IDEAS home Printed from https://ideas.repec.org/p/pra/mprapa/63496.html
   My bibliography  Save this paper

Progress in utilization of antenatal and delivery care services in Bangladesh: Where does the equity gap lie?

Author

Listed:
  • Pulok, Mohammad Habibullah
  • Sabah, Md Nasim-Us Sabah
  • Uddin, Jalal
  • Enemark, Ulrika

Abstract

Despite a central element of the Millennium Development Goals (MDGs), the progress in making pregnancy and childbearing safer for women has been slow in many developing countries. Though Bangladesh has achieved commendable progress in reducing maternal mortality in recent decades, the country faces pervasive inequity in antennal (ANC) and delivery care services. The purpose of this study is to provide recent estimates of trend in inequity in antenatal and delivery care services in Bangladesh during 2004-2011. We employ rich-poor ratio, concentration curve and concentration index to examine the trends of inequities in ANC and delivery care services using the latest three waves of Bangladesh Demographic and Health Survey. This study uses logistic regression analysis to investigate the relationship between socioeconomic factors and six indicators of ANC and delivery care. Concentration index for 4+ ANC visits dropped from 0.42 in 2004 to 0.31 in 2011 while it remained around 0.20 for receiving ANC from medically trained provider. Findings indicate that inequity in delivery at health facility and delivery by caesarean section decreased by about 33% in between 2004 and 2011. Women from the richest households were about 3 times more likely to have 4+ ANC visits (OR=2.91, 95% CI: 2.24-3.78), delivery at health facility (OR=3.16, 95% CI: 2.40-4.17), and skilled assistance at birth (OR=3.32, 95% CI: 2.51-4.38) compared to women from the poorest households. There was an overall progress in reducing inequity in utilization of maternal health care but rural area lagged behind to achieve equity compared to urban area. The evidence of inequity in maternal health care utilization highlights that the country faces not only a persistent equity gap between rich and poor women but also substantial rural-urban inequity. It is essential to design multi-sectoral and concerted interventions from an equity perspective to accelerate safe motherhood and childbirth in Bangladesh.

Suggested Citation

  • Pulok, Mohammad Habibullah & Sabah, Md Nasim-Us Sabah & Uddin, Jalal & Enemark, Ulrika, 2015. "Progress in utilization of antenatal and delivery care services in Bangladesh: Where does the equity gap lie?," MPRA Paper 63496, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:63496
    as

    Download full text from publisher

    File URL: https://mpra.ub.uni-muenchen.de/63496/1/MPRA_paper_63496.pdf
    File Function: original version
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    2. Jahan, R., 2007. "Securing maternal health through comprehensive reproductive health services: Lessons from Bangladesh," American Journal of Public Health, American Public Health Association, vol. 97(7), pages 1186-1190.
    3. Adam Wagstaff & Eddy van Doorslaer, 2004. "Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 297-301, March.
    4. Hossain, M. I., 2010. "Inequality in the Utilization of Maternal Care and the Impact of a Macroeconomic Policy: Evidence from Bangladesh," Health, Econometrics and Data Group (HEDG) Working Papers 10/08, HEDG, c/o Department of Economics, University of York.
    5. Ahmed, Shakil & Khan, M. Mahmud, 2011. "Is demand-side financing equity enhancing? Lessons from a maternal health voucher scheme in Bangladesh," Social Science & Medicine, Elsevier, vol. 72(10), pages 1704-1710, May.
    6. Nguyen, Ha T.H. & Hatt, Laurel & Islam, Mursaleena & Sloan, Nancy L. & Chowdhury, Jamil & Schmidt, Jean-Olivier & Hossain, Atia & Wang, Hong, 2012. "Encouraging maternal health service utilization: An evaluation of the Bangladesh voucher program," Social Science & Medicine, Elsevier, vol. 74(7), pages 989-996.
    7. 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.
    8. Story, William T. & Burgard, Sarah A., 2012. "Couples’ reports of household decision-making and the utilization of maternal health services in Bangladesh," Social Science & Medicine, Elsevier, vol. 75(12), pages 2403-2411.
    9. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432, April.
    10. Raghupathy, Shobana, 1996. "Education and the use of maternal health care in Thailand," Social Science & Medicine, Elsevier, vol. 43(4), pages 459-471, August.
    11. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July.
    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. Muhammad Badiuzzaman & Syed Mansoob Murshed, 2016. "Impact of post-conflict development interventions on maternal healthcare utilization," WIDER Working Paper Series 082, World Institute for Development Economic Research (UNU-WIDER).
    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. Derek Asuman & Ama Pokuaa Fenny & Doreen Nyarko Anyamesem Odame, 2021. "Trends and antecedents of inequalities in maternal healthcare coverage in four African countries," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(3), pages 515-544, April.
    4. Gowokani Chijere Chirwa & Jacob Mazalale & Gloria Likupe & Dominic Nkhoma & Levison Chiwaula & Jesman Chintsanya, 2019. "An evolution of socioeconomic related inequality in teenage pregnancy and childbearing in Malawi," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-16, November.
    5. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.

    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. Mary O. Obiyan & Abhishek Kumar, 2015. "Socioeconomic Inequalities in the Use of Maternal Health Care Services in Nigeria," SAGE Open, , vol. 5(4), pages 21582440156, November.
    2. Olufunke Alaba & Lumbwe Chola, 2014. "Socioeconomic Inequalities in Adult Obesity Prevalence in South Africa: A Decomposition Analysis," IJERPH, MDPI, vol. 11(3), pages 1-20, March.
    3. Sözmen, Kaan & Ünal, Belgin, 2016. "Explaining inequalities in Health Care Utilization among Turkish adults: Findings from Health Survey 2008," Health Policy, Elsevier, vol. 120(1), pages 100-110.
    4. Nazmul Alam & Mohammad Hajizadeh & Alexandre Dumont & Pierre Fournier, 2015. "Inequalities in Maternal Health Care Utilization in Sub-Saharan African Countries: A Multiyear and Multi-Country Analysis," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-16, April.
    5. Aizawa, Toshiaki, 2019. "Ex-ante Inequality of Opportunity in Child Malnutrition: New Evidence from Ten Developing Countries in Asia," Economics & Human Biology, Elsevier, vol. 35(C), pages 144-161.
    6. Randive, Bharat & San Sebastian, Miguel & De Costa, Ayesha & Lindholm, Lars, 2014. "Inequalities in institutional delivery uptake and maternal mortality reduction in the context of cash incentive program, Janani Suraksha Yojana: Results from nine states in India," Social Science & Medicine, Elsevier, vol. 123(C), pages 1-6.
    7. Carrieri, Vincenzo & Wuebker, Ansgar, 2013. "Assessing inequalities in preventive care use in Europe," Health Policy, Elsevier, vol. 113(3), pages 247-257.
    8. Abhishek Singh & Saseendran Pallikadavath & Faujdar Ram & Reuben Ogollah, 2012. "Inequalities in Advice Provided by Public Health Workers to Women during Antenatal Sessions in Rural India," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-8, September.
    9. Hajizadeh, Mohammad & Nandi, Arijit & Heymann, Jody, 2014. "Social inequality in infant mortality: What explains variation across low and middle income countries?," Social Science & Medicine, Elsevier, vol. 101(C), pages 36-46.
    10. Pulok, Mohammad Habibullah & van Gool, Kees & Hall, Jane, 2020. "Inequity in physician visits: the case of the unregulated fee market in Australia," Social Science & Medicine, Elsevier, vol. 255(C).
    11. Philip Clarke & Tom Van Ourti, 2009. "Correcting the Bias in the Concentration Index when Income is Grouped," CEPR Discussion Papers 599, Centre for Economic Policy Research, Research School of Economics, Australian National University.
    12. Clifton Makate & Marshall Makate & Nelson Mango, 2019. "Wealth-related inequalities in adoption of drought-tolerant maize and conservation agriculture in Zimbabwe," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 11(4), pages 881-896, August.
    13. Juan Antonio Córdoba-Doña & Antonio Escolar-Pujolar & Miguel San Sebastián & Per E Gustafsson, 2018. "Withstanding austerity: Equity in health services utilisation in the first stage of the economic recession in Southern Spain," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-21, March.
    14. John E. Ataguba, 2019. "Socio‐economic inequality in health service utilisation: Does accounting for seasonality in health‐seeking behaviour matter?," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1370-1376, November.
    15. Hernández-Quevedo, Cristina & Masseria, Cristina, 2013. "Measuring Income-Related Inequalities in Health in Multi-Country Analysis/Midiendo las desigualdades en salud relacionadas con la renta entre países," Estudios de Economia Aplicada, Estudios de Economia Aplicada, vol. 31, pages 455-476, Septiembr.
    16. repec:zbw:rwirep:0371 is not listed on IDEAS
    17. Vincenzo Carrieri & Ansgar Wübker, 2012. "Assessing Inequalities in Preventive Care Use in Europe," Ruhr Economic Papers 0371, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    18. Erreygers, Guido & Clarke, Philip & Van Ourti, Tom, 2012. "“Mirror, mirror, on the wall, who in this land is fairest of all?”—Distributional sensitivity in the measurement of socioeconomic inequality of health," Journal of Health Economics, Elsevier, vol. 31(1), pages 257-270.
    19. Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 83897, University Library of Munich, Germany, revised 12 Jan 2018.
    20. Hernández-Quevedo, Cristina & Masseria, Cristina, 2013. "Measuring income-related inequalities in health in multi-country analysis," LSE Research Online Documents on Economics 53576, London School of Economics and Political Science, LSE Library.
    21. Marjorie Opuni & Amber Peterman & David Bishai, 2011. "Inequality in prime‐age adult deaths in a high AIDS mortality setting: does the measure of economic status matter?," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1298-1311, November.

    More about this item

    Keywords

    Antennal care; Bangladesh; delivery care; concentration index; inequity.;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:pra:mprapa:63496. 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: Joachim Winter (email available below). General contact details of provider: https://edirc.repec.org/data/vfmunde.html .

    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.