Trends and inequities in use of maternal health care services in Bangladesh, 1991-2011
Monitoring use-inequity is important to measure progress in efforts to address health-inequities. Using data from six Bangladesh Demographic and Health Surveys (BDHS), we examine trends, inequities and socio-demographic determinants of use of maternal health care services in Bangladesh between 1991...
Gespeichert in:
Veröffentlicht in: | PloS one 2015-03, Vol.10 (3), p.e0120309-e0120309 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | e0120309 |
---|---|
container_issue | 3 |
container_start_page | e0120309 |
container_title | PloS one |
container_volume | 10 |
creator | Anwar, Iqbal Nababan, Herfina Y Mostari, Shabnam Rahman, Aminur Khan, Jahangir A M |
description | Monitoring use-inequity is important to measure progress in efforts to address health-inequities. Using data from six Bangladesh Demographic and Health Surveys (BDHS), we examine trends, inequities and socio-demographic determinants of use of maternal health care services in Bangladesh between 1991 and 2011.
Access to maternal health care services has improved in the last two decades. The adjusted yearly trend was 9.0% (8.6%-9.5%) for any antenatal care (ANC), 11.9% (11.1%-12.7%) for institutional delivery, and 18.9% (17.3%-20.5%) for C-section delivery which is above the WHO recommended rate of 5-15%. Use-inequity was significant for all three indicators but is reducing over time. Between 1991-1994 and 2007-2011 the rich:poor ratio reduced from 3.65 to 1.65 for ANC and from 15.80 to 6.77 for institutional delivery. Between 1995-1998 and 2007-2011, the concentration index reduced from 0.27 (0.25-0.29) to 0.15 (0.14-0.16) for ANC, and from 0.65 (0.60-0.71) to 0.39 (0.37-0.41) for institutional delivery during that period. For use of c-section, the rich:poor ratio reduced from 18.17 to 13.39 and the concentration index from 0.66 (0.57-0.75) to 0.47 (0.45-0.49). In terms of rich:poor differences, there was equity-gain for ANC but not for facility delivery or C-section delivery. All socio-demographic variables were significant predictors of use; of them, maternal education was the most powerful. In addition, the contribution of for-profit private sector is increasingly growing in maternal health.
Both access and equity are improving in maternal health. We recommend strengthening ongoing health and non-health interventions for the poor. Use-inequity should be monitored using multiple indicators which are incorporated into routine health information systems. Rising C-section rate is alarming and indication of C-sections should be monitored both in private and public sector facilities. |
doi_str_mv | 10.1371/journal.pone.0120309 |
format | Article |
fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1667181114</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A422548323</galeid><doaj_id>oai_doaj_org_article_2cf280d39cc4498cb59bc32d06f9be51</doaj_id><sourcerecordid>A422548323</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-46613597cf04e035cd6b144772eb09135a350cadfcf75faafcde41f3c045bebc3</originalsourceid><addsrcrecordid>eNqNkl1rFDEUhgdRbK3-A9EBQRTcNd8zuRFq8WOhUNDa25BJTnazzE62yUzRf2-2Oy070gvJRZKT57wnOXmL4iVGc0wr_HEdhtjpdr4NHcwRJogi-ag4xpKSmci7xwfro-JZSmuEOK2FeFocEV5JyRE6Lq4uI3Q2lbqzpe_gevC9h5SX5ZCgDK7c6B52dcoV6LZflUZHKBPEG2_23GfdLVttIa0-lFhKPCMI4-fFE6fbBC_G-aT49fXL5dn32fnFt8XZ6fnMCEn6GRMCUy4r4xADRLmxosGMVRWBBsl8pClHRltnXMWd1s5YYNhRgxhvoDH0pHi91922IamxJUlhISpcY4xZJhZ7wga9VtvoNzr-UUF7dRsIcal07L1pQRHjSI0slcYwJmvTcJlLEIuEkw1wnLU-jdWGZgPWQNdH3U5EpyedX6lluFGMVkjIOgu8GwViuB4g9Wrjk4G21R2E4fbeoiKcMJ7RN_-gD79upJY6P8B3LuS6ZieqThkhnNWU0EzNH6DysLDxJvvH-RyfJLyfJGSmh9_9Ug8pqcXPH__PXlxN2bcH7N5RKbRD70OXpiDbgyaGlCK4-yZjpHb2v-uG2tlfjfbPaa8OP-g-6c7v9C-k7f19</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1667181114</pqid></control><display><type>article</type><title>Trends and inequities in use of maternal health care services in Bangladesh, 1991-2011</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>Public Library of Science (PLoS)</source><creator>Anwar, Iqbal ; Nababan, Herfina Y ; Mostari, Shabnam ; Rahman, Aminur ; Khan, Jahangir A M</creator><contributor>Moore, Spencer</contributor><creatorcontrib>Anwar, Iqbal ; Nababan, Herfina Y ; Mostari, Shabnam ; Rahman, Aminur ; Khan, Jahangir A M ; Moore, Spencer</creatorcontrib><description>Monitoring use-inequity is important to measure progress in efforts to address health-inequities. Using data from six Bangladesh Demographic and Health Surveys (BDHS), we examine trends, inequities and socio-demographic determinants of use of maternal health care services in Bangladesh between 1991 and 2011.
Access to maternal health care services has improved in the last two decades. The adjusted yearly trend was 9.0% (8.6%-9.5%) for any antenatal care (ANC), 11.9% (11.1%-12.7%) for institutional delivery, and 18.9% (17.3%-20.5%) for C-section delivery which is above the WHO recommended rate of 5-15%. Use-inequity was significant for all three indicators but is reducing over time. Between 1991-1994 and 2007-2011 the rich:poor ratio reduced from 3.65 to 1.65 for ANC and from 15.80 to 6.77 for institutional delivery. Between 1995-1998 and 2007-2011, the concentration index reduced from 0.27 (0.25-0.29) to 0.15 (0.14-0.16) for ANC, and from 0.65 (0.60-0.71) to 0.39 (0.37-0.41) for institutional delivery during that period. For use of c-section, the rich:poor ratio reduced from 18.17 to 13.39 and the concentration index from 0.66 (0.57-0.75) to 0.47 (0.45-0.49). In terms of rich:poor differences, there was equity-gain for ANC but not for facility delivery or C-section delivery. All socio-demographic variables were significant predictors of use; of them, maternal education was the most powerful. In addition, the contribution of for-profit private sector is increasingly growing in maternal health.
Both access and equity are improving in maternal health. We recommend strengthening ongoing health and non-health interventions for the poor. Use-inequity should be monitored using multiple indicators which are incorporated into routine health information systems. Rising C-section rate is alarming and indication of C-sections should be monitored both in private and public sector facilities.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0120309</identifier><identifier>PMID: 25799500</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Bangladesh ; Cesarean section ; Cesarean Section - utilization ; Child ; Confidence intervals ; Demographic variables ; Demographics ; Education ; Female ; Health care ; Health care industry ; Health insurance ; Health Surveys ; Healthcare Disparities - statistics & numerical data ; Healthcare Disparities - trends ; Humans ; Indicators ; Information systems ; Low income groups ; Maternal & child health ; Maternal Health Services - utilization ; Maternal mortality ; Medical informatics ; Obstetrics ; Pregnancy ; Prenatal Care - utilization ; Private sector ; Public health ; Public sector ; Sociodemographics ; Socioeconomic Factors ; Studies ; Trends ; Variables ; Young Adult</subject><ispartof>PloS one, 2015-03, Vol.10 (3), p.e0120309-e0120309</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Anwar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Anwar et al 2015 Anwar et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-46613597cf04e035cd6b144772eb09135a350cadfcf75faafcde41f3c045bebc3</citedby><cites>FETCH-LOGICAL-c692t-46613597cf04e035cd6b144772eb09135a350cadfcf75faafcde41f3c045bebc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370698/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370698/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25799500$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Moore, Spencer</contributor><creatorcontrib>Anwar, Iqbal</creatorcontrib><creatorcontrib>Nababan, Herfina Y</creatorcontrib><creatorcontrib>Mostari, Shabnam</creatorcontrib><creatorcontrib>Rahman, Aminur</creatorcontrib><creatorcontrib>Khan, Jahangir A M</creatorcontrib><title>Trends and inequities in use of maternal health care services in Bangladesh, 1991-2011</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Monitoring use-inequity is important to measure progress in efforts to address health-inequities. Using data from six Bangladesh Demographic and Health Surveys (BDHS), we examine trends, inequities and socio-demographic determinants of use of maternal health care services in Bangladesh between 1991 and 2011.
Access to maternal health care services has improved in the last two decades. The adjusted yearly trend was 9.0% (8.6%-9.5%) for any antenatal care (ANC), 11.9% (11.1%-12.7%) for institutional delivery, and 18.9% (17.3%-20.5%) for C-section delivery which is above the WHO recommended rate of 5-15%. Use-inequity was significant for all three indicators but is reducing over time. Between 1991-1994 and 2007-2011 the rich:poor ratio reduced from 3.65 to 1.65 for ANC and from 15.80 to 6.77 for institutional delivery. Between 1995-1998 and 2007-2011, the concentration index reduced from 0.27 (0.25-0.29) to 0.15 (0.14-0.16) for ANC, and from 0.65 (0.60-0.71) to 0.39 (0.37-0.41) for institutional delivery during that period. For use of c-section, the rich:poor ratio reduced from 18.17 to 13.39 and the concentration index from 0.66 (0.57-0.75) to 0.47 (0.45-0.49). In terms of rich:poor differences, there was equity-gain for ANC but not for facility delivery or C-section delivery. All socio-demographic variables were significant predictors of use; of them, maternal education was the most powerful. In addition, the contribution of for-profit private sector is increasingly growing in maternal health.
Both access and equity are improving in maternal health. We recommend strengthening ongoing health and non-health interventions for the poor. Use-inequity should be monitored using multiple indicators which are incorporated into routine health information systems. Rising C-section rate is alarming and indication of C-sections should be monitored both in private and public sector facilities.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Bangladesh</subject><subject>Cesarean section</subject><subject>Cesarean Section - utilization</subject><subject>Child</subject><subject>Confidence intervals</subject><subject>Demographic variables</subject><subject>Demographics</subject><subject>Education</subject><subject>Female</subject><subject>Health care</subject><subject>Health care industry</subject><subject>Health insurance</subject><subject>Health Surveys</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Healthcare Disparities - trends</subject><subject>Humans</subject><subject>Indicators</subject><subject>Information systems</subject><subject>Low income groups</subject><subject>Maternal & child health</subject><subject>Maternal Health Services - utilization</subject><subject>Maternal mortality</subject><subject>Medical informatics</subject><subject>Obstetrics</subject><subject>Pregnancy</subject><subject>Prenatal Care - utilization</subject><subject>Private sector</subject><subject>Public health</subject><subject>Public sector</subject><subject>Sociodemographics</subject><subject>Socioeconomic Factors</subject><subject>Studies</subject><subject>Trends</subject><subject>Variables</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl1rFDEUhgdRbK3-A9EBQRTcNd8zuRFq8WOhUNDa25BJTnazzE62yUzRf2-2Oy070gvJRZKT57wnOXmL4iVGc0wr_HEdhtjpdr4NHcwRJogi-ag4xpKSmci7xwfro-JZSmuEOK2FeFocEV5JyRE6Lq4uI3Q2lbqzpe_gevC9h5SX5ZCgDK7c6B52dcoV6LZflUZHKBPEG2_23GfdLVttIa0-lFhKPCMI4-fFE6fbBC_G-aT49fXL5dn32fnFt8XZ6fnMCEn6GRMCUy4r4xADRLmxosGMVRWBBsl8pClHRltnXMWd1s5YYNhRgxhvoDH0pHi91922IamxJUlhISpcY4xZJhZ7wga9VtvoNzr-UUF7dRsIcal07L1pQRHjSI0slcYwJmvTcJlLEIuEkw1wnLU-jdWGZgPWQNdH3U5EpyedX6lluFGMVkjIOgu8GwViuB4g9Wrjk4G21R2E4fbeoiKcMJ7RN_-gD79upJY6P8B3LuS6ZieqThkhnNWU0EzNH6DysLDxJvvH-RyfJLyfJGSmh9_9Ug8pqcXPH__PXlxN2bcH7N5RKbRD70OXpiDbgyaGlCK4-yZjpHb2v-uG2tlfjfbPaa8OP-g-6c7v9C-k7f19</recordid><startdate>20150323</startdate><enddate>20150323</enddate><creator>Anwar, Iqbal</creator><creator>Nababan, Herfina Y</creator><creator>Mostari, Shabnam</creator><creator>Rahman, Aminur</creator><creator>Khan, Jahangir A M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150323</creationdate><title>Trends and inequities in use of maternal health care services in Bangladesh, 1991-2011</title><author>Anwar, Iqbal ; Nababan, Herfina Y ; Mostari, Shabnam ; Rahman, Aminur ; Khan, Jahangir A M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-46613597cf04e035cd6b144772eb09135a350cadfcf75faafcde41f3c045bebc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Bangladesh</topic><topic>Cesarean section</topic><topic>Cesarean Section - utilization</topic><topic>Child</topic><topic>Confidence intervals</topic><topic>Demographic variables</topic><topic>Demographics</topic><topic>Education</topic><topic>Female</topic><topic>Health care</topic><topic>Health care industry</topic><topic>Health insurance</topic><topic>Health Surveys</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Healthcare Disparities - trends</topic><topic>Humans</topic><topic>Indicators</topic><topic>Information systems</topic><topic>Low income groups</topic><topic>Maternal & child health</topic><topic>Maternal Health Services - utilization</topic><topic>Maternal mortality</topic><topic>Medical informatics</topic><topic>Obstetrics</topic><topic>Pregnancy</topic><topic>Prenatal Care - utilization</topic><topic>Private sector</topic><topic>Public health</topic><topic>Public sector</topic><topic>Sociodemographics</topic><topic>Socioeconomic Factors</topic><topic>Studies</topic><topic>Trends</topic><topic>Variables</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anwar, Iqbal</creatorcontrib><creatorcontrib>Nababan, Herfina Y</creatorcontrib><creatorcontrib>Mostari, Shabnam</creatorcontrib><creatorcontrib>Rahman, Aminur</creatorcontrib><creatorcontrib>Khan, Jahangir A M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anwar, Iqbal</au><au>Nababan, Herfina Y</au><au>Mostari, Shabnam</au><au>Rahman, Aminur</au><au>Khan, Jahangir A M</au><au>Moore, Spencer</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends and inequities in use of maternal health care services in Bangladesh, 1991-2011</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-03-23</date><risdate>2015</risdate><volume>10</volume><issue>3</issue><spage>e0120309</spage><epage>e0120309</epage><pages>e0120309-e0120309</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Monitoring use-inequity is important to measure progress in efforts to address health-inequities. Using data from six Bangladesh Demographic and Health Surveys (BDHS), we examine trends, inequities and socio-demographic determinants of use of maternal health care services in Bangladesh between 1991 and 2011.
Access to maternal health care services has improved in the last two decades. The adjusted yearly trend was 9.0% (8.6%-9.5%) for any antenatal care (ANC), 11.9% (11.1%-12.7%) for institutional delivery, and 18.9% (17.3%-20.5%) for C-section delivery which is above the WHO recommended rate of 5-15%. Use-inequity was significant for all three indicators but is reducing over time. Between 1991-1994 and 2007-2011 the rich:poor ratio reduced from 3.65 to 1.65 for ANC and from 15.80 to 6.77 for institutional delivery. Between 1995-1998 and 2007-2011, the concentration index reduced from 0.27 (0.25-0.29) to 0.15 (0.14-0.16) for ANC, and from 0.65 (0.60-0.71) to 0.39 (0.37-0.41) for institutional delivery during that period. For use of c-section, the rich:poor ratio reduced from 18.17 to 13.39 and the concentration index from 0.66 (0.57-0.75) to 0.47 (0.45-0.49). In terms of rich:poor differences, there was equity-gain for ANC but not for facility delivery or C-section delivery. All socio-demographic variables were significant predictors of use; of them, maternal education was the most powerful. In addition, the contribution of for-profit private sector is increasingly growing in maternal health.
Both access and equity are improving in maternal health. We recommend strengthening ongoing health and non-health interventions for the poor. Use-inequity should be monitored using multiple indicators which are incorporated into routine health information systems. Rising C-section rate is alarming and indication of C-sections should be monitored both in private and public sector facilities.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25799500</pmid><doi>10.1371/journal.pone.0120309</doi><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2015-03, Vol.10 (3), p.e0120309-e0120309 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_1667181114 |
source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
subjects | Adolescent Adult Bangladesh Cesarean section Cesarean Section - utilization Child Confidence intervals Demographic variables Demographics Education Female Health care Health care industry Health insurance Health Surveys Healthcare Disparities - statistics & numerical data Healthcare Disparities - trends Humans Indicators Information systems Low income groups Maternal & child health Maternal Health Services - utilization Maternal mortality Medical informatics Obstetrics Pregnancy Prenatal Care - utilization Private sector Public health Public sector Sociodemographics Socioeconomic Factors Studies Trends Variables Young Adult |
title | Trends and inequities in use of maternal health care services in Bangladesh, 1991-2011 |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T18%3A00%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Trends%20and%20inequities%20in%20use%20of%20maternal%20health%20care%20services%20in%20Bangladesh,%201991-2011&rft.jtitle=PloS%20one&rft.au=Anwar,%20Iqbal&rft.date=2015-03-23&rft.volume=10&rft.issue=3&rft.spage=e0120309&rft.epage=e0120309&rft.pages=e0120309-e0120309&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0120309&rft_dat=%3Cgale_plos_%3EA422548323%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1667181114&rft_id=info:pmid/25799500&rft_galeid=A422548323&rft_doaj_id=oai_doaj_org_article_2cf280d39cc4498cb59bc32d06f9be51&rfr_iscdi=true |