背景:孕产妇保健的利用率很低,在孟加拉国,它在产前到产后期间持续下降。然而,在孟加拉国,缺乏知识来了解在沿着这一途径寻求连续的孕产妇保健方面的差距和相关因素。因此,我们旨在使用孟加拉国多指标类集调查(MICS)评估孕产妇CoC中社会经济和人口因素以及财富不平等的趋势.
方法:我们对最近两次MICS调查的全国代表性数据进行了二次分析,在2012-13和2019年进行。该研究包括调查前两年内活产的育龄妇女(15-49岁)。从这两项调查中,共确定了7,950和9,183名受访者,分别。我们使用多变量逻辑回归和集中指数来检验协变量和不公平,分别,在利用CoC方面。
结果:使用≥4的产前护理,熟练的交付,母亲和新生儿的产后护理从2012-13年的13%增加到2019年的25%。此外,财富不平等持续存在,有利于富人利用孟加拉国的CoC。属于较富裕五分之一的女性,城市地区,非穆斯林家庭,高等教育,受过高等教育的户主,媒体使用,在两项调查中,较少的儿童最有可能利用完整的CoC。
结论:在2012年至13年至2019年期间,孕产妇CoC的总体利用率有所增加,孟加拉国的妇女仍然缺乏持续的财富不平等的CoC。综合提供ANC,由SBA交付,应该引入PNC,包括私人和公共卫生设施,针对贫困和农村社区的妇女。努力还应侧重于妇女的教育,自主性,生育率,和媒体曝光。
BACKGROUND: Utilisation of maternal healthcare is low, and it consistently decreases across antenatal to postnatal period in Bangladesh. However, there is paucity of knowledge in Bangladesh to understand gaps and associated factors in seeking continuum of maternal healthcare along the pathway. Therefore, we aimed to assess the trend in socioeconomic and demographic factors and wealth inequity in maternal CoC using the Bangladesh Multiple Indicator Cluster Survey (MICS).
METHODS: We performed a secondary analysis on nationally representative data from the last two MICS survey, carried out in 2012-13 and 2019. The study included women of reproductive age (15-49 years) with a live birth within two years preceding the survey. Total of 7,950 and 9,183 respondents were identified from these two surveys, respectively. We used multivariable logistic regression and concentration index to examine the covariates and inequity, respectively, in the utilisation of CoC.
RESULTS: Utilisation of ≥4 antenatal care, skilled delivery, and postnatal care for both mother and newborn increased from 13 percent in 2012-13 to 25 percent in 2019 survey. Moreover, wealth inequity persists favouring the rich in utilisation of CoC in Bangladesh. Women belonging to wealthier quintile, urban areas, and non-Muslim families, with higher education, a household head with higher education, media use, and fewer children were most likely to avail complete CoC in both the surveys.
CONCLUSIONS: Overall utilisation of maternal CoC increased between 2012 and 13 and 2019, however, women in Bangladesh still lack the CoC with persistent wealth inequality. Integrated provision of ANC, delivery by SBA, and PNC should be introduced, comprising both private and public health facilities, and targeting women in poor and rural communities. Efforts should also focus on women\'s education, autonomy, fertility rate, and exposure to media.