Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis

Abstract

BackgroundThere has been an increasing availability and accessibility of modern health services in rural Bangladesh over the past decades. However, previous studies on the socioeconomic differentials in the utilization of these services were based on a limited number of factors, focusing either on preventive or on curative modern health services. These studies failed to collect data from remote rural areas of the different regions to examine the socioeconomic differentials in health-seeking behavior.MethodsData from 3,498 randomly selected currently married women from three strata of households within 128 purposively chosen remote villages in three divisions of Bangladesh were collected in 2006. This study used bivariate and multivariate logistic analyses to examine both curative and preventive health-seeking behaviors in seven areas of maternal and child health care: antenatal care, postnatal care, child delivery care, mother's receipt of Vitamin A postpartum, newborn baby care, care during recent child fever/cough episodes, and maternal coverageby tetanus toxoid (TT).ResultsA principal finding was that a household's relative poverty status, as reflected by wealth quintiles, was a major determinant in health-seeking behavior. Mothers in the highest wealth quintile were significantly more likely to use modern trained providers for antenatal care, birth attendance, post natal care and child health care than those in the poorest quintile (χ2, p < 0.01). The differentials were less pronounced for other factors examined, such as education, age, and the relative decision-making power of a woman, in both bivariate and multivariate analyses.ConclusionWithin rural areas of Bangladesh, where overall poverty is greater and access to health care more difficult, wealth differentials in utilization remain pronounced. Those programs with high international visibility and dedicated funding (e.g., Immunization and Vitamin A delivery) have higher overall prevalence and a more equitable distribution of beneficiaries than the use of modern trained providers for basic essential health care services. Implications of these findings and recommendations are provided.

Pattern of utilization of ante-natal and delivery services in a semi-urban community of North-Central Nigeria

“…This is similar to findings in some similar studies conducted in Nigeria, some other African countries and in rural Bangladesh. 13,14,16,19,21,22 Issue of financial constraints, traditional beliefs, cultural inhibitions and ignorance about importance and need for ANC and delivery also emerged from the FGD -Examples are these statements from some of the participants. Some of these reasons such as expense of care, home comfort, no permission from husbands, and poor attitude of health workers were also reported from the study from Kano by Doctor et al 12 These findings are also consistent with some of the findings in a similar study by Titaleyet al in Indonesia.…”

Choice of service facility for maternal care and its proximate correlates

“…Factors that prevent women from receiving or seeking health care during pregnancy and childbirth include inadequate services, poverty, distance, lack of information, and cultural practices (UNICEF 2012). In Bangladesh studies have found that education, household socioeconomic status, and urban-rural residence are consistently significant predictors of service utilization (Amin et al 2010).…”

Inequalities in health care and behaviour in patients with diabetes and concurrent hypertension in Lahore, Pakistan

“…To predict the SES of the patient, a pool of potential indicators of both dimensions of the SES was collected from previous studies (Amin et al, 2010, Durkin et al, 1994, Shavers, 2007, Tiwari & Kumar, 2005. These indicators were pre-tested and validated in different socioeconomic contexts.…”