Socioeconomic and regional disparities in postnatal care utilization in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey 2022

Maternal and neonatal mortality in Bangladesh remains high, particularly in rural areas where access to skilled postnatal care (PNC) is limited. This study assessed urban-rural disparities in PNC utilization using data from the 2022 Bangladesh Demographic and Health Survey. A sample of 4,844 ever-married women aged 15–49 with a recent live birth (3,249 from rural areas; 1,595 from urban areas) was analyzed. Outcomes included receiving any PNC, receiving a timely PNC within two days, and receiving a PNC from a trained provider. Socio-demographic, reproductive, and healthcare determinants are analyzed using survey-adjusted weighted logistic regression. Overall, 76.6% of women received PNC, with 70.4% receiving it within 48 hours, and 24.7% from skilled providers. Utilization was consistently higher in urban than rural areas. Education, wealth, antenatal visits, and maternal employment were positively associated with PNC use, with women attending four or more antenatal visits showing nearly twice the odds of receiving timely and skilled PNC. Conversely, higher birth order and regional disparities, particularly in Rangpur, were associated with reduced access to skilled care. Chattogram showed comparatively higher coverage. Persistent inequities in PNC utilization, with rural women lagging in both timeliness and access to skilled providers, indicate targeted interventions addressing education, socio-economic inequality, and service availability are critical to improving maternal and newborn health outcomes in Bangladesh.