Practices and determinants of delivery by skilled birth attendants in Bangladesh

Islam, Nazrul; Islam, Mohammad Tajul; Yoshimura, Yukie

doi:10.1186/1742-4755-11-86

Cited by 54 publications

(51 citation statements)

References 24 publications

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“…The finding of our study that education level of the women and their husbands had association with delivery attendance is supported by other studies (8,9,11). The educated couples might be more aware of the importance of skilled attendance during delivery.…”

Section: Discussionsupporting

confidence: 91%

“…Women who received antenatal check-up from a skilled provider were more likely to be delivered by skilled attendants than the women who were not checked by a skilled health care provider. Other studies also found a similar association (8,9,11,12). The increased likelihood of skilled attendance could have an association with receiving information and counseling from the health care providers regarding the importance of safe delivery attendance during that period.…”

Section: Discussionsupporting

confidence: 65%

“…A total of 7,000 CSBAs have been trained by the year 2012. Their lower utilization has been found by several studies from Bangladesh (9,31). A re-evaluation of the CSBA training program is required.…”

Section: Discussionmentioning

confidence: 66%

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Birth attendance in rural Bangladesh: practices and correlates

Korim

2018

Preprint

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 65%

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Birth attendance in rural Bangladesh: practices and correlates

Korim

2018

Preprint

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“…Earlier studies that examined factors associated with care seeking found that women belonging to wealthier households were more likely to seek skilled care for antepartum complications [11, 13]. Factors associated with skilled birth attendants during intrapartum period included mothers’ occupation, higher parity, complications during antepartum period, having antenatal care [14], and closer distance to a health facility [13, 15, 16]. In addition, access to skilled attendants, availability of quality care and associated medical cost remained major barriers to seeking care [11].…”

Section: Introductionmentioning

confidence: 99%

Patterns and Determinants of Care-Seeking for Antepartum and Intrapartum Complications in Rural Bangladesh: Results from a Cohort Study

et al. 2016

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BackgroundThe burden of maternal complications during antepartum and intrapartum periods is high and care seeking from a trained provider is low, particularly in low middle income countries of sub-Saharan Africa and South Asia. Identification of barriers to access to trained care and development of strategies to address them will contribute to improvements in maternal health. Using data from a community-based cohort of pregnant women, this study identified the prevalence of antepartum and intrapartum complications and determinants of care-seeking for these complications in rural Bangladesh.MethodsThe study was conducted in 24,274 pregnant women between June 2011 and December 2013 in rural Sylhet district of Bangladesh. Women were interviewed during pregnancy to collect data on demographic and socioeconomic characteristics; prior miscarriages, stillbirths, live births, and neonatal deaths; as well as data on their ability to make decision to go to health center alone. They were interviewed within the first 7 days of child birth to collect data on self-reported antepartum and intrapartum complications and care seeking for those complications.Bivariate analysis was conducted to explore association between predisposing (socio-demographic), enabling (economic), perceived need, and service related factors with care-seeking for self-reported antepartum and intrapartum complications. Multivariable multinomial logistic regression was performed to examine the association of selected factors with care-seeking for self-reported antepartum and intrapartum complications adjusting for co-variates.ResultsSelf-reported antepartum and intrapartum complications among women were 14.8% and 20.9% respectively. Among women with any antepartum complication, 58.9% sought care and of these 46.5% received care from a trained provider. Of the women with intrapartum complications, 61.4% sought care and of them 46.5% did so from a trained provider. Care-seeking for both antepartum and intrapartum complications from a trained provider was significantly higher for women with higher household wealth status, higher literacy level of both women and their husbands, and for those living close to a health facility (<10 km). Women’s decision making ability to go to health centre alone was associated with untrained care only for antepartum complications, but was associated with both trained and untrained care for intrapartum complications.ConclusionsNearly 40.0% of the women who experienced either an antepartum or intrapartum complications did not seek care from any provider and 11.5% -14.9% received care from untrained providers, primarily because of economic and geographic barriers to access. Development and evaluation of context specific, cost-effective, and sustainable strategies that will address these barriers to access to care for the maternal complications will enhance care seeking from trained health care providers and improve maternal health.

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“…Additionally, the number of nurses and midwives is falling sharply; the latest data found in 2011 was 0.22 in per 1000 people [1]. Approximately 3 million births take place yearly in Bangladesh and a 20% rise of institutional delivery means that at least an extra 600,000 deliveries need to be conducted at the health facilities [24]. In general, the present health facilities in Bangladesh are not ready to handle these large numbers of deliveries with SBAs.…”

Section: Human Resourcesmentioning

confidence: 99%

Access to a Skilled Birth Attendant in Bangladesh: What We Know and what Health System Framework can Teach Us

Saha¹,

Odjidja²

2017

Health Syst Policy Res

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Despite some visible progress in some areas of health sectors, Bangladesh is still struggling to sustain efforts towards decreasing Maternal Mortality Rate (MMR). Evidence shows that there is lower access to skilled birth attendant in Bangladesh. Access to skilled birth attendants (SBAs) during delivery has been identified as an effective mechanism to significantly reducing MMR. Previous studies have focused on socio-demographic characteristics of women including cultural and religious dynamics with communities with limited attention to the health system. Using the World Health Organisation's health system strengthening framework, this paper analyses how health system 'architecture' playing role in create fragile platform for the women to access skilled birth attendants. It draws emphasis on governance and policy, financing, health information, workforce, service delivery, medicines and commodities including infrastructure. As governance is the dominant factor and plays critical role in determining success of all facets of the health system, this paper further proposes a systematic strategy that seeks to mitigate the identified challenges. Lessons from this study are relevant to guiding policy makers in Bangladesh as well as in other resource-constrained settings in making evidencebased decisions regarding strengthening the health system to access a skill birth attendant to make birth safer for both mothers and newborns.

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Practices and determinants of delivery by skilled birth attendants in Bangladesh

Cited by 54 publications

References 24 publications

Birth attendance in rural Bangladesh: practices and correlates

Birth attendance in rural Bangladesh: practices and correlates

Patterns and Determinants of Care-Seeking for Antepartum and Intrapartum Complications in Rural Bangladesh: Results from a Cohort Study

Access to a Skilled Birth Attendant in Bangladesh: What We Know and what Health System Framework can Teach Us

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