Birth attendance in rural Bangladesh: practices and correlates

Abstract

IntroductionThe maternal mortality ratio (MMR) and neonatal mortality rate (NMR) are higher in the rural regions of Bangladesh compared to the urban areas or the national average. These two rates could be reduced by increasing use of skilled birth attendance in rural regions of this country. Although the majority of Bangladeshi population lives in rural areas, there has been a little investigation of the practices and determinants of delivery attendance in this region of Bangladesh. This study investigated the practices and determinants of attendance during child-births in rural Bangladesh.MethodsData were collected by the 2014 Bangladesh Demographic and Health Survey (BDHS 2014). After reporting the distribution of deliveries by types of attendance and distribution of selected factors, logistic regression was applied to calculate the crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs), and p-values.ResultsMore than half of the deliveries (53.1%) were conducted by traditional attendants; community skilled attendants were present in only a small number of deliveries. The following factors were positively associated with deliveries by skilled attendants: 25-34 years age group of women (adjusted odds ratio (AOR): 1.4; 95% CI: 1.1-1.8), a higher education level of women (AOR: 2.9; 95% CI: 1.7-4.9), or their husbands (AOR: 2.4; 95% CI: 1.6-3.7), receiving antenatal care (AOR: 2.1; 95% CI: 1.6-2.7), and higher wealth quintiles (AOR of the richest wealth quintile vs the poorest: 3.5; 95% CI: 2.3-5.3). On the other hand, women having a higher parity (i.e., number of pregnancy, ≥2) led to a lower likelihood of delivery by skilled birth attendants. The proportion of deliveries attended by skilled attendants was significantly lower in the other six divisions compared to Khulna.ConclusionsSocioeconomic factors should be considered to design future interventions to increase the proportion of deliveries attended by skilled delivery attendants. Awareness programs are required in rural areas to highlight the importance of skilled attendants. Further re-evaluation of the community skilled birth attendants program is required.