Abstract
IntroductionUtilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh. Birth attendance by SBAs is considered as the “single most important factor in preventing maternal deaths”. This paper examined the practices and determinants of delivery by SBAs in rural Bangladesh.MethodsThe data come from the post-intervention survey of a cluster-randomized community controlled trial conducted to evaluate the impact of limited post-natal care (PNC) services on healthcare seeking behavior of women with a recent live birth in rural Bangladesh (n = 702). Multivariable logistic regression model was used to identify the potential determinants of delivery by SBAs.ResultsThe respondents were aged between 16 and 45, with the mean age of 24.41 (± 5.03) years. Approximately one-third (30.06%) of the women had their last delivery by SBAs. Maternal occupation, parity, complications during pregnancy and antenatal checkup (ANC) by SBAs were the significant determinants of delivery by SBAs. Women who took antenatal care by SBAs were 2.62 times as likely (95% CI: 1.66, 4.14; p < 0.001) to have their delivery conducted by SBAs compared to those who did not, after adjusting for other covariates.ConclusionOur findings suggest that ANC by SBAs and complications during pregnancies are significant determinants of delivery by SBAs. Measure should be in place to promote antenatal checkup by SBAs to increase utilization of SBAs at birth in line with achieving the Millennium Development Goal-5. Future research should focus in exploring the unmet need for, and potential barriers in, the utilization of delivery by SBAs.Electronic supplementary materialThe online version of this article (doi:10.1186/1742-4755-11-86) contains supplementary material, which is available to authorized users.
Highlights
Utilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh
Recent evaluation of the Communitybased Skilled Birth Attendant (CSBA) program indicates that even though CSBAs are available in the rural areas, their utilization is low in the community [11]
702 women who had a live birth between November 2010 and October 2011 were identified through household visits and were interviewed by the data collectors
Summary
Utilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh. Birth attendance by SBAs is considered as the “single most important factor in preventing maternal deaths”. Most of the complications related to pregnancy and childbirth are unpredictable, and take place around the time of delivery and postpartum period This is why, access to Skilled Birth Attendants (SBAs) is strongly recommended for all the pregnant women so as to make sure a normal delivery is conducted well, related complications are recognized early and referred immediately to the appropriate healthcare facilities [4]. Recent evaluation of the CSBA program indicates that even though CSBAs are available in the rural areas, their utilization is low in the community [11]. It is, imperative to examine the determinants of delivery by SBAs so as to understand well the areas that require further policy reform and programmatic interventions in line with progress toward MDG-5. Current paper aims at identifying the determinants of delivery by SBAs in rural Bangladesh
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