Levels and determinants of quality antenatal care in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey

Abstract

Background Assessing the quality of antenatal care (ANC) is imperative for improving care provisions during pregnancy to ensure the health of mother and baby. In Bangladesh, there is a dearth of research on ANC quality using nationally representative data to understand its levels and determinants. Thus, the current study aimed to assess ANC quality and identify the sociodemographic factors associated with the usage of quality ANC services in Bangladesh. Methods Secondary data analysis was conducted using the last two Bangladesh Demographic and Health Surveys (BDHSs) from 2014 and 2017–18. A total of 8,277 ever-married women were included in the analysis (3,631 from 2014 and 4,646 from 2017–18). The quality ANC index was constructed using a principal component analysis on the following ANC components: weight and blood pressure measurements, blood and urine test results, counselling about pregnancy complications and completion of a minimum of four ANC visits, one of which was performed by a medically trained provider. Multinomial logistic regression was used to determine the strength of the association. Results The percentage of mothers who received all components of quality ANC increased from about 13% in 2014 to 18% in 2017–18 (p < 0.001). Women from the poorest group, those in rural areas, with no education, a high birth order and no media exposure were less likely to receive high-quality ANC than those from the richest group, those from urban areas, with a higher level of education, a low birth order and media exposure, respectively. Conclusion Although the quality of ANC improved from 2014 to 2017–18, it remains poor in Bangladesh. Therefore, there is a need to develop targeted interventions for different socio-demographic groups to improve the overall quality of ANC. Future interventions should address both the demand and supply-side perspectives.

Women’s Decision-Making Autonomy as a Mitigating Factor for Complete Antenatal Care Coverage: Evidence from Bangladesh Demographic and Health Survey, 2017-18

“…But in this study, therefore, the correlation between the observations is avoided in the analysis. Also due to data limitations, several important confounding factors that may influence the uptake of quality ANC could not be addressed, such as cost of care, availability of healthcare facilities, and knowledge about antenatal healthcare services [42].…”

Socio-economic status and pregnancy complications and their impact on antenatal care services provided at home and Upazila health complex

“…During the whole pregnancy period and even after childbirth, skilled maternity care could save the lives of pregnant mothers and their newborn children [ 6 ]. Quality antenatal care can mitigate low childbirth weight and premature childbirth along with pregnancy complications [ 7 ]. This procedure consists of supplementation, vaccination, health-related education, and counseling which are also good for reducing the death of newborns [ 8 ] World Health Organization (WHO) recognized antenatal care as a defensive factor for any successful childbirth [ 9 ].…”