Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.

Despite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children's Fund (UNICEF) and World Health Organization (WHO)...

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Main Authors: Mohammad Rifat Haider, Mohammad Masudur Rahman, Md Moinuddin, Ahmed Ehsanur Rahman, Shakil Ahmed, M Mahmud Khan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5526556?pdf=render
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author Mohammad Rifat Haider
Mohammad Masudur Rahman
Md Moinuddin
Ahmed Ehsanur Rahman
Shakil Ahmed
M Mahmud Khan
author_facet Mohammad Rifat Haider
Mohammad Masudur Rahman
Md Moinuddin
Ahmed Ehsanur Rahman
Shakil Ahmed
M Mahmud Khan
author_sort Mohammad Rifat Haider
collection DOAJ
description Despite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children's Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization.Two surveys were carried out in four districts in Bangladesh- baseline in 2008 and end-line in 2013. The baseline survey collected data from 13,206 women giving birth in the preceding year and in end-line 7,177 women were interviewed. Inequity in maternal healthcare utilization was calculated pre and post-MNHIB using rich-to-poor ratio and concentration index.Mean age of respondents were 23.9 and 24.6 years in 2008 and 2013 respectively. Utilization of pregnancy-related care increased for all socioeconomic strata between these two surveys. The concentration indices (CI) for various maternal health service utilization in 2013 were found to be lower than the indices in 2008. However, in comparison to contemporary BDHS data in nearby districts, MNHIB was successful in reducing inequity in receiving ANC from a trained provider (CI: 0.337 and 0.272), institutional delivery (CI: 0.435 in 2008 to 0.362 in 2013), and delivery by skilled personnel (CI: 0.396 and 0.370).Overall use of maternal health care services increased in post-MNHIB year compared to pre-MNHIB year and inequity in maternal service utilization declined for three indicators out of six considered in the paper. The reductions in CI values for select maternal care indicators imply that the program has been successful not only in improving utilization of maternal health services but also in lowering inequality of service utilization across socioeconomic groups. Maternal health programs, if properly designed and implemented, can improve access, partially overcoming the negative effects of socioeconomic disparities.
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spelling doaj.art-0cb72b2f55d642b8a4110964999937dc2022-12-22T02:45:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018140810.1371/journal.pone.0181408Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.Mohammad Rifat HaiderMohammad Masudur RahmanMd MoinuddinAhmed Ehsanur RahmanShakil AhmedM Mahmud KhanDespite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children's Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization.Two surveys were carried out in four districts in Bangladesh- baseline in 2008 and end-line in 2013. The baseline survey collected data from 13,206 women giving birth in the preceding year and in end-line 7,177 women were interviewed. Inequity in maternal healthcare utilization was calculated pre and post-MNHIB using rich-to-poor ratio and concentration index.Mean age of respondents were 23.9 and 24.6 years in 2008 and 2013 respectively. Utilization of pregnancy-related care increased for all socioeconomic strata between these two surveys. The concentration indices (CI) for various maternal health service utilization in 2013 were found to be lower than the indices in 2008. However, in comparison to contemporary BDHS data in nearby districts, MNHIB was successful in reducing inequity in receiving ANC from a trained provider (CI: 0.337 and 0.272), institutional delivery (CI: 0.435 in 2008 to 0.362 in 2013), and delivery by skilled personnel (CI: 0.396 and 0.370).Overall use of maternal health care services increased in post-MNHIB year compared to pre-MNHIB year and inequity in maternal service utilization declined for three indicators out of six considered in the paper. The reductions in CI values for select maternal care indicators imply that the program has been successful not only in improving utilization of maternal health services but also in lowering inequality of service utilization across socioeconomic groups. Maternal health programs, if properly designed and implemented, can improve access, partially overcoming the negative effects of socioeconomic disparities.http://europepmc.org/articles/PMC5526556?pdf=render
spellingShingle Mohammad Rifat Haider
Mohammad Masudur Rahman
Md Moinuddin
Ahmed Ehsanur Rahman
Shakil Ahmed
M Mahmud Khan
Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.
PLoS ONE
title Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.
title_full Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.
title_fullStr Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.
title_full_unstemmed Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.
title_short Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh.
title_sort impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in bangladesh
url http://europepmc.org/articles/PMC5526556?pdf=render
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