Determinants of Antenatal Care Visits in Bangladesh: A Quantile Regression Analysis

Abstract

Background Maternal and infant mortality is a major problem in a developing country like Bangladesh and these deaths are mostly related to incomplete antenatal care (ANC) visits. Adequate ANC visits for women are crucial in controlling maternal and infant mortality. Aims To investigate factors associated with ANC visits among women of reproductive age (15-49) in Bangladesh using the Bangladesh Demographic Health Survey 2017–2018 (BDHS) data. Methods This study included 5012 respondents, of whom 2414 women (48.2%) were complete ANC visits and 2598 women (51.8%) were incomplete ANC visits. Quantile regression was used for analysis indicating that the effects of different covariates functioned differently across the utilization of antenatal care visits. The results revealed the women's educational level, birth order number, sex of household head, and wealth index were highly significant on the lower, middle, and higher quantiles of the number of incomplete ANC visits. Besides, in the higher quantiles (for example, 75% quantile), the place of residence was highly significant. For division variables, Rajshahi, Rangpur, and Khulna were highly significant in lower and middle quantiles, while Dhaka, Khulna, Mymensingh, and Rajshahi were insignificant in higher quantiles. Conclusions This study observed that education, wealth index, birth order of children, and place of residence are associated with utilization of ANC visits and significantly influence maternal mortality. These determinations can help healthcare programmers and policymakers to take appropriate policies and programs for complete antennal care visits among pregnant women in Bangladesh. In order to increase the number of ANC visits among women, it is necessary to establish a mutually coordinated and trusting relationship between the government, non-governmental organizations and NGOs.

Disparities, distribution, and determinants in appropriate timely initiation, number, and quality of antenatal care in Bangladesh: Evidence from Demographic and Health Survey 2017–18

“…However, we observed an association between parity and the timing of initiation and the number of ANC visits, although it did not show any association with the quality of ANC. These findings align with multiple previous studies [ 17 , 30 , 31 ]. Women with a history of previous pregnancies (i.e., two or more pregnancies) may possess more knowledge about the importance of ANC.…”

Association of rural-urban place of residence with adequate antenatal care visit in Bangladesh

“…About two-thirds of the people in Bangladesh live in rural regions [ 12 ], and without reducing the differences found here, it would be hard to increase adequate ANC coverage. Apart from the socioeconomic differences mentioned above, there are several other barriers that could contribute to the differences in ANC utilization [ 9 , 15 , 18 ]. For instance, the distance from health facilities to homes and inadequate transport facilities in rural regions may prevent some women to receive adequate care [ 7 , 19 ].…”