Abstract
The situation of pregnancy and childbirth related morbidity and mortality is worse in Bangladesh because of low utilization of maternal health services. This situation is much more vulnerable among fishermen community than that of the majority community of Bangladesh due to their marginalized and disadvantaged status. Based on a qualitative investigation this article investigates the determinants of health seeking behavior and their influence on health service utilization among the pregnant women of fishermen community in Sylhet region. The findings reveal that women's culturally and socially determined roles greatly impair their health and play an important role in health seeking behavior through a complex web of social, economic, religious, cultural and behavioral interrelationships and synergies that pervade every aspect of their life. It also reveals that only infrastructural development cannot ensure the success in health sector, changing people's behavior through health promotion and building awareness is the key to bring success in this area.
Highlights
The use of health services is related to availability, quality and cost of services as well as the social structures, religious faith, health beliefs and personal characteristics of the users
The study found sixteen pregnant women living in the selected villages who were regarded as the population of the study and all of them were interviewed as respondents of the research
As the study conducted on pregnant women and considered only pregnant women as participants, we found all participants within the age of fertility ranging from eighteen to thirty seven
Summary
The use of health services is related to availability, quality and cost of services as well as the social structures, religious faith, health beliefs and personal characteristics of the users. The reduction in levels of maternal mortality and improvement of maternal health has been central policy goals since the inception of Fourth Population and Health Program in Bangladesh in 1992 Efforts to address these issues have gained considerable momentum with the formulation of the National Strategy for Maternal Health (Ministry of Health and Family Welfare, 2001) and further strengthened by establishing a National Steering Committee (NSC) to review the progress (Nath, 2008). This strategy is predicated on the ‘Three Delays Causal Framework’ that affects safe motherhood service utilization and outcomes: delays in making the decision to seek care, delays in reaching a medical facility and delays in receiving adequate treatment or management at the facility (Thaddeus and Maine, 1994) and emphasizes the provision of emergency obstetric care to resolve this endemic problem
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