IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0242729.html
   My bibliography  Save this article

Assessing the effect of pregnancy intention at conception on the continuum of care in maternal healthcare services use in Bangladesh: Evidence from a nationally representative cross-sectional survey

Author

Listed:
  • Md Nuruzzaman Khan
  • Melissa L Harris
  • Deborah Loxton

Abstract

Background: The Continuum of Care (CoC; defined as accessing the recommended healthcare services during pregnancy and the early postpartum period) is low in lower-middle-income countries (LMICs). This may be a major contributor to the high rates of pregnancy-related complications and deaths in LMICs, particularly among women who had an unintended pregnancy. With a lack of research on the subject in Bangladesh, we aimed to examine the effect of unintended pregnancy on CoC. Methods: Data from 4,493 mother-newborn dyads who participated in the cross-sectional 2014 Bangladesh Demographic and Health Survey were analysed. Women’s level of CoC was generated from responses to questions on the use and non-use of three recommended services during the course of pregnancy: four or more antenatal care (ANC) visits, skilled birth attendance (SBA) during delivery, and at least one postnatal care (PNC) visit within 24 hours of giving birth. Global recommendations of service use were used to classify CoC as high (used each of the recommended services), moderate (used at least two of the three recommended services), and low/none (no PNC, no SBA, and ≤3 ANC visits). Women’s pregnancy intention at the time of conception of their last pregnancy (ending with a live birth) was the major exposure variable, classified as wanted, mistimed, and unwanted. Unadjusted and adjusted (with individual-, household-, and community-level factors) multilevel multinomial logistic regression models were used to assess the association between unintended pregnancy and level of CoC. Results: In Bangladesh, the highest level of CoC occurred in only 12% of pregnancies that ended with live births. This figure was reduced to 5.6% if the pregnancy was unwanted at conception. The antenatal period saw the greatest drop in CoC, with 65.13% of women receiving at least one ANC visit and 26.32% having four or more ANC visits. Following the adjustment of confounders, an unwanted pregnancy was found to be associated with 39% and 62% reduced odds of women receiving moderate and high levels of CoC, respectively, than those with a wanted pregnancy. Having a mistimed pregnancy was found to be associated with a 31% reduction in odds of women achieving a high CoC than women with a wanted pregnancy. Conclusion: Almost nine in ten women did not achieve CoC in their last pregnancy, which was even higher when the pregnancy was unintended. Given that the ANC period has been identified as a critical time for intervention for these women, it is necessary for policies to scale up current maternal healthcare services that provide in-home maternal healthcare services and to monitor the continuity of ANC, with a particular focus on women who have an unintended pregnancy. Integration of maternal healthcare services with family planning services is also required to ensure CoC.

Suggested Citation

  • Md Nuruzzaman Khan & Melissa L Harris & Deborah Loxton, 2020. "Assessing the effect of pregnancy intention at conception on the continuum of care in maternal healthcare services use in Bangladesh: Evidence from a nationally representative cross-sectional survey," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-20, November.
  • Handle: RePEc:plo:pone00:0242729
    DOI: 10.1371/journal.pone.0242729
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242729
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0242729&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0242729?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. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7097, eSocialSciences.
    2. Md. Nuruzzaman Khan & Pushpendra Kumar & Md. Mijanur Rahman & Md. Nazrul Islam Mondal & M. Mofizul Islam, 2020. "Inequalities in Utilization of Maternal Reproductive Health Care Services in Urban Bangladesh: A Population-Based Study," SAGE Open, , vol. 10(1), pages 21582440209, March.
    3. Md Nuruzzaman Khan & Melissa L. Harris & Desalegn Markos Shifti & Alexander Suuk Laar & Deborah Loxton, 2019. "Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 743-754, June.
    4. United Nations UN, 2015. "The Millennium Development Goals Report 2015," Working Papers id:7222, eSocialSciences.
    5. Jennifer Anne Hall & Geraldine Barrett & Tambosi Phiri & Andrew Copas & Address Malata & Judith Stephenson, 2016. "Prevalence and Determinants of Unintended Pregnancy in Mchinji District, Malawi; Using a Conceptual Hierarchy to Inform Analysis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-22, October.
    6. Rabe-Hesketh, Sophia & Skrondal, Anders & Pickles, Andrew, 2005. "Maximum likelihood estimation of limited and discrete dependent variable models with nested random effects," Journal of Econometrics, Elsevier, vol. 128(2), pages 301-323, October.
    Full references (including those not matched with items on IDEAS)

    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. José Antonio Rodríguez Martín & Juan Dios Jiménez Aguilera & José Antonio Salinas Fernández & José María Martín Martín, 2016. "Millennium Development Goals 4 and 5: Progress in the Least Developed Countries of Asia," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(2), pages 489-504, November.
    2. Caroline Jennings Saul & Heiko Gebauer, 2018. "Digital Transformation as an Enabler for Advanced Services in the Sanitation Sector," Sustainability, MDPI, vol. 10(3), pages 1-18, March.
    3. Subramaniam, Mega & Pang, Natalie & Morehouse, Shandra & Asgarali-Hoffman, S. Nisa, 2020. "Examining vulnerability in youth digital information practices scholarship: What are we missing or exhausting?," Children and Youth Services Review, Elsevier, vol. 116(C).
    4. Bruno F. Sunguya & Yue Ge & Linda B. Mlunde & Rose Mpembeni & Germana H. Leyna & Krishna C. Poudel & Niyati Parekh & Jiayan Huang, 2022. "Targeted and Population-Wide Interventions Are Needed to Address the Persistent Burden of Anemia among Women of Reproductive Age in Tanzania," IJERPH, MDPI, vol. 19(14), pages 1-12, July.
    5. Yong‐Shik Lee, 2020. "New general theory of economic development: Innovative growth and distribution," Review of Development Economics, Wiley Blackwell, vol. 24(2), pages 402-423, May.
    6. Leena Eklund Karlsson & Anne Leena Ikonen & Kothar Mohammed Alqahtani & Pernille Tanggaard Andersen & Subash Thapa, 2020. "Health Equity Lens Embedded in the Public Health Policies of Saudi Arabia: A Qualitative Document Analysis," SAGE Open, , vol. 10(4), pages 21582440209, October.
    7. Valensisi, Giovanni & Gauci, Adrian, 2013. "Graduated without passing? The employment dimension and LDCs' prospects under the Istanbul Programme of Action," MPRA Paper 86966, University Library of Munich, Germany.
    8. Yue-Hui Yu & Man-Man Peng, 2022. "Development and Poverty Dynamics in Severe Mental Illness: A Modified Capability Approach in the Chinese Context," IJERPH, MDPI, vol. 19(4), pages 1-13, February.
    9. Lisa F. Clark, 2018. "Policy conflicts in global food assistance strategies: balancing local procurement and harmonization," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 10(1), pages 211-222, February.
    10. Simon Meunier & Dale T. Manning & Loic Queval & Judith A. Cherni & Philippe Dessante & Daniel Zimmerle, 2019. "Determinants of the marginal willingness to pay for improved domestic water and irrigation in partially electrified Rwandan villages," Post-Print hal-02179229, HAL.
    11. Jussi T. S. Heikkila, 2020. "Classifying economics for the common good: Connecting sustainable development goals to JEL codes," Papers 2004.04384, arXiv.org.
    12. Menon Martina & Perali Federico & Veronesi Marcella, 2017. "“Leaving No Child Behind:” Preferences for Social Inclusion and Altruism," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 17(3), pages 1-19, July.
    13. Shannon L. Sibbald & Nicole Haggerty, 2019. "Integrating Business and Medical Pedagogy to Accomplish the Sustainable Development Goals," Journal of Education for Sustainable Development, , vol. 13(1), pages 92-101, March.
    14. Dedy Rahman Wijaya & Ni Luh Putu Satyaning Pradnya Paramita & Ana Uluwiyah & Muhammad Rheza & Annisa Zahara & Dwi Rani Puspita, 2022. "Estimating city-level poverty rate based on e-commerce data with machine learning," Electronic Commerce Research, Springer, vol. 22(1), pages 195-221, March.
    15. Józsa, Krisztián & Török, Balázs & Stevenson, Cerissa, 2018. "Preschool and kindergarten in Hungary and the United States: A comparison within transnational development policy," International Journal of Educational Development, Elsevier, vol. 62(C), pages 88-95.
    16. Kasuga, Hidefumi & Morita, Yuichi, 2022. "The health gap and its effect on economic outcomes," Journal of Macroeconomics, Elsevier, vol. 74(C).
    17. Soumi Roy Chowdhury & Alok K. Bohara & Hari Katuwal & José A. Pagán & Jennifer A. Thacher, 2019. "The Impact of Ritual Bathing in a Holy Hindu River on Waterborne Diseases," The Developing Economies, Institute of Developing Economies, vol. 57(1), pages 36-54, March.
    18. Samuel Dorevitch, 2015. "Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns," IJERPH, MDPI, vol. 12(10), pages 1-3, October.
    19. Santangelo, Grazia D., 2018. "The impact of FDI in land in agriculture in developing countries on host country food security," Journal of World Business, Elsevier, vol. 53(1), pages 75-84.
    20. Sheilla Nyasha Author-Name: Yvonne Gwenhure & Nicholas M. Odhiambo, 2017. "Poverty and Economic Growth in Ethiopia: A Multivariate Causal Linkage," Journal of Developing Areas, Tennessee State University, College of Business, vol. 51(1), pages 343-359, January-M.

    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:pone00:0242729. 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.