Gestational diabetes mellitus (GDM) has serious consequences for both maternal and neonatal health. The growing number of noncommunicable diseases and related risk factors as well as the introduction of new World Health Organization (WHO) diagnostic criteria for GDM are likely to impact the GDM prevalence in Bangladesh. Our study aimed to assess the national prevalence and identify the risk factors using the most recent WHO criteria. We used the secondary data of 272 pregnant women (weighted for sampling strategy) from the Bangladesh Demographic and Health Survey 2017–2018. Multivariate logistic regression was performed to determine the risk factors of GDM. The overall prevalence of GDM in Bangladesh was 35% (95/272). Increased odds of GDM were observed among women living in the urban areas (adjusted odds ratio (aOR) 2.74, 95% confidence interval (CI) 1.43–5.27) compared to rural areas and those aged ≥25 years (aOR 2.03, 95% CI 1.13–3.65). GDM rates were less prevalent in the later weeks of pregnancy compared to early weeks. Our study demonstrates that the national prevalence of GDM in Bangladesh is very high, which warrants immediate attention of policy makers, health practitioners, public health researchers, and the community. Context-specific and properly tailored interventions are needed for the prevention and early diagnosis of GDM.

Background Assessing the quality of antenatal care (ANC) is imperative for improving care provisions during pregnancy to ensure the health of mother and baby. In Bangladesh, there is a dearth of research on ANC quality using nationally representative data to understand its levels and determinants. Thus, the current study aimed to assess ANC quality and identify the sociodemographic factors associated with the usage of quality ANC services in Bangladesh. Methods Secondary data analysis was conducted using the last two Bangladesh Demographic and Health Surveys (BDHSs) from 2014 and 2017–18. A total of 8,277 ever-married women were included in the analysis (3,631 from 2014 and 4,646 from 2017–18). The quality ANC index was constructed using a principal component analysis on the following ANC components: weight and blood pressure measurements, blood and urine test results, counselling about pregnancy complications and completion of a minimum of four ANC visits, one of which was performed by a medically trained provider. Multinomial logistic regression was used to determine the strength of the association. Results The percentage of mothers who received all components of quality ANC increased from about 13% in 2014 to 18% in 2017–18 (p < 0.001). Women from the poorest group, those in rural areas, with no education, a high birth order and no media exposure were less likely to receive high-quality ANC than those from the richest group, those from urban areas, with a higher level of education, a low birth order and media exposure, respectively. Conclusion Although the quality of ANC improved from 2014 to 2017–18, it remains poor in Bangladesh. Therefore, there is a need to develop targeted interventions for different socio-demographic groups to improve the overall quality of ANC. Future interventions should address both the demand and supply-side perspectives.

Background: Assessing the quality of antenatal care (ANC) is imperative for improving care provisions during pregnancy to ensure the health of mother and baby. In Bangladesh, there is a dearth of research on the quality of ANC using nationally representative data to understand its levels and determinants. The current study aims to assess the quality of ANC and identify the sociodemographic factors associated with the usage of quality ANC services in Bangladesh. Methods: We conducted secondary data analysis using the last two Bangladesh Demographic and Health Surveys (BDHS) (2014 and 2017–18). A total of 8,277 ever-married women were included in the analysis (3,631 from 2014 and 4,646 from 2017–18 BDHS). We constructed the quality ANC index using a principal component analysis on different ANC components: weight, blood pressure measurement, blood and urine tests, counseling about pregnancy complications and a minimum of four ANC visits of which one is by a medically trained provider. Multinomial logistic regression was used to determine the strength of association. Results: Receiving all the six components of quality ANC increased from about 13% in 2014 (BDHS 2014) to 18% in 2017/18 (BDHS 2017–18) with a significant difference of p < 0.001. Women from the poorest group, being rural areas, with no education, high birth order and unexposed to media were less likely to receive high-quality ANC than women from the richest group, from urban areas, with a higher level of education, low birth order and exposure to media. Conclusion: There is a need to improve the quality of ANC services in Bangladesh. An education program for women, with regular knowledge-enhancing sessions for pregnant mothers, may help them understand the value of ANC visits. Documentaries about maternal and child healthcare can be broadcast on television, YouTube, Facebook, radio and other digital platforms regularly.

Background Utilisation of maternal healthcare is low and it consistently decreases across antenatal to postnatal period in Bangladesh. However, there is paucity of knowledge in Bangladesh to understand gaps and associated factors in seeking continuum of maternal healthcare along the pathway. Therefore, we aimed to assess the trend in socioeconomic and demographic factors and wealth inequity in maternal CoC using the Bangladesh Multiple Indicator Cluster Survey (MICS). Methods We performed a secondary analysis on nationally representative data from the last two MICS survey, carried out in 2012-13 and 2019. The study included women of reproductive age (15–49 years) with a live birth within two years preceding the survey. Total of 7,950 and 9,183 respondents were identified from these two surveys, respectively. We used multivariable logistic regression and concentration index to examine the covariates and inequity, respectively, in the utilisation of CoC. Results Utilisation of ≥ 4 antenatal care, skilled delivery, and postnatal care for both mother and newborn increased from 13 percent in 2012-13 to 25 percent in 2019 survey. Moreover, inequity persists favouring the rich in utilisation of CoC in Bangladesh. Women belonging to wealthier quintile, urban areas, and non-Muslim families, with higher education, a household head with higher education, media use, and fewer children were most likely to avail complete CoC in both the surveys. Conclusion Overall utilisation of maternal CoC increased between 2012-13 and 2019, however, women in Bangladesh still lack the CoC with persistent wealth inequality. Integrated provision of ANC, delivery by SBA, and PNC should be introduced, comprising both private and public health facilities, and targeting women in poor and rural communities. Efforts should also focus on women’s education, autonomy, fertility rate, and exposure to media.

Background: Although Bangladesh has made significant improvements in maternal, neonatal, and child health, the disparity between rich and poor remains a matter for concern. Objective: The study aimed to increase coverage of women in seeking skilled maternal healthcare services while minimizing inequity gap among different socioeconomic groups. Methods: icddr, b implemented an integrated maternal and neonatal health (MNH) intervention between 2009 and 2012, in Shahjadpur sub-district of Shirajganj district, Bangladesh. The study was pre- and post-test in design for evaluation including baseline and endline surveys. The baseline and endline surveys were conducted among 3158 and 3540 recently delivered mothers respectively. Asset index derived from household assets using principal component analysis was categorized into five ordinal categories, i.e. Poor, Less poor, Middle, Upper middle, Rich. Inequity in maternal healthcare utilization was calculated for the baseline and endline periods using rich-to-poor ratio and the concentration index. Result: Mean age of mothers were 23.5 and 24.3 years in baseline and endline, respectively. Reduction in rich-poor ratio was quite large in utilization of skilled 4+ antenatal care (ANC) (2.4:1 to 1.1:1), childbirth (1.7:1 to 1.0:1), and postnatal care (PNC) (2.5:1 to 1.0:1) from trained providers between these two surveys. The concentration indices (CI) in endline for skilled 4+ ANC (CI: 0.220 and 0.013), delivery (CI: 0.161 and -0.021), and PNC (CI: 0.197 and -0.004) were found to be lower than the indices in baseline period respectively. Conclusion: The MNH intervention was successful in reducing inequity in receiving skilled 4+ ANC, delivery, and PNC in rural Bangladesh. Improvements in maternal healthcare utilizations by poor mothers would be influenced by the properly designed and integrated demand- and supply-side MNH interventions package.