Antenatal care in rural Bangladesh: Gaps in adequate coverage and content

Siddique, Abu; Perkins, Janet; Mazumder, Tapas; Haider, Mohammad Rifat; Banik, Goutom; Tahsina, Tazeen; Islam, Md. Jahurul; Arifeen, Shams El; Rahman, Ahmed Ehsanur

doi:10.1371/journal.pone.0205149

Cited by 44 publications

(72 citation statements)

References 37 publications

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“…Consistent with other studies conducted in the context of rural Bangladesh, we found the coverage of ANC to be relatively low compared to the ambitious targets set at the global and national level (8,12,34,35). With less than one-tenth of women attending at least four ANC contacts, the global vision of women attending eight visits as proposed in the most recent WHO guidelines seem that it will be di cult to achieve in the near term (2).…”

Section: Discussionsupporting

confidence: 90%

“…It can reduce maternal and neonatal morbidity and mortality, and stillbirths through prevention, early identi cation and management of pregnancyrelated complications or pre-existing conditions (4)(5)(6). However, the quality of this care is often compromised in resource-scarce settings where women and newborns face the greatest risks to their health and well-being (7,8).…”

Section: Page 3/24mentioning

confidence: 99%

“…Previous studies have suggested that the technical content of ANC contacts is suboptimal in facilities (1,8), particularly in rural settings (13). Others have found that health facilities in rural areas often lack functioning equipment, ANC/PNC registers, essential medicines, electricity, and running water to provide quality ANC (14)(15)(16)(17)(18).…”

Section: Page 3/24mentioning

confidence: 99%

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Quality of antenatal care experience in rural Bangladesh: social support, respect, dignity, communication and counselling

Mhajabin

Perkins

Siddique

et al. 2020

Preprint

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Background Quality antenatal care (ANC) can contribute to reducing maternal and neonatal morbidity and mortality. Very little information is available on the experience of care during ANC contacts in Bangladesh. This study aims to understand social support received by women, their experience of respect and dignity, and quality of communication and counselling during ANC contacts in rural Bangladesh for improving the quality of ANC services. Methods A cross-sectional household survey was administered in three upazillas (sub-districts) of Bangladesh in 2018. We defined the experience of care as reported by women using three indicators: social support received, respect and dignity experienced, quality of communication and counselling. Associations between explanatory and outcome variables were explored through binary and multiple logistic regression models controlling for background characteristics and health system contacts. Findings: Most women (79%) reported having any social support during their ANC contacts, i.e. someone was present during the ANC contact. More than half the women desired their husbands’ presence during their ANC contact while only one-fourth of the husbands were present. Experiences regarding different aspects of respect and dignity were mixed. Almost all women reported that their visual (94%) and auditory privacy (94%) were maintained. However, only in 58% of the ANC contacts the health service providers sought permission before carrying physical examination. Less than half of the women reported that the health services listened to their problems, assessed the overall situation and encouraged women to take part in the discussion during ANC counselling. After adjusting for background characteristics and other covariates, the odds of experiencing respect and dignity and the odds of receiving quality communication and counselling were significantly higher (AOR 1.9 and 16 respectively at p < 0.5) when the women were accompanied by someone during ANC contact. Conclusion Ensuring quality ANC in Bangladesh required focusing on addressing the existing gaps in the experience of care for a positive pregnancy experience. This study presents the importance of social support in improving the experience of care and suggests further research to identify effective interventions for the integration of quality of care components in this context.

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Section: Discussionsupporting

confidence: 90%

Section: Page 3/24mentioning

confidence: 99%

Section: Page 3/24mentioning

confidence: 99%

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Quality of antenatal care experience in rural Bangladesh: social support, respect, dignity, communication and counselling

Mhajabin

Perkins

Siddique

et al. 2020

Preprint

Self Cite

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“…Antenatal care (ANC) provides a unique window of opportunity to ensure a healthy pregnancy through ensuring healthy weight gain and proper nutrition (e.g. intake of iron and folic acid), taking necessary immunizations packages such as tetanus toxoid and antimalarial drugs, controlling gestational diabetes, hypertension, and many other pregnancy related medical conditions [4,6,7].…”

Section: Introductionmentioning

confidence: 99%

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Yaya¹,

Oladimeji

et al. 2019

BMC Pregnancy Childbirth

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Background:In low-income countries with poor coverage of healthcare services such as Mozambique, antenatal care serves as a vital tool for providing life-saving and cost-effective services for pregnant mothers. Nonetheless, many countries in Africa, including Mozambique, are struggling to attain an optimum level of antenatal care (at least 4 visits) utilisation among pregnant women. In the present study, we aimed to assess the sociodemographic and economic factors associated with antenatal care use in Mozambique. Methods: Cross-sectional data from the latest round of Mozambique Demographic and Health Survey (2011) on women aged 15-49 years (n = 7080) were analysed. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analysed using descriptive and multivariate regression methods. The predictor variables included various demographic (e.g. age, parity), empowerment (e.g. type of employment, household wealth status) and sociocultural factors (e.g. ethnicity, religion). Results: Of the 7080 women whose data was analyzed, 15.3 and 60.1% had early and adequate ANC visits respectively while 75.4% received HIV test during ANC visits. The odds of early ANC visits were higher [OR = 1.300, 95%CI = 1.062, 1.592] among women in the rural areas compared with those in the urban areas. However, participants in rural areas had lower odds [OR = 0.788, 0.687,0.902] of receiving HIV tests during ANC visits. Women in the urban areas with secondary [OR = 1.296, 95%CI = 1.007,1.666] and higher [OR = 1.663, 95%CI = 1.052,2.628] education had higher odds of having early ANC visit. Those in the higher wealth quintiles also had significantly increased odds of using all three types of ANC indicators, particularly for rural women in the highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Being within the higher wealth quintiles was found to significantly increase the odds of using all three types of ANC indicators, particularly women from rural areas with highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Conclusion: About two-fifth of the women in Mozambique are not using adequate antenatal care and about and a quarter do not take HIV tests during pregnancy. The sources of low and unequal use of these vital health services might be rooted in women's socioeconomic status and cultural issues that require special policy and research attention.

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“…Antenatal care (ANC) offers a distinctive platform that ensures a healthy pregnancy through; promotion of healthy weight gain and proper nutrition (e.g. intake of iron and folic acid), encouraging the uptake of necessary immunization packages such as tetanus toxoid and antimalarial drugs, controlling gestational diabetes, hypertension, and other pregnancy-related medical conditions [3][4][5]. Through ANC visits, pregnant women can easily follow up on the growth of the fetus, their own health including HIV status with focus on prevent mother-tochild transmission of HIV [6][7][8], a key contributor to childhood HIV in Africa [9,10].…”

Section: (Continued From Previous Page)mentioning

confidence: 99%

Prenatal care and uptake of HIV testing among pregnant women in Gambia: a cross-sectional study

Yaya

Oladimeji

et al. 2020

BMC Public Health

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Background: Improving the coverage of antenatal care is regarded as an important strategy to reduce the risks of maternal and child mortality in low income settings like Gambia. Nonetheless, a large number of countries in Africa, including Gambia, are struggling to attain an optimum level of healthcare utilization among pregnant women. The role of socioeconomic inequalities in maternal healthcare uptake has received little attention in Gambia. To address this evidence gap, the present study analyses nationally representative data to explore the socioeconomic inequalities in the use of maternal healthcare. Methods: Data on women aged 15-49 years (n = 5351) were extracted from the latest round of Gambia Demographic and Health Survey in 2013 for this study. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analyzed using descriptive and multivariate regression methods. Socioeconomic status was assessed through the women's education, type of employment, and household wealth quintile. Results: From the total of 5351 participants included in the study, 38.7 and 78.8% of the women had early and adequate ANC visits respectively with a 65.4% HIV test coverage during ANC visits. The odds of early [OR = 1.30, 95% confidence interval (CI) =1.06, 1.59] and adequate [OR = 1.45, 95%CI = 1.15, 1.82] ANC visits were higher in the rural areas compared with urban. Women with secondary [OR = 1.24, 95%CI = 1.04, 1.48] and higher education [OR = 1.80, 95%CI = 1.20, 2.70] had higher odds of making early ANC visits. Women from richest wealth quintile households had significantly higher odds of having early [OR = 1.49, 95%CI = 1.14, 1.95] and adequate ANC visits [OR = 2.06, 95%CI = 1.48, 2.87], but not of having HIV tests. Having access to electronic media showed a positive association with adequate ANC visits [OR = 1.32, 95%CI = 1.08, 1.62] and with taking HIV test during ANC [OR = 1.48, 95%CI = 1.21, 1.80]. A fewer odds of having unintended child was associated with early ANC visit [OR = 0.70, 95%CI = 0.59, 0.84], but positively associated with taking HIV test [OR = 1.75, 95%CI = 1.42, 2.15]. (Continued on next page)

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Antenatal care in rural Bangladesh: Gaps in adequate coverage and content

Cited by 44 publications

References 37 publications

Quality of antenatal care experience in rural Bangladesh: social support, respect, dignity, communication and counselling

Quality of antenatal care experience in rural Bangladesh: social support, respect, dignity, communication and counselling

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Prenatal care and uptake of HIV testing among pregnant women in Gambia: a cross-sectional study

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