Levels and determinants of quality of antenatal care in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey

Abstract

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.

Determinants of quality Antenatal Care utilization in Kenya: insights from the 2022 Kenya Demographic and Health Survey

“…Access to media was significantly associated with quality ANC utilization. The findings are similar to studies in Uganda (Bbaale, 2011) and Bangladesh (Akter et al, 2023) that established a significant correlation between media exposure and the quality of ANC. This was because media exposure gave mothers visual and audio access to health-related information, which eventually improved access to healthcare and demand for ANC services (Ndugga, Namiyonga, & Sebuwufu, 2020; Zhao, Zhang, Xiao, He, & Tang, 2023).…”

“…Quality Antenatal care (ANC) encompasses assessments and treatments provided by licensed medical practitioners to pregnant adolescent girls and women to maintain the health of the mother and child (Akter et al, 2023; Kare, Gujo, & Yote, 2021). The absence of quality ANC can have severe consequences, which lead to increased risks of maternal mortality and morbidity, as well as adverse outcomes for the newborn, including stillbirth, low birth weight, and preterm birth (World Health Organization, 2019).…”

Bangladesh: 50 Years of Advances in Health and Challenges Ahead

“…The improvement in life expectancy at birth from 50 years in 1971 to 72 years in 2021 6 The reduction in mortality of children younger than 5 years of age from 251 in 1971 to 31 deaths per 1,000 live births in 2021 7,8 The reduction in the total fertility rate from 6.6 in 1975 to 2.0 births per woman in 2021 9,10 The expansion in coverage of childhood immunizations from 2% in 1978 to nearly 100% in 2021 as well as the elimination of polio 10,11 The discovery in Bangladesh of oral rehydration therapy as an effective treatment for dehydration produced by diarrhea and the implementation by BRAC of its national Oral Therapy Extension Program, setting the foundation for the highest usage rate (87%) in the world of oral rehydration therapy for childhood diarrhea 12 and contributing to the decline in the percentage of deaths in children younger than 5 years from diarrhea from 25% in 1970 to 2% in 2000 and since 11 The detection of more than 70% of cases of pulmonary-active TB and the completion of treatment in 90% of detected cases 13 The reduction in the rate of open defecation from 34% to less than 1% between 2000 and 2015 12 The development of strategies that have mitigated the mortality and consequent sufferings associated with cyclones and floods through early warning systems, construction of shelters and housing that provide a safe haven, and pre-planning for rapid response when disaster strikes 14 Routine home visits by women community health workers (CHWs) were responsible, to a considerable degree, for the remarkable progress in child and reproductive health. Female CHWs visited all homes to promote family planning at a time when women could not leave their homes or immediate neighborhoods.…”