Inequalities in Utilization of Maternal Reproductive Health Care Services in Urban Bangladesh: A Population-Based Study

Abstract

This study examined inequalities in the utilization of maternal reproductive health care services in urban Bangladesh. Data of 6,617 urban women were extracted from most recent two rounds of Bangladesh Demographic and Health Survey, conducted in the years 2011 and 2014. Inequalities in the utilization of antenatal checkup, receiving care from a skilled birth attendant, delivery in health care facilities, and postnatal care were investigated through concentration index. Contributions of selected predictors to inequalities were estimated by using the regression-based decomposition method. Noticeable inequalities were observed. Concentration index for utilization of at least one antenatal care visit was 0.09, four or more antenatal visits was 0.17, care from skilled birth attendant was 0.16, delivery care in health care facilities was 0.17, and postnatal care within 2 days of delivery was 0.19. Exposure to mass media, educational status of women and their spouses, wealth status, employment, birth order, and age of pregnancy were significant determinants of inequalities. There was a gradient in the utilization of services when examined across wealth status. Those with unfavorable social determinants of health reported low levels of utilization. Alongside providing tailored health care services to urban poor women, efforts should be made to reduce inequalities in social determinants of health.

Assessing the effect of pregnancy intention at conception on the continuum of care in maternal healthcare services use in Bangladesh: Evidence from a nationally representative cross-sectional survey

“…For instance, the patriarchal system in Bangladesh often restricts women’s decision-making capability and the economic affordability of visiting healthcare facilities. Besides, cultural norms within Islam (the religion of more than 90% of the total population in Bangladesh) do not permit women to leave their homes while pregnant, with pregnant women believed to be highly vulnerable to evil spirits (one reason why their mobility is restricted, particularly during delivery and soon after childbirth) [ 68 ]. These practices are even more prevalent among women with disadvantaged individual-, household-, and community-level characteristics (e.g.…”

Assessing Risk Factors for Short Birth Interval Hot Spots using Geographically Weighted Regression: Findings from a Nationally Representative Survey Data

“…Our results also suggest that these factors are the signi cant predictors of SBI in the SBI hot spots area in the Sylhet division. A possible reason for such association is that couples with these characteristics are less likely to access maternal healthcare services, including intrapartum, birthing, and post-partum care [33][34][35] .…”

“…Providing integrated reproductive healthcare services may help improve the current service delivery. Also, tailoring service modality considering the divisional level barriers is needed 36 , as it is not possible in the current uniform top-down policy approach 35,36 .…”

Drivers of Utilization, Quality of Care, and RMNCH-N Services in Bangladesh: A Comparative Analysis of Demand and Supply-Side Determinants using Machine Learning for Investment Decision-Making

“…division), residence and sociodemographic groups; the role of individual determinants (e.g., age and birth order) has less influential after 2015. 27,28 The persistent efforts of the government in integrating community needs into the safe motherhood programs, identifying local needs through community-based platforms and mainstreaming NGOs into community health, are worth acknowledging here as success factors. 27 The study found two exceptions to the above findings.…”