Inequality of Opportunity in Accessing Maternal and Newborn Healthcare Services: Evidence from the Bangladesh Demographic and Health Survey

Abstract

Under-five mortality is known to be the result of a wide variety of inputs, among which the availability of maternal and child health services. However, their coverage and distribution, in low- and middle-income countries, continue to remain inadequate and characterized by significant inequalities. The main aim of this study is to investigate the causes of inequality in accessing the basic maternal and newborn healthcare services in Bangladesh. To this end, we use nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey (BDHS), 2014. Our study builds on the Human Opportunity Index (HOI), developed at the World Bank (in World development report: Equity and development, World Bank, Washington, 2006), which measures the total contribution of individual socioeconomic and demographic circumstances to inequality of opportunity in accessing basic services. Our findings reveal that a mother’s education, wealth index and place of residence, are closely associated with access to basic maternal and newborn healthcare services.

Proximity to Health Care Centres and Service Use: The Case of Community Clinics in Bangladesh

“…Previous studies find a similar pattern as the national family planning programs usually target poor women (Vu et al, 2016). There are regional variations in the use of contraceptives, and rural women use them to a lesser extent, as observed in earlier research (Di Novi & Thakare, 2020). Fewer women in two conservative regions in Bangladesh-Chittagong (Chottogram) and Sylhet divisions-use modern birth control measures compared to their counterparts in the Dhaka division; more women in the remaining four divisions use modern contraceptives.…”

“…On the other hand, higher education and SES can increase the demand for the service among women (Di Novi & Thakare, 2020). Again, rural mothers take lower ANC services, and the utilization varies by administrative divisions, reflecting the difference in socio-cultural factors (Di Novi & Thakare, 2020). Finally, the ANC service utilization increases over time due to the increased awareness of maternal and child healthcare services in Bangladesh (Akter et al, 2018).…”

“…The vector X includes a series of dummy variables that are likely to be important in determining health service utilization for women and children, although differently for different types of services (Akter et al, 2015;Anwar et al, 2015;Di Novi & Thakare, 2020). The analysis for women includes a person's age, education, partner's education, socio-economic status, and rural/urban location of residence.…”

Proximity to healthcare centres and service use: The case of Community Clinics in Bangladesh

“…Schooling generally increases contraceptive use. Better-educated women are likely to prefer smaller families and thus have a higher demand for contraceptives (Di Novi & Thakare, 2020). On the other hand, women with secondary or higher educated partners have a lower contraceptive use.…”

“…Akter et al (2016) find women with more than one child utilizing ANC services to a lower extent due to their previous pregnancy experiences and time constraint resulting from an increased responsibility of child care. On the other hand, higher education and SES can increase the demand for the service among women (Di Novi & Thakare, 2020). Again, rural mothers take lower ANC services, and the utilization varies by administrative divisions, reflecting the difference in socio-cultural factors (Di Novi & Thakare, 2020).…”