Socioeconomic inequalities in the use of delivery care services in Bangladesh: a comparative study between 2004 and 2007

Jahan Shabnam,Mervyn Gifford,Koustuv Dalal

doi:10.4236/health.2011.312127

Jahan Shabnam, Mervyn Gifford + Show 1 more

Open Access

https://doi.org/10.4236/health.2011.312127

Copy DOI

Journal: Health	Publication Date: Jan 1, 2011
Citations: 32	License type: CC BY 4.0

Affiliation: University of Skövde

Abstract

The study explores inequalities in the utilization of delivery care services in different administrative divisions in Bangladesh, by key socioeconomic factors. It estimates the extent of the relationship between women’s socioeconomic inequalities and their place of delivery during 2004 and 2007. Trends in relation to place of delivery in relation to residency and education over a period of thirteen years (1993-2007) have also been measured. The study analyzed the trends and patterns in utilization of institutional delivery care among mothers, using data from the Bangladesh Demographic Health Survey (BDHS) conducted during 1993-2007. The data was disaggregated by area of residence in different divisions in Bangladesh. Bi-variate analyses, concentration curves and multivariate logistic regression were employed in the analysis of the data. The study indicated slow progress in the utilization of institutional delivery care among mothers in Bangladesh between 1993 and 2007. Large variations in outcome measures were observed among the different divisions. Multivariate analyses suggested growing inequalities in utilization of delivery care services between different economic groups and parents with different educational levels. The use of institutional delivery care remains substantially lower among poor and less educated rural mothers in Bangladesh, irrespective of age and employment. Further studies are recommended to explore the specific causes relating to the non-utilization of institutional delivery care.

Highlights

1500 women die every day because of problems in pregnancy and childbirth
Despite the improvements in child health and family planning outcomes in Bangladesh, the Maternal Mortality Ratio (MMR) has reduced by only 38%, between 1991 and 2007, in spite of the fact that making pregnancy and childbearing safer for women has been identified as a central element of the Millennium Development Goal (MDG) [8]
The demographic factors of residency, level of education, wealth index and religion were associated with the choice of delivery in a health facility rather than delivery at home in both the years examined

Summary

Introduction

1500 women die every day because of problems in pregnancy and childbirth. The burden is highest in Africa, followed by the South Asian region [1]. It is evident that most of these deaths could be prevented through timely careseeking during pregnancy and the presence of a Skilled Birth Attendant (SBA) during delivery [4,5,6]. According to data from UNICEF, Bangladesh has a high Maternal Mortality Ratio (MMR), with 320 deaths per 100,000 births [7]. Along with the United Nations, the Government of Bangladesh is committed to achieving the Millennium Development Goal (MDG)-5, to reduce the MMR by 75% between 1990 and 2015. Despite the improvements in child health and family planning outcomes in Bangladesh, the MMR has reduced by only 38%, between 1991 and 2007, in spite of the fact that making pregnancy and childbearing safer for women has been identified as a central element of the MDGs [8]

Methods

Results

Conclusion