women with a recent live birth in rural Bangladesh (n = 702). Multivariable logistic regression model was used to identify the potential determinants of delivery by SBAs. Results: The respondents were aged between 16 and 45, with the mean age of 24.41 (± 5.03) years. Approximately one-third (30.06%) of the women had their last delivery by SBAs. Maternal occupation, parity, complications during pregnancy and antenatal checkup (ANC) by SBAs were the significant determinants of delivery by SBAs. Women who took antenatal care by SBAs were 2.62 times as likely (95% CI: 1.66, 4.14; p < 0.001) to have their delivery conducted by SBAs compared to those who did not, after adjusting for other covariates. Conclusion: Our findings suggest that ANC by SBAs and complications during pregnancies are significant determinants of delivery by SBAs. Measure should be in place to promote antenatal checkup by SBAs to increase utilization of SBAs at birth in line with achieving the Millennium Development Goal-5. Future research should focus in exploring the unmet need for, and potential barriers in, the utilization of delivery by SBAs.
MOJ Public Health, 2018
The rate of home delivery and role of traditional birth attendants are declining rapidly. The aim of this study was to find out the current situation of home delivery and participation of birth attendants in Dhaka City regarding safe motherhood. A descriptive cross-sectional study was conducted in this research. This study found that 53.9% baby was delivered normally and 45.9% baby was delivered by surgical operation during study period. Institutional delivery rate was 75.5% in this study (37.7% in Clinic, 35.6% in Hospital, and 2.3% health care center) and one forth (24.5%) was delivered in home. The type of delivery was significantly related to maternal age, education and income level. In case of birth attendants, 56.2% babies were delivered by health service personnel, 35.2% by TTBA and 8.7% babies were delivered by TBA. Maternal education, pre-pregnancy nutritional status and family income have strong effect on type of birth attendants. Type of birth attendants had strong correlation with maternal age (p=0.000) and family income (p=0.000) and had association with parental education (p=0.000). Types of delivery (p=0.000), place of delivery (p=0.000), bleeding after delivery (p=0.000) were significantly associated with birth attendants. Moreover, infection after delivery (p=0.000), treatment with antibiotics (p=0.000) had significant association with birth attendants. It can be concluded that rate of home delivery and involvement of TBA in pregnancy outcome decreasing day by day which is strongly related with maternal age, education and family income. Type of birth attendants is also related with other obstetric care services in Dhaka City.