Factors influencing health service utilization among mothers for under-five children: A cross-sectional study in Khulna district of Bangladesh

Akter, Shahinur

doi:10.1371/journal.pone.0274449

Cited by 8 publications

(7 citation statements)

References 32 publications

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“…These conditions can impact the ability of residents to adopt and implement recommended ENC practices due to resource constraints and a lack of awareness [31]. Thirdly, cultural and educational differences among urban populations can in uence healthcareseeking behaviors and adherence to ENC guidelines [32]. Factors such as education levels, awareness campaigns, and community norms play a signi cant role in shaping maternal and newborn care practices [6].…”

Section: Discussionmentioning

confidence: 99%

Exploring Essential Newborn Care Practices and Predictors Among Non-Institutional Births in Urban Bangladesh

Khanam,

Alam,

Kabir

et al. 2024

Preprint

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Background Non-institutional births, often occurring at home or in traditional settings, remain prevalent in Bangladesh despite ongoing efforts to promote facility-based deliveries. Ensuring essential newborn care (ENC) practices for these non-institutional births is crucial for reducing neonatal mortality and improving child health outcomes. This study aimed to identify current status and factors associated with the adoption of ENC practices among non-institutional births in urban areas of Bangladesh. Methods A secondary analysis of the 2165 mother-child dyads was conducted extracted from the 2019 Bangladesh Urban Health Facility Survey. Six ENC indicators as well as their composite index was considered as the outcome variables. Respondents’ socio-demographic factors were considered as the explanatory variables. Multivariate logistic regression model was used to explore association between outcome and explanatory variables. Results Approximately 37% of all mothers reported employing a minimum of three out of the six ENC practices. Among individual indicators, the highest adherence was observed for the use of a sterilized instrument to sever the umbilical cord (90%), while the lowest adherence was noted for delayed bathing (7.4%). The likelihood of adopting at least three of the six ENC indicators was lower among mothers in relatively higher wealth quintiles, while it was higher among those residing in non-slum areas of city corporations and in the divisions of Chattogram, Khulna, and Sylhet. Concerning individual indicators, factors associated with each ENC practice varied, with no specific indicator consistently significant across all categories. Conclusion More than two-thirds of all mothers do not report employing a minimum of three ENC practices in urban areas of Bangladesh. This lower adherence to ENC practices may be linked to elevated neonatal and under-five mortality rates in Bangladesh. There is a crucial need for awareness-building programs to educate the population about the significance of practicing ENC for improving child health outcomes.

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Section: Discussionmentioning

confidence: 99%

Exploring Essential Newborn Care Practices and Predictors Among Non-Institutional Births in Urban Bangladesh

Khanam,

Alam,

Kabir

et al. 2024

Preprint

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“…Similarly, a study in Bangladesh by Akter et al . [ 17 ] revealed a lack of knowledge about preventive measures and health promotion activities, resulting in limited healthcare utilization. These studies support the notion that inadequate awareness and knowledge about available healthcare services can act as significant barriers to utilization.…”

Section: Discussionmentioning

confidence: 99%

“…Prinja et al ,[ 16 ] Jahan et al ,[ 5 ] and Akter et al . [ 17 ] all identified financial constraints as a major barrier to healthcare utilization. These studies demonstrated that the inability to afford medical expenses, transportation costs, and medications often leads to delayed or forgone healthcare seeking.…”

Section: Discussionmentioning

confidence: 99%

Qualitative exploration for the under-foot fall in utilization of health services at Primary Health Center of Shahdol, Madhya Pradesh

Kabirpanthi,

Gupta,

Mishra

et al. 2024

Journal of Family Medicine and Primary Care

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Background: Despite efforts to improve healthcare infrastructure and service delivery, significant disparities in healthcare utilization persist, leading to suboptimal health outcomes and hindering progress toward achieving universal health coverage. This research article aims to conduct a qualitative exploration of the under-foot fall in utilization of health services, shedding light on the barriers and challenges faced by individuals in accessing and utilizing health care to inform targeted interventions and improve health service utilization. Methods: This qualitative study employed free listing, pile sorting, and focus group discussions (FGDs) as data collection methods. Representatives from various stakeholders involved in the primary healthcare delivery system were selected based on their vocalness, knowledge, willingness to participate, and heterogeneity of responses. Subsequently, FGDs and key informant interviews (KIIs) were conducted to further explore the identified barriers. The collected transcripts underwent manual thematic analysis using coding rules and theme generation procedures. Results: A total of 30 participants, including healthcare providers, community leaders, and individuals from the local community, took part in the qualitative exploration. The themes encompassed limited awareness and knowledge, geographical and infrastructural barriers, socioeconomic constraints, trust and perceptions of the healthcare system, and cultural and social factors. These findings provide valuable insights into the multifaceted barriers hindering healthcare utilization and can guide the development of targeted interventions and policies to improve healthcare access and delivery in the study area. Conclusion: The identified barriers, including limited awareness and knowledge, geographical and infrastructural challenges, socioeconomic constraints, trust and perceptions of the healthcare system, cultural and social factors, and gender disparities, are consistent with the existing literature.

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“…The fundamental objective of the current study was to understand the antepartum care utilization pattern among the Garo indigenous women. Although a previous study found that antepartum care-seeking is less proportionate among rural Garo moms compared to urban Garo women, other indigenous women, and non-indigenous women [ 55 ], similar to a substantial number of other studies focused on maternal health care-seeking behavior [ 39 , 40 , 56 , 57 ], it considered the indigenous women as a homogenous group. The author argues that it is insufficient to investigate the pattern of antepartum biomedical care uptake among women by considering them as a homogenous group and, thus, approached the Garo indigenous mothers as a heterogeneous group to understand one particular issue by listening to their less-heard voices.…”

Section: Introductionmentioning

confidence: 99%

“…The behavioral model, developed in 1968 by Ronald M. Andersen, a US medical sociologist and expert on healthcare [ 8 ], is the most frequently suggested framework for understanding healthcare service uptake [ 58 ]. It has been used to guide the examination of predictors associated with the utilization of healthcare services [ 56 ] According to this model, the uptake of healthcare services depends on three fundamental issues [ 8 ]. These are: (1) predisposing characteristics (e.g., age, family size, educational level, birth order, and health belief), (2) enabling characteristics, including income, availability of health care centers and services, the quality of the care services, and (3) need characteristics (i.e., nature of the illness, perceived understanding of health status, the perceived need for health care, and expected satisfaction from the received services).…”

Section: Introductionmentioning

confidence: 99%

Uptake of antepartum care services in a matrilineal-matrilocal society: a study of Garo indigenous women in Bangladesh

Chowdhury

2023

BMC Pregnancy Childbirth

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Background The indigenous Garo is a close-knit matrilineal-matrilocal community. This community's expectant mothers receive less antepartum biomedical care, making them prone to maternal mortality. This study developed a conceptual framework to explore how the external environment, personal predispositions, enabling components and perceived antepartum care needs influence and generate a gap in antepartum biomedical care uptake. Methods The author used qualitative data from the study area. The data were collected through conducting 24 semi-structured interviews with purposively selected Garo women. After transcribing the data, the author generated the themes, grouped them into two broader domains, and analyzed them using the grounded theory approach. Results The emergent themes suggest adding the external environment (i.e., healthcare facilities' availability and services and culturally relevant healthcare services) to Anderson's behavioral model to understand indigenous women's antepartum care uptake disparity. Antepartum care uptake disparities arise when Andersen's behavioral model's other three drivers-personal predisposition, enabling components, and needs components-interact with the external environment. The interplay between enabling resources and the external environment is the conduit by which their predispositions and perceived needs are shaped and, thus, generate a disparity in antepartum care uptake. The data demonstrate that enabling resources include gendered power dynamics in families, home composition and income, men's spousal role, community practices of maternal health, and mother groups' and husbands' knowledge. Birth order, past treatment, late pregnancy, and healthcare knowledge are predispositions. According to data, social support, home-based care, mental health well-being, cultural norms and rituals, doctors' friendliness, affordable care, and transportation costs are perceived needs. Conclusions Garo family members (mothers/in-laws and male husbands) should be included in health intervention initiatives to address the problem with effective health education, highlighting the advantages of biomedical antepartum care. Health policymakers should ensure the availability of nearby and culturally appropriate pregnancy care services.

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Factors influencing health service utilization among mothers for under-five children: A cross-sectional study in Khulna district of Bangladesh

Cited by 8 publications

References 32 publications

Exploring Essential Newborn Care Practices and Predictors Among Non-Institutional Births in Urban Bangladesh

Exploring Essential Newborn Care Practices and Predictors Among Non-Institutional Births in Urban Bangladesh

Qualitative exploration for the under-foot fall in utilization of health services at Primary Health Center of Shahdol, Madhya Pradesh

Uptake of antepartum care services in a matrilineal-matrilocal society: a study of Garo indigenous women in Bangladesh

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