Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh?
Background: Bangladesh has improved maternal and child health, but healthcare indicators and access still need enhancement. Factors that contribute to increased antenatal care (ANC) need to be explored to inform healthcare policies. The study examined whether community-level (supply-side) predictors...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024010363 |
| _version_ | 1797304592767123456 |
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| author | Md Zakir Hossain Md Mizanur Rahman Nazneen Rahman Md Shahab Uddin Morgan Siegel |
| author_facet | Md Zakir Hossain Md Mizanur Rahman Nazneen Rahman Md Shahab Uddin Morgan Siegel |
| author_sort | Md Zakir Hossain |
| collection | DOAJ |
| description | Background: Bangladesh has improved maternal and child health, but healthcare indicators and access still need enhancement. Factors that contribute to increased antenatal care (ANC) need to be explored to inform healthcare policies. The study examined whether community-level (supply-side) predictors outperform individual/family-level (demand-side) predictors for the desired number of ANC services. Methods: This cross-sectional study collected primary data from 630 pregnant and lactating women (PLW) in seven upazilas in Rangpur and Nilphamari districts of Bangladesh in 2022. The individual/family and community-level factors as predictors of desired antenatal care services were investigated using a semi-structured questionnaire. Various statistical techniques including the Student t-test, z-test, Chi-square test, and logistic regression model were employed in analyzing the data. Results: Out of the total 630 participants, the majority were literate women who belong to higher pregnancy order and received benefits from SSNPs. In addition to this, these women did not earn and neither were the empowered. The outcome variable was the receiving status of 4+ ANC services by PLWs, which varied by different covariates. The desired 4+ ANC service received by 73 % PLWs. The significant (p < 0.05) predictors of receiving 4+ ANC services were secondary-level education (95 % CI:0.97–7.55), knowledge on danger signs (95 % CI:1.02–1.48), empowered women (95 % CI:0.99–2.69), community clinics as place of services (95 % CI:1.52–3.49), sources of information through SMS (95 % CI:2.63–7.04) and fully functional community clinic (95 % CI:1.0–2.347). The statistical evidence through the values of pseudo R2 of the reduced models of community level (0.09), individual level (0.03) and family level (0.01) revealed that the community level predictors are more influential than individual/family level predictors. Conclusion: The findings indicate that community level predictors played a dominant role in receiving the 4+ ANC services in Bangladesh. In short, the well-functioning of community clinics in tandem with government forums/bodies and awareness raising through SMS messages, are sufficient for ensuring the desired number of ANC services in rural areas of Bangladesh. |
| first_indexed | 2024-03-08T00:11:39Z |
| format | Article |
| id | doaj.art-f0a26c60cc89497cbe5df3eb8190d212 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-08T00:11:39Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-f0a26c60cc89497cbe5df3eb8190d2122024-02-17T06:39:16ZengElsevierHeliyon2405-84402024-02-01103e25005Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh?Md Zakir Hossain0Md Mizanur Rahman1Nazneen Rahman2Md Shahab Uddin3Morgan Siegel4Department of Statistics, Shahjalal University of Science & Technology, Sylhet, 3114, Bangladesh; Corresponding author.. Cooperative for Assistance and Relief Everywhere (CARE), BangladeshCooperative for Assistance and Relief Everywhere (CARE), USAData Analyst, Data Management Aid, Dhaka, Bangladesh. Cooperative for Assistance and Relief Everywhere (CARE), AustriaBackground: Bangladesh has improved maternal and child health, but healthcare indicators and access still need enhancement. Factors that contribute to increased antenatal care (ANC) need to be explored to inform healthcare policies. The study examined whether community-level (supply-side) predictors outperform individual/family-level (demand-side) predictors for the desired number of ANC services. Methods: This cross-sectional study collected primary data from 630 pregnant and lactating women (PLW) in seven upazilas in Rangpur and Nilphamari districts of Bangladesh in 2022. The individual/family and community-level factors as predictors of desired antenatal care services were investigated using a semi-structured questionnaire. Various statistical techniques including the Student t-test, z-test, Chi-square test, and logistic regression model were employed in analyzing the data. Results: Out of the total 630 participants, the majority were literate women who belong to higher pregnancy order and received benefits from SSNPs. In addition to this, these women did not earn and neither were the empowered. The outcome variable was the receiving status of 4+ ANC services by PLWs, which varied by different covariates. The desired 4+ ANC service received by 73 % PLWs. The significant (p < 0.05) predictors of receiving 4+ ANC services were secondary-level education (95 % CI:0.97–7.55), knowledge on danger signs (95 % CI:1.02–1.48), empowered women (95 % CI:0.99–2.69), community clinics as place of services (95 % CI:1.52–3.49), sources of information through SMS (95 % CI:2.63–7.04) and fully functional community clinic (95 % CI:1.0–2.347). The statistical evidence through the values of pseudo R2 of the reduced models of community level (0.09), individual level (0.03) and family level (0.01) revealed that the community level predictors are more influential than individual/family level predictors. Conclusion: The findings indicate that community level predictors played a dominant role in receiving the 4+ ANC services in Bangladesh. In short, the well-functioning of community clinics in tandem with government forums/bodies and awareness raising through SMS messages, are sufficient for ensuring the desired number of ANC services in rural areas of Bangladesh.http://www.sciencedirect.com/science/article/pii/S2405844024010363Maternal healthCommunity clinicANC servicesPredictorsBangladesh |
| spellingShingle | Md Zakir Hossain Md Mizanur Rahman Nazneen Rahman Md Shahab Uddin Morgan Siegel Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh? Heliyon Maternal health Community clinic ANC services Predictors Bangladesh |
| title | Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh? |
| title_full | Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh? |
| title_fullStr | Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh? |
| title_full_unstemmed | Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh? |
| title_short | Do community-level predictors have more impact than individual/family-level predictors on receiving the desired number of ANC services in Bangladesh? |
| title_sort | do community level predictors have more impact than individual family level predictors on receiving the desired number of anc services in bangladesh |
| topic | Maternal health Community clinic ANC services Predictors Bangladesh |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024010363 |
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