Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018
Objectives This study investigated the inequalities in access to maternal healthcare services in Bangladesh.Design and setting This study used cross-sectional data from the nationally representative Bangladesh Demographic and Health Survey conducted in 2017–2018. The survey encompassed diverse regio...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e070111.full |
| _version_ | 1797641908050198528 |
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| author | Bright Opoku Ahinkorah Joshua Okyere Md Injamul Haq Methun Sutopa Roy Md Ismail Hossain Iqramul Haq Shatabdi Shamrita Ume Md Kamrul Hasan |
| author_facet | Bright Opoku Ahinkorah Joshua Okyere Md Injamul Haq Methun Sutopa Roy Md Ismail Hossain Iqramul Haq Shatabdi Shamrita Ume Md Kamrul Hasan |
| author_sort | Bright Opoku Ahinkorah |
| collection | DOAJ |
| description | Objectives This study investigated the inequalities in access to maternal healthcare services in Bangladesh.Design and setting This study used cross-sectional data from the nationally representative Bangladesh Demographic and Health Survey conducted in 2017–2018. The survey encompassed diverse regions and households across Bangladesh. The study used the Human Opportunity Index (HOI) and Shapley’s decomposition technique to measure the inequality in access to maternal healthcare opportunities.Participants This study included 20 127 women aged 15–49 years. Among them, 5012 women had live births in the preceding 3 years of the survey, forming the study sample.Primary and secondary outcome measures This study has no secondary outcome variable. The primary dependent variable is ‘adequate maternal healthcare’, a dichotomous variable.Results Household wealth status contributed the highest to inequality in accessing adequate maternal healthcare services (41.4%) such as receiving at least four antenatal care (ANC) visits (39.7%), access to proper ANC (50.7% and 44.0%) and health facility birth (43.4%). Maternal educational status contributes the second highest inequality among all factors in accessing adequate maternal healthcare (29.5%). Adequate maternal healthcare presented the lowest coverage rate and opportunity index among all (approximately 24% with HOI=17.2).Conclusions We found that attained adequate maternal healthcare had the lowest coverage and widest dissimilarity, while wealth index, education and place of residence are the major factors that contribute to inequalities in accessibility to maternal healthcare services in Bangladesh. These findings underscore a need for pro-poor interventions to narrow the economic inequalities between the poor and rich in terms of accessibility to maternal healthcare services. The results indicate the need for the Bangladeshi government and its health department to strengthen their commitment to improving female education. Investments should be made in initiatives that facilitate the proximity of maternal healthcare services to women in rural areas. |
| first_indexed | 2024-03-11T13:52:29Z |
| format | Article |
| id | doaj.art-92e883d57a00457887305a0cfeed3585 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T13:52:29Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-92e883d57a00457887305a0cfeed35852023-11-02T08:10:08ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2022-070111Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018Bright Opoku Ahinkorah0Joshua Okyere1Md Injamul Haq Methun2Sutopa Roy3Md Ismail Hossain4Iqramul Haq5Shatabdi Shamrita Ume6Md Kamrul Hasan7Faculty of Health, The Australian Centre for Public and Population Health Research, University of Technology Sydney, Liverpool, New South Wales, AustraliaDepartment of Population and Health, University of Cape Coast, Cape Coast, GhanaDepartment of Statistics, Tejgaon College, National University Bangladesh, Dhaka, BangladeshDepartment of Statistics, Jagannath University, Dhaka, BangladeshDepartment of Statistics, Jagannath University, Dhaka, BangladeshDepartment of Agricultural Statistics, Faculty of Agribusiness Management, Sher-e-Bangla Agricultural University, Dhaka, BangladeshDepartment of Statistics, Jagannath University, Dhaka, BangladeshDepartment of Public Health, North South University, Dhaka, BangladeshObjectives This study investigated the inequalities in access to maternal healthcare services in Bangladesh.Design and setting This study used cross-sectional data from the nationally representative Bangladesh Demographic and Health Survey conducted in 2017–2018. The survey encompassed diverse regions and households across Bangladesh. The study used the Human Opportunity Index (HOI) and Shapley’s decomposition technique to measure the inequality in access to maternal healthcare opportunities.Participants This study included 20 127 women aged 15–49 years. Among them, 5012 women had live births in the preceding 3 years of the survey, forming the study sample.Primary and secondary outcome measures This study has no secondary outcome variable. The primary dependent variable is ‘adequate maternal healthcare’, a dichotomous variable.Results Household wealth status contributed the highest to inequality in accessing adequate maternal healthcare services (41.4%) such as receiving at least four antenatal care (ANC) visits (39.7%), access to proper ANC (50.7% and 44.0%) and health facility birth (43.4%). Maternal educational status contributes the second highest inequality among all factors in accessing adequate maternal healthcare (29.5%). Adequate maternal healthcare presented the lowest coverage rate and opportunity index among all (approximately 24% with HOI=17.2).Conclusions We found that attained adequate maternal healthcare had the lowest coverage and widest dissimilarity, while wealth index, education and place of residence are the major factors that contribute to inequalities in accessibility to maternal healthcare services in Bangladesh. These findings underscore a need for pro-poor interventions to narrow the economic inequalities between the poor and rich in terms of accessibility to maternal healthcare services. The results indicate the need for the Bangladeshi government and its health department to strengthen their commitment to improving female education. Investments should be made in initiatives that facilitate the proximity of maternal healthcare services to women in rural areas.https://bmjopen.bmj.com/content/13/10/e070111.full |
| spellingShingle | Bright Opoku Ahinkorah Joshua Okyere Md Injamul Haq Methun Sutopa Roy Md Ismail Hossain Iqramul Haq Shatabdi Shamrita Ume Md Kamrul Hasan Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018 BMJ Open |
| title | Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018 |
| title_full | Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018 |
| title_fullStr | Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018 |
| title_full_unstemmed | Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018 |
| title_short | Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018 |
| title_sort | inequalities in adequate maternal healthcare opportunities evidence from bangladesh demographic and health survey 2017 2018 |
| url | https://bmjopen.bmj.com/content/13/10/e070111.full |
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