Adopting Andersen’s behavior model to identify factors influencing maternal healthcare service utilization in Bangladesh

Abstract

Background Equitable maternal healthcare service access and it’s optimum utilization remains a challenge for many developing countries like Bangladesh, and different predisposing, enabling, and need-based factors affect the level of maternal healthcare use. The evidently poor maternal healthcare service utilization and disparities among groups in Bangladesh are concerning considering its effect on maternal health outcomes. The study aimed to identify the factors that influence maternal healthcare service (MHS) utilization in Bangladesh by adopting Andersen’s behavior model of health service use as the theoretical framework. Methods The 2017–18 Bangladesh Demographic Health Survey (2017–18 BDHS) data were used which is nationally representative. The survey study used two-stage stratified sampling to select study households, and data were collected through face-to-face interviews. The desirable, moderate, and undesirable maternal health service (MHS) package was developed based on antenatal, and delivery care services use during pregnancy and childbirth. Multinomial logistic regression and discriminant analysis were performed to analyze the factors that affect MHS use. Results Out of 5,011 ever-married women, only 31.2% of women utilized the desirable level of MHS. The likelihood of using the desirable level of MHS package, relative to the undesirable category, was 9.38 times (OR: 9.38, 95% CI: 4.30–20.44) higher for women with a higher level of education compared to illiterate women, and the same trend was noticed for husband’s education. The wealth index had the highest standardized function coefficients (Beta coefficient: 0.49) in discriminatory function. Women with the richest wealth index were more than 23 times (OR: 23.27, 95% CI: 12.69–42.68) likely to have utilized desirable MHS than their poorest counterparts. The likelihood of service uses also varied according to the child’s birth order, administrative regions, and area of residence (rural vs. urban). Conclusions Policies and interventions directed towards poverty reduction, universal education, and diminishing geographical disparities of healthcare access might influence the desirable use of maternal healthcare services in Bangladesh.

How do traditional media access and mobile phone use affect maternal healthcare service use in Bangladesh? Moderated mediation effects of socioeconomic factors

“…Given that Bangladesh’s maternal mortality rate is perilously close to the danger level, any chance to increase maternal health service utilization should be seized with both hands. In Bangladesh, desirable maternal healthcare utilization (when women make the necessary number of ANC visits and deliver at a health facility) is still a long way off, and it is critical to make an effort to promote health service utilization concurrently with socioeconomic improvements [ 1 ].…”

“…Insufficient health education [ 4 , 5 ] and lack of information [ 3 ] are major considerations that repeatedly resonate when deciding to use maternal health care. For this reason, it is important to consider how to inform women about their own healthcare better and increase the idea that they should use health services more frequently in low- and medium-income settings, given the lack of awareness that comes from women’s poor education, socioeconomic disparities, [ 1 , 6 ] and the systematic failure of health systems to meet health service expectations [ 7 , 8 ]. In that manner, they may be able to grasp the severity of the problem, appraise the risks, and realize their own health rights to ensure that the pregnancy outcomes are not harmed [ 9 ].…”

“…Several socioeconomic-demographic characteristics were found to be significant in the research of maternal health service utilization, with the educational attainment of women and household wealth status topping the list. Apart from that, rural-urban residency, women’s age, and religion all have an effect on how much antenatal, delivery and postnatal care is used [ 1 , 21 ]. To better understand women’s socioeconomic vulnerability in relation to health service usage, this study examines the mediating function of women’s education in the link between media, mobile access, and MHS use.…”

Factors influencing health service utilization among mothers for under-five children: A cross-sectional study in Khulna district of Bangladesh

“…This model has recently been applied in numerous systematic reviews on different aspects of healthcare utilization to structure their results [23][24][25][26]. The behavioral model has been applied in the present study to assess the factors influencing the utilization of healthcare services for under-five children (Fig 1).…”

“Do we even have a voice?” Health providers’ perspective on the patient accommodation strategies in Bangladesh

“…The communication accommodation theory [ 12 ] is extrapolated to understand the health providers’ accommodation techniques in response to patient needs and expectations. This study seeks to advance knowledge by examining the context of Bangladesh, where the optimal level of maternal health service usage is very low [ 13 ], despite widespread concern about maternal deaths.…”