Publication: Bangladesh : Inequalities in Utilization of Maternal Health Care Services, Evidence from MATLAB
Date
2004-10
ISSN
Published
2004-10
Author(s)
Anwar, A.T.M. Iqbal
Killewo, Japhet
Chowdhury, Mahbub-E-Elahi K.
Dasgupta, Sushil Kanta
Abstract
This study investigates the equity
implications of introducing a facility-based maternity care
strategy in rural Bangladesh. The study took place in Matlab
subdistrict in Chandpur District, where the Centre for
Population and Health Research (ICDDR,B) had initiated a
home-based maternity care program during 1987. During
1996-2001 the home-based strategy was replaced by a
facility-based strategy that featured gradual upgrading of
four ICDDR,B subcentres to provide basic emergency
obstetrical care (EOC). During the 1997-2001 study period 19
percent of births took place in ICDDR,B facilities, 4
percent occurred in other facilities (public & private),
and 2.6 percent births were attended by ICDDR,B midwives at
home. The remaining deliveries took place at home without
trained attendants. The study examines: 1) the extent to
which poorer women in the community used the EOC services
introduced and 2) the factors determining the use of those
services. It does so by analyzing monitoring and service
data from the ICDDR,B's maternity care program. The
principal findings are that: (i) Women from poorer
households used ICDDR, B delivery facilities significantly
less than their better-off counterparts: the ratio between
the best-off and worst-off 20 percent of the population was
nearly 3:1. (ii) While overall facility utilization
increased during the study period, the economic disparities
in use persisted. (iii) Factors other than economic status
associated with use of maternity care were area of
residence, number of antenatal visits, birth order, maternal
education and age, and year of delivery.
Citation
“Anwar, A.T.M. Iqbal; Killewo, Japhet; Chowdhury, Mahbub-E-Elahi K.; Dasgupta, Sushil Kanta. 2004. Bangladesh : Inequalities in Utilization of Maternal Health Care Services, Evidence from MATLAB. HNP discussion paper;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/ac42ab2a-a11b-5abe-bb7a-bde44c7c645e License: CC BY 3.0 IGO.”