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Maternal Pregnancy Intention and Antenatal Care Seeking Behaviors in Bangladesh: Evidence From Bangladesh Demographic and Health Survey, 2018.

ABSTRACT: Objective: This study aimed to examine the association between pregnancy intention and antenatal care (ANC)-seeking behaviors among women in Bangladesh. Methods: ANC-related data of 5,012 women, from the 2018 Bangladesh Demographic and Health Survey (BDHS), who had a live birth within 3 years preceding the survey were analyzed in the study. Multivariate logistic regression models were used to assess the association of pregnancy intention with ANC utilization. Results: Approximately one-fifth (20.9%) of the women had unintended pregnancy. Among all the women, 40.4% received their first ANC visit within the first three months of pregnancies, 47% had at least four ANC visits, 26.1% received all the components of ANC services, and 22.2% received an adequate dosage of supplementary iron-folic acid tablets/syrup. Women with unintended pregnancy were less likely to receive their first ANC visit within the first 3 months, four or more ANC visits, and all ANC services than those with intended pregnancy. Conclusion: Unintended pregnancy was inversely associated with the proper utilization of ANC among women in Bangladesh. Appropriate measures to reduce unintended pregnancy might foster the utilization of optimum antenatal care.

SUBMITTER: Islam MH

PROVIDER: S-EPMC10366356 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Maternal Pregnancy Intention and Antenatal Care Seeking Behaviors in Bangladesh: Evidence From Bangladesh Demographic and Health Survey, 2018.

Islam Md Hafizul MH Jubayer Ahmed A Nayan Md Moniruzzaman MM Nowar Abira A Islam Saiful S

International journal of public health 20230711

Objective: This study aimed to examine the association between pregnancy intention and antenatal care (ANC)-seeking behaviors among women in Bangladesh. Methods: ANC-related data of 5,012 women, from the 2018 Bangladesh Demographic and Health Survey (BDHS), who had a live birth within 3 years preceding the survey were analyzed in the study. Multivariate logistic regression models were used to assess the association of pregnancy intention with ANC utilization. Results: Approx ...[more]

PMID: 37497121

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Project description:ObjectivesThis study investigated the inequalities in access to maternal healthcare services in Bangladesh.Design and settingThis study used cross-sectional data from the nationally representative Bangladesh Demographic and Health Survey conducted in 2017-2018. The survey encompassed diverse regions and households across Bangladesh. The study used the Human Opportunity Index (HOI) and Shapley's decomposition technique to measure the inequality in access to maternal healthcare opportunities.ParticipantsThis study included 20 127 women aged 15-49 years. Among them, 5012 women had live births in the preceding 3 years of the survey, forming the study sample.Primary and secondary outcome measuresThis study has no secondary outcome variable. The primary dependent variable is 'adequate maternal healthcare', a dichotomous variable.ResultsHousehold wealth status contributed the highest to inequality in accessing adequate maternal healthcare services (41.4%) such as receiving at least four antenatal care (ANC) visits (39.7%), access to proper ANC (50.7% and 44.0%) and health facility birth (43.4%). Maternal educational status contributes the second highest inequality among all factors in accessing adequate maternal healthcare (29.5%). Adequate maternal healthcare presented the lowest coverage rate and opportunity index among all (approximately 24% with HOI=17.2).ConclusionsWe found that attained adequate maternal healthcare had the lowest coverage and widest dissimilarity, while wealth index, education and place of residence are the major factors that contribute to inequalities in accessibility to maternal healthcare services in Bangladesh. These findings underscore a need for pro-poor interventions to narrow the economic inequalities between the poor and rich in terms of accessibility to maternal healthcare services. The results indicate the need for the Bangladeshi government and its health department to strengthen their commitment to improving female education. Investments should be made in initiatives that facilitate the proximity of maternal healthcare services to women in rural areas.

Project description:BackgroundInequality in maternal health has remained a challenge in many low-income countries, like Bangladesh and Pakistan. The study examines within-country and between-country inequality in utilization of maternal healthcare services for Bangladesh and Pakistan.MethodsThe study used the latest Demographic Health Surveys (DHS, 2017-2018) datasets of Bangladesh and Pakistan for women aged 15-49 years who had given at least one live birth in three years preceding the survey. Equity strata were identified from the literature and conformed by binary logistic regressions. For ordered equity strata with more than two categories, the relative concentration index (RCI), absolute concentration index (ACI) and the slope index of inequality (SII) were calculated to measure inequalities in the utilization of four maternal healthcare services. For two-categories equity strata, rate ratio (RR), and rate difference (RD) were calculated. Concentration curves and equiplots were constructed to visually demonstrate inequality in maternal healthcare services.ResultsIn Bangladesh, there was greater inequality in skilled birth attendance (SBA) based on wealth (RCI: 0.424, ACI: 0.423, and SII: 0.612), women's education (RCI: 0.380, ACI: 0.379 and SII: 0.591), husband's education (RCI: 0.375, ACI: 0.373 and SII: 0.554) and birth order (RCI: - 0.242, ACI: - 0.241, and SII: -0.393). According to RCI, ACI, and SII, there was inequality in Pakistan for at least four ANC visits by the skilled provider based on wealth (RCI: 0.516, ACI: 0.516 and SII: 0.738), women's education (RCI: 0.470, ACI: 0.470 and SII: 0.757), and husband's education (RCI: 0.380, ACI: 0.379 and SII: 0.572). For Bangladesh, the RR (1.422) and RD (0.201) imply more significant urban-rural inequality in SBA. In Pakistan, urban-rural inequality was greater for at least four ANC visits by the skilled provider (RR: 1.650 and RD 0.279).ConclusionInequality in maternal healthcare is greater among the underprivileged group in Pakistan than in Bangladesh. In Bangladesh, the SBA is the most inequitable maternal healthcare, while for Pakistan it is at least four ANC visits by the skilled provider. Customized policies based on country context would be more effective in bridging the gap between the privileged and underprivileged groups.

Project description:BackgroundMaternal education is universally recognised as a major factor in positive societal indicators (health, wellbeing, overall education, etc.) and a country's growth and economic sustainability, yet the underlying factors contributing to maternal education have not been widely investigated, especially in developing countries.ObjectiveThis study investigated the 15-year trend of maternal education in Bangladesh (2004-2018) to identify the factors contributing to maternal education.MethodThis study used publicly available cross-data from five consecutive Bangladesh Demographic and Health Surveys (2004, 2007, 2011, 2014 and 2018). Level of maternal education was grouped as 'no education', 'incomplete primary', 'complete primary', 'incomplete secondary', 'complete secondary' and 'higher education' (reference group). The differences in factors/exposure variables suspected to contribute to maternal education were measured for these groups for 2004-2018, and a survey multinomial logistic regression was performed to estimate the explanatory value of these factors.ResultsFrom 2004-2018, there was a 62% gross reduction of the no education group and a 61% gross increase in the higher education group. A gross increase was also observed for complete secondary (49%), incomplete secondary (39%) and complete primary education (14%). In multivariate analysis, in rural areas, in 2018, the probability of a woman being in the complete primary, incomplete primary or no education groups was increased (adjusted relative risk ratio: 1.21, 1.40 and 1.59), compared to 2004 (0.73, 1.09, 1.12), respectively. From 2004-2018, the factor of no television watching reduced the probability of maternal education levels. Having a husband/partner who had no education increased the probability of a woman's education level. The probability of all maternal education levels decreased across all wealth index groups.ConclusionThe data suggest that average maternal education level in Bangladesh increased from 2004-2018. However, an integrated effort is required to improve factors associated with maternal education to both increase maternal education and Bangladesh's long-term sustainability.

Project description:BackgroundIntimate partner violence (IPV) during pregnancy is a global issue of public health importance. Due to the low rates of help-seeking in response to IPV, research on survivors' help-seeking behaviors is scarce, particularly within low- and middle-income countries (LMICs). The present study provides a cross-national evidence of informal and formal help-seeking patterns among pregnant women experiencing IPV.MethodsThis study made use of population-based data from the Demographic and Health Surveys (DHS) Program from 54 LMICs, collected between 2005 and 2020 (N = 359,027). Applying bivariate and multivariable analyses, the present study examined IPV survivors' help-seeking distributions and associations with individual, partner, family, and community factors.ResultsOnly half of survivors sought help in response to IPV during pregnancy with wide regional and national variations, mainly from informal support networks (including family, neighbors, and friends), and rarely from formal institutions (including legal, socio-cultural, and medical services). Evidence shows that help-seeking behaviors were associated with IPV survivors' age and educational attainment, survivors' employment status and earnings compared to their partners, survivors' consumption of mass media, intimate partner's age and education, spouse's alcohol consumption and controlling behaviors, survivors' wealth index, place of residence, and health-seeking barriers, among others.ConclusionPractitioners are encouraged to consider the study's outcomes when designing interventions and support for survivors seeking help in response to IPV during pregnancy. Strong advocacy and action are needed, including fostering survivors' educational attainment, diminishing pregnant women's social and financial dependencies on their intimate partners, promoting pre- and peri-natal health care, informing survivors about help, and increasing gender equality by engaging women and men equally within the whole community.

Dataset Information

Maternal Pregnancy Intention and Antenatal Care Seeking Behaviors in Bangladesh: Evidence From Bangladesh Demographic and Health Survey, 2018.

Publications

Maternal Pregnancy Intention and Antenatal Care Seeking Behaviors in Bangladesh: Evidence From Bangladesh Demographic and Health Survey, 2018.

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