IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0120309.html
   My bibliography  Save this article

Trends and Inequities in Use of Maternal Health Care Services in Bangladesh, 1991-2011

Author

Listed:
  • Iqbal Anwar
  • Herfina Y Nababan
  • Shabnam Mostari
  • Aminur Rahman
  • Jahangir A M Khan

Abstract

Background and Methods: 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. Findings: 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. Conclusion: 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.

Suggested Citation

  • Iqbal Anwar & Herfina Y Nababan & Shabnam Mostari & Aminur Rahman & Jahangir A M Khan, 2015. "Trends and Inequities in Use of Maternal Health Care Services in Bangladesh, 1991-2011," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0120309
    DOI: 10.1371/journal.pone.0120309
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0120309
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0120309&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0120309?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Oster, Emily, 2004. "Are All Lotteries Regressive? Evidence From the Powerball," National Tax Journal, National Tax Association;National Tax Journal, vol. 57(2), pages 179-187, June.
    2. Kristjana Einarsdóttir & Anna Kemp & Fatima A Haggar & Rachael E Moorin & Anthony S Gunnell & David B Preen & Fiona J Stanley & C D’Arcy J Holman, 2012. "Increase in Caesarean Deliveries after the Australian Private Health Insurance Incentive Policy Reforms," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-5, July.
    3. Shujie Yao, 1999. "On the decomposition of Gini coefficients by population class and income source: a spreadsheet approach and application," Applied Economics, Taylor & Francis Journals, vol. 31(10), pages 1249-1264.
    4. Chowdhury, Omar Haider & Osmani, S. R., 2010. "Towards Achieving the Right to Health:The Case of Bangladesh," Bangladesh Development Studies, Bangladesh Institute of Development Studies (BIDS), vol. 33(1-2), pages 205-274, March-Jun.
    5. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    6. Ayesha De Costa & Kranti S Vora & Kayleigh Ryan & Parvathy Sankara Raman & Michele Santacatterina & Dileep Mavalankar, 2014. "The State-Led Large Scale Public Private Partnership ‘Chiranjeevi Program’ to Increase Access to Institutional Delivery among Poor Women in Gujarat, India: How Has It Done? What Can We Learn?," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-8, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Cinzia Di Novi & Harshita Thakare, 2022. "Inequality of Opportunity in Accessing Maternal and Newborn Healthcare Services: Evidence from the Bangladesh Demographic and Health Survey," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 164(3), pages 1505-1529, December.
    2. Haque, Md Rabiul & Parr, Nick & Muhidin, Salut, 2020. "The effects of household's climate-related displacement on delivery and postnatal care service utilization in rural Bangladesh," Social Science & Medicine, Elsevier, vol. 247(C).
    3. Syed Hasan & Tasnima Akter & Musharrat Jahan & Ashraf Dewan, 2023. "Proximity to healthcare centres and service use: The case of Community Clinics in Bangladesh," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 31(3), pages 819-849, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Diane Coffey & Ashwini Deshpande & Jeffrey Hammer & Dean Spears, 2019. "Local Social Inequality, Economic Inequality, and Disparities in Child Height in India," Demography, Springer;Population Association of America (PAA), vol. 56(4), pages 1427-1452, August.
    2. Francesca Gastaldi & Paolo Liberati & Elena Pisano & Simone Tedeschi, 2014. "Progressivity-Improving VAT Reforms in Italy," Working papers 6, Società Italiana di Economia Pubblica.
    3. Angus Deaton & Jean Dreze, 2008. "Nutrition in India: Facts and Interpretations," Working Papers 1071, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    4. Cornelie Nienaber-Rousseau & Olusola F. Sotunde & Patricia O. Ukegbu & P. Hermanus Myburgh & Hattie H. Wright & Lize Havemann-Nel & Sarah J. Moss & Iolanthé M. Kruger & H. Salomé Kruger, 2017. "Socio-Demographic and Lifestyle Factors Predict 5-Year Changes in Adiposity among a Group of Black South African Adults," IJERPH, MDPI, vol. 14(9), pages 1-16, September.
    5. Kumar, Kaushalendra & Shukla, Ankita & Singh, Abhishek & Ram, Faujdar & Kowal, Paul, 2016. "Association between wealth and health among older adults in rural China and India," The Journal of the Economics of Ageing, Elsevier, vol. 7(C), pages 43-52.
    6. Winters, P. & Kafle, K. & Benfica, R., 2018. "IFAD RESEARCH SERIES 21 - Does relative deprivation induce migration? Evidence from sub-Saharan Africa," IFAD Research Series 280070, International Fund for Agricultural Development (IFAD).
    7. Langyintuo, Augustine S. & Mungoma, Catherine, 2008. "The effect of household wealth on the adoption of improved maize varieties in Zambia," Food Policy, Elsevier, vol. 33(6), pages 550-559, December.
    8. Ravi Prakash & Abhishek Singh, 2014. "Who Marries Whom? Changing Mate Selection Preferences in Urban India and Emerging Implications on Social Institutions," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 33(2), pages 205-227, April.
    9. Samikshya Poudel & Timothy Dobbins & Husna Razee & Blessing Akombi-Inyang, 2023. "Adolescent Pregnancy in South Asia: A Pooled Analysis of Demographic and Health Surveys," IJERPH, MDPI, vol. 20(12), pages 1-14, June.
    10. Tuccio, Michele & Wahba, Jackline & Hamdouch, Bachir, 2016. "International Migration: Driver of Political and Social Change?," IZA Discussion Papers 9794, Institute of Labor Economics (IZA).
    11. Pritchett, Lant & Sumarto, Sudarno & Suryahadi, Asep, 2001. "Targeted Programs in an Economic Crisis: Empirical Findings from Indonesia’s Experience," MPRA Paper 58727, University Library of Munich, Germany.
    12. Derek Headey & David Stifel & Liangzhi You & Zhe Guo, 2018. "Remoteness, urbanization, and child nutrition in sub‐Saharan Africa," Agricultural Economics, International Association of Agricultural Economists, vol. 49(6), pages 765-775, November.
    13. Barik, Debasis & Desai, Sonalde & Vanneman, Reeve, 2018. "Economic Status and Adult Mortality in India: Is the Relationship Sensitive to Choice of Indicators?," World Development, Elsevier, vol. 103(C), pages 176-187.
    14. Laetitia Duval & François-Charles Wolff, 2016. "Emigration intentions of Roma: evidence from Central and South-East Europe," Post-Communist Economies, Taylor & Francis Journals, vol. 28(1), pages 87-107, January.
    15. Jonathan Guryan & Melissa S. Kearney, 2010. "Is Lottery Gambling Addictive?," American Economic Journal: Economic Policy, American Economic Association, vol. 2(3), pages 90-110, August.
    16. Antonia Grohmann & Lukas Menkhoff & Helke Seitz, 2022. "The Effect of Personalized Feedback on Small Enterprises’ Finances in Uganda," Economic Development and Cultural Change, University of Chicago Press, vol. 70(3), pages 1197-1227.
    17. Zhang, Yingqiang & Eriksson, Tor, 2010. "Inequality of opportunity and income inequality in nine Chinese provinces, 1989-2006," China Economic Review, Elsevier, vol. 21(4), pages 607-616, December.
    18. Paschalis Arvanitidis & Athina Economou & Christos Kollias, 2016. "Terrorism’s effects on social capital in European countries," Public Choice, Springer, vol. 169(3), pages 231-250, December.
    19. Christopher H. Herbst & Monique Vledder & Karen Campbell & Mirja Sjöblom & Agnes Soucat, 2011. "The Human Resources for Health Crisis in Zambia : An Outcome of Health Worker Entry, Exit, and Performance within the National Health Labor Market," World Bank Publications - Books, The World Bank Group, number 5938.
    20. Janina Isabel Steinert & Lucie Dale Cluver & G. J. Melendez-Torres & Sebastian Vollmer, 2018. "One Size Fits All? The Validity of a Composite Poverty Index Across Urban and Rural Households in South Africa," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(1), pages 51-72, February.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0120309. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.