Determinants of the use of maternal health services in rural Bangladesh

Abstract

Utilization of health services is a complex behavioral phenomenon. Empirical studies of preventive and curative services have often found that use of health services is related to the availability, quality and cost of services, as well as to social structure, health beliefs and personal characteristics of the users. In this paper an attempt is made to examine the factors associated with the use of maternal health care services in Bangladesh on the basis of data from a survey of maternal morbidity in Bangladesh, conducted by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT). The results from both the bivariate and multivariate analyses confirmed the importance of mother's education in explaining the utilization of health care services. Female education retains a net effect on maternal health service use, independent of other women's background characteristics, household's socioeconomic status and access to healthcare services. The strong influence of mother's education on the utilization of health care services is consistent with findings from other studies. Women whose husbands are involved in business/services also positively influenced the utilization of modern health care services. However, the study results are inconclusive with respect to the influence of other predisposing and enabling factors, such as women's age, number of previous pregnancies and access to health facilities. Multivariate logistic regression estimates do not show any significant impact of these factors on the use of maternal health care. The influence of severity of disease condition in explaining the utilization of maternal health care appears to be significant. Multivariate analysis indicate that women having had a life-threatening condition are little over two times more likely to seek care from a doctor or nurse to treat their maternal morbidities.

Analysis of Socio-Economic Characteristics and Utilization of Healthcare Facilities in Owo Local Government Area of Ondo State, Nigeria

“…This level of utilization have been said to be influenced by the following factors some of which include; availability, quality and cost of services, as well as social-economic structure, and personal characteristics of the users (Chakraborty et al, 2003;Onah et al 2009). Moreover, Leive and Xu (2008) asserted that a number of factors have been showed to be potential barriers in assessing healthcare services and these include distance and cost of travel to the health facility, socio-cultural factors and cost of service especially in developing countries of the world.…”

“…Various studies in developing countries has consistently showed that acquired western education tend to be strongly and positively associated with utilization of healthcare facilities and services (Chakraborty et al, 2003;Kamal, 2009). It has been established that the higher a woman's level of education the more likely she is to utilize maternal healthcare services (MCHS).…”

“…The type of facility visited, duration of visit and action taken after sickness is a function of their income. It has been established that an increase income play a substantial role in determining the rate at which people patronize the healthcare facilities (Elo, 1992 cited in Chakraborty et al, 2003). This is because the cost of seeking healthcare may include costs for transportation, user fees, medications and other supplies which people who are not earning enough or from poor background, may not have the ability to afford such, this is likely to discourage them from patronizing the available healthcare facilities because of the inability to pay for it (Adamu, 2011 …”

Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach

“…Many studies have approached the use of health care services as a behavioral phenomenon (Becker et al, 1993;Chakraborty et al, 2003), while the quality and cost of and access to services are not included. Recently, analysis using the National Family Health Survey -1 (NFHS -1) indicated that community access to health facilities is not an important factor in explaining the utilization of various antenatal care services (Das et al 2001).…”

Users Experiences and Perceptions on Maternal Healthcare Services in Siaya County, Western Kenya: A Qualitative Study.

“…Moreover, unskilled persons attend to about 50% of deliveries by Kenyan women [12]. The low utilization of skilled maternal healthcare services has been attributed to cost of service, distance, quality of service, culture, birth order, living conditions of the mother, type of place or residence, level of education, wealth and weak healthcare infrastructure [10,[12][13][14]. Siaya County is one of the counties in Kenya with high maternal mortality ration (MMR) that is above the national average of 495 deaths for every 100,000 live births, with most of these deaths being attributed to home deliveries and low utilization of skilled maternal healthcare services [11].…”