An empirical analysis of socioeconomic risk factors associated with antenatal care attendance in Bangladesh

Faria Hossain Borsha; Sujan Rudra; Lutfun Naher

doi:10.31893/multiscience.2024042

Keywords:

ANC

Hurdle Negative Binomial Model

BDHS

Logistic Regression Model

Bangladesh

Abstract

Maternal mortality and morbidity reduction constitute policy priorities, facilitated by prenatal care and World Health Organization (WHO)-endorsed antenatal care (ANC) utilization during pregnancy. Progress in Bangladesh is hindered as only 47% of expectant women participated in a minimum of four ANC sessions according to the latest maternal mortality survey. This study, utilizing 2018 Bangladesh Demographic and Health Survey (BDHS) data, undertakes an assessment of the socioeconomic determinants influencing the utilization or non-utilization of ANC services. Additionally, the study investigates socioeconomic factors significantly impacting the attainment of the WHO-recommended four or more ANC sessions. A Hurdle Negative Binomial Model is employed to ascertain ANC risk variables and their frequency, while the utilization characteristics of WHO ANC services are discerned through the Binary Logistic Regression Model. Noteworthy among the statistically significant determinants influencing the reception of any antenatal care (ANC) in Bangladesh are the sex of the household head, place of residence, wealth index, husband/partner's education, the highest educational attainment of women, decision-making regarding the expenditure of women's earnings, ease of obtaining medical assistance permission, mobile phone ownership, and media exposure. Furthermore, this empirical inquiry reveals that income inequality, the highest educational attainment of women, decision-making regarding the expenditure of women's earnings, distance to health facilities, mobile phone ownership, utilization of phones for financial transactions, and media exposure significantly determine adherence to WHO-recommended ANC guidelines. This study identifies four crucial determinants for the initiation of ANC services and adherence to recommended prenatal care: a pregnant woman's wealth index ranking, highest educational attainment, ownership of a mobile phone, and exposure to media. The findings of this study can aid Bangladeshi healthcare programmers and policymakers in devising strategies to achieve comprehensive ANC coverage for all pregnant women.
References
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2. Ali, N., Sultana, M., Sheikh, N., Akram, R., Mahumud, R. A., Asaduzzaman, M., & Sarker, A. R. (2018). Predictors of Optimal Antenatal Care Service Utilization Among Adolescents and Adult Women in Bangladesh. Health Services Research and Managerial Epidemiology, 5, 233339281878172. https://doi.org/10.1177/2333392818781729
3. Amin, R., Shah, N. M., & Becker, S. (2010). Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis. International Journal for Equity in Health, 9, 1–11. https://doi.org/10.1186/1475-9276-9-9
4. Benova, L., Tunçalp, Ö., Moran, A. C., & Campbell, O. M. R. (2018). Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries. BMJ Global Health, 3(2), e000779. https://doi.org/10.1136/bmjgh-2018-000779
5. Bhowmik, J., Biswas, R. K., & Woldegiorgis, M. (2019). Antenatal care and skilled birth attendance in Bangladesh are influenced by female education and family affordability: BDHS 2014. Public Health, 170, 113–121. https://doi.org/10.1016/j.puhe.2019.02.027
6. Bhowmik, K. R., Das, S., & Islam, M. A. (2020). Modelling the number of antenatal care visits in Bangladesh to determine the risk factors for reduced antenatal care attendance. PLoS ONE, 15(1), 1–17. https://doi.org/10.1371/journal.pone.0228215
7. Fagbamigbe, A. F., & Idemudia, E. S. (2015). Barriers to antenatal care use in Nigeria: Evidences from non-users and implications for maternal health programming. BMC Pregnancy and Childbirth, 15(1), 1–10. https://doi.org/10.1186/s12884-015-0527-y
8. Fenta, S. M., Fenta, H. M., & Ayenew, G. M. (2020). The best statistical model to estimate predictors of under-five mortality in Ethiopia. Journal of Big Data, 7(1). https://doi.org/10.1186/s40537-020-00339-0
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10. Joshi, C., Torvaldsen, S., Hodgson, R., & Hayen, A. (2014). Factors associated with the use and quality of antenatal care in Nepal: A population-based study using the demographic and health survey data. BMC Pregnancy and Childbirth, 14(1), 1–11. https://doi.org/10.1186/1471-2393-14-94
11. Mugo, N. S., Dibley, M. J., & Agho, K. E. (2015). Prevalence and risk factors for non-use of antenatal care visits: Analysis of the 2010 South Sudan household survey. BMC Pregnancy and Childbirth, 15(1), 1–13. https://doi.org/10.1186/s12884-015-0491-6
12. Nisingizwe, M. P., Tuyisenge, G., Hategeka, C., & Karim, M. E. (2020). Are perceived barriers to accessing health care associated with inadequate antenatal care visits among women of reproductive age in Rwanda? BMC Pregnancy and Childbirth 20(1), 1–10. https://doi.org/10.1186/s12884-020-2775-8
13. Nketiah-Amponsah, E., Senadza, B., & Arthur, E. (2013). Determinants of utilization of antenatal care services in developing countries: Recent evidence from Ghana. African Journal of Economic and Management Studies, 4(1), 58–73. https://doi.org/10.1108/20400701311303159
14. Ousman, S. K., Mdala, I., Thorsen, V. C., Sundby, J., & Magnus, J. H. (2019). Social determinants of antenatal care service use in ethiopia: Changes over a 15-year span. Frontiers in Public Health, 7(JUN), 1–10. https://doi.org/10.3389/fpubh.2019.00161
15. Pervin, J., Venkateswaran, M., Nu, U. T., Rahman, M., O’Donnell, B. F., Friberg, I. K., Rahman, A., & Frøen, J. F. (2021). Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh. PLoS ONE, 16(9 September), 1–16. https://doi.org/10.1371/journal.pone.0257782
16. Phommachanh, S., Essink, D. R., Jansen, M., Broerse, J. E. W., Wright, P., & Mayxay, M. (2019). Improvement of Quality of Antenatal Care (ANC) Service Provision at the Public Health Facilities in Lao PDR: Perspective and Experiences of Supply and Demand Sides. BMC Pregnancy and Childbirth, 19(1), 255. https://doi.org/10.1186/s12884-019-2345-0
17. Rahman, A., Nisha, M. K., Begum, T., Ahmed, S., Alam, N., & Anwar, I. (2017). Trends, determinants and inequities of 4+ ANC utilisation in Bangladesh. Journal of Health, Population, and Nutrition, 36(1), 2. https://doi.org/10.1186/s41043-016-0078-5
18. Rahman, M., Islam, R., & Islam, A. Z. (2008). Rural-Urban Differentials of Utilization of Ante-Natal Health-Care Services in Bangladesh. Health Policy and Development, 6(3), 117–125.
19. Rahman, M. M., Rahman, M. M., Tareque, M. I., Ferdos, J., & Jesmin, S. S. (2016). Maternal pregnancy intention and professional antenatal care utilization in Bangladesh: A nationwide population-based survey. PLoS ONE, 11(6), 1–15. https://doi.org/10.1371/journal.pone.0157760
20. Rwabilimbo, A. G., Ahmed, K. Y., Page, A., & Ogbo, F. A. (2020). Trends and factors associated with the utilisation of antenatal care services during the Millennium Development Goals era in Tanzania. Tropical Medicine and Health, 48(1). https://doi.org/10.1186/s41182-020-00226-7
21. Saad-Haddad, G., DeJong, J., Terreri, N., Restrepo-Méndez, M. C., Perin, J., Vaz, L., Newby, H., Amouzou, A., Barros, A. J. D., & Bryce, J. (2016). Patterns and determinants of antenatal care utilization: Analysis of national survey data in seven countdown countries. Journal of Global Health, 6(1). https://doi.org/10.7189/jogh.06.010404
22. Shahjahan, M., Chowdhury, H. A., Akter, J., Afroz, A., Rahman, M. M., & Hafez, M. (2013). Factors associated with use of antenatal care services in a rural area of Bangladesh. South East Asia Journal of Public Health, 2(2), 61–66. https://doi.org/10.3329/seajph.v2i2.15956
23. Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110. https://doi.org/10.1016/0277-9536(94)90226-7
24. Tunçalp, Ӧ, Pena-Rosas, J., Lawrie, T., Bucagu, M., Oladapo, O., Portela, A., & Metin Gülmezoglu, A. (2017). WHO recommendations on antenatal care for a positive pregnancy experience-going beyond survival. BJOG: An International Journal of Obstetrics & Gynaecology, 124(6), 860–862. https://doi.org/10.1111/1471-0528.14599
25. Victora, C. G., Requejo, J. H., Barros, A. J. D., Berman, P., Bhutta, Z., Boerma, T., Chopra, M., de Francisco, A., Daelmans, B., Hazel, E., Lawn, J., Maliqi, B., Newby, H., & Bryce, J. (2016). Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. The Lancet, 387(10032) 2049–2059. https://doi.org/10.1016/S0140-6736(15)00519-X
26. Yesuf, E. A., & Calderon-Margalit, R. (2013). Disparities in the use of antenatal care service in Ethiopia over a period of fifteen years. BMC Pregnancy and Childbirth, 13. https://doi.org/10.1186/1471-2393-13-131

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Hossain Borsha, F., Rudra, S., & Naher , L. (2023). An empirical analysis of socioeconomic risk factors associated with antenatal care attendance in Bangladesh. Multidisciplinary Science Journal, 6(4), 2024042. https://doi.org/10.31893/multiscience.2024042

[1] Adedokun, S. T., & Yaya, S. (2020). Correlates of antenatal care utilization among women of reproductive age in sub-Saharan Africa: evidence from multinomial analysis of demographic and health surveys (2010–2018) from 31 countries. Archives of Public Health, 78(1), 1–10. https://doi.org/10.1186/s13690-020-00516-w

[2] Ali, N., Sultana, M., Sheikh, N., Akram, R., Mahumud, R. A., Asaduzzaman, M., & Sarker, A. R. (2018). Predictors of Optimal Antenatal Care Service Utilization Among Adolescents and Adult Women in Bangladesh. Health Services Research and Managerial Epidemiology, 5, 233339281878172. https://doi.org/10.1177/2333392818781729

[3] Amin, R., Shah, N. M., & Becker, S. (2010). Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis. International Journal for Equity in Health, 9, 1–11. https://doi.org/10.1186/1475-9276-9-9

[4] Benova, L., Tunçalp, Ö., Moran, A. C., & Campbell, O. M. R. (2018). Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries. BMJ Global Health, 3(2), e000779. https://doi.org/10.1136/bmjgh-2018-000779

[5] Bhowmik, J., Biswas, R. K., & Woldegiorgis, M. (2019). Antenatal care and skilled birth attendance in Bangladesh are influenced by female education and family affordability: BDHS 2014. Public Health, 170, 113–121. https://doi.org/10.1016/j.puhe.2019.02.027

[6] Bhowmik, K. R., Das, S., & Islam, M. A. (2020). Modelling the number of antenatal care visits in Bangladesh to determine the risk factors for reduced antenatal care attendance. PLoS ONE, 15(1), 1–17. https://doi.org/10.1371/journal.pone.0228215

[7] Fagbamigbe, A. F., & Idemudia, E. S. (2015). Barriers to antenatal care use in Nigeria: Evidences from non-users and implications for maternal health programming. BMC Pregnancy and Childbirth, 15(1), 1–10. https://doi.org/10.1186/s12884-015-0527-y

[8] Fenta, S. M., Fenta, H. M., & Ayenew, G. M. (2020). The best statistical model to estimate predictors of under-five mortality in Ethiopia. Journal of Big Data, 7(1). https://doi.org/10.1186/s40537-020-00339-0

[9] Global indicator framework for the Sustainable Development Goals and targets of the 2030 Agenda for Sustainable Development. (2017). https://unstats.un.org/sdgs/indicators/Global Indicator Framework_A.RES.71.313 Annex.pdf Accessed on:December 26,2022

[10] Joshi, C., Torvaldsen, S., Hodgson, R., & Hayen, A. (2014). Factors associated with the use and quality of antenatal care in Nepal: A population-based study using the demographic and health survey data. BMC Pregnancy and Childbirth, 14(1), 1–11. https://doi.org/10.1186/1471-2393-14-94

[11] Mugo, N. S., Dibley, M. J., & Agho, K. E. (2015). Prevalence and risk factors for non-use of antenatal care visits: Analysis of the 2010 South Sudan household survey. BMC Pregnancy and Childbirth, 15(1), 1–13. https://doi.org/10.1186/s12884-015-0491-6

[12] Nisingizwe, M. P., Tuyisenge, G., Hategeka, C., & Karim, M. E. (2020). Are perceived barriers to accessing health care associated with inadequate antenatal care visits among women of reproductive age in Rwanda? BMC Pregnancy and Childbirth 20(1), 1–10. https://doi.org/10.1186/s12884-020-2775-8

[13] Nketiah-Amponsah, E., Senadza, B., & Arthur, E. (2013). Determinants of utilization of antenatal care services in developing countries: Recent evidence from Ghana. African Journal of Economic and Management Studies, 4(1), 58–73. https://doi.org/10.1108/20400701311303159

[14] Ousman, S. K., Mdala, I., Thorsen, V. C., Sundby, J., & Magnus, J. H. (2019). Social determinants of antenatal care service use in ethiopia: Changes over a 15-year span. Frontiers in Public Health, 7(JUN), 1–10. https://doi.org/10.3389/fpubh.2019.00161

[15] Pervin, J., Venkateswaran, M., Nu, U. T., Rahman, M., O’Donnell, B. F., Friberg, I. K., Rahman, A., & Frøen, J. F. (2021). Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh. PLoS ONE, 16(9 September), 1–16. https://doi.org/10.1371/journal.pone.0257782

[16] Phommachanh, S., Essink, D. R., Jansen, M., Broerse, J. E. W., Wright, P., & Mayxay, M. (2019). Improvement of Quality of Antenatal Care (ANC) Service Provision at the Public Health Facilities in Lao PDR: Perspective and Experiences of Supply and Demand Sides. BMC Pregnancy and Childbirth, 19(1), 255. https://doi.org/10.1186/s12884-019-2345-0

[17] Rahman, A., Nisha, M. K., Begum, T., Ahmed, S., Alam, N., & Anwar, I. (2017). Trends, determinants and inequities of 4+ ANC utilisation in Bangladesh. Journal of Health, Population, and Nutrition, 36(1), 2. https://doi.org/10.1186/s41043-016-0078-5

[18] Rahman, M., Islam, R., & Islam, A. Z. (2008). Rural-Urban Differentials of Utilization of Ante-Natal Health-Care Services in Bangladesh. Health Policy and Development, 6(3), 117–125.

[19] Rahman, M. M., Rahman, M. M., Tareque, M. I., Ferdos, J., & Jesmin, S. S. (2016). Maternal pregnancy intention and professional antenatal care utilization in Bangladesh: A nationwide population-based survey. PLoS ONE, 11(6), 1–15. https://doi.org/10.1371/journal.pone.0157760

[20] Rwabilimbo, A. G., Ahmed, K. Y., Page, A., & Ogbo, F. A. (2020). Trends and factors associated with the utilisation of antenatal care services during the Millennium Development Goals era in Tanzania. Tropical Medicine and Health, 48(1). https://doi.org/10.1186/s41182-020-00226-7

[21] Saad-Haddad, G., DeJong, J., Terreri, N., Restrepo-Méndez, M. C., Perin, J., Vaz, L., Newby, H., Amouzou, A., Barros, A. J. D., & Bryce, J. (2016). Patterns and determinants of antenatal care utilization: Analysis of national survey data in seven countdown countries. Journal of Global Health, 6(1). https://doi.org/10.7189/jogh.06.010404

[22] Shahjahan, M., Chowdhury, H. A., Akter, J., Afroz, A., Rahman, M. M., & Hafez, M. (2013). Factors associated with use of antenatal care services in a rural area of Bangladesh. South East Asia Journal of Public Health, 2(2), 61–66. https://doi.org/10.3329/seajph.v2i2.15956

[23] Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110. https://doi.org/10.1016/0277-9536(94)90226-7

[24] Tunçalp, Ӧ, Pena-Rosas, J., Lawrie, T., Bucagu, M., Oladapo, O., Portela, A., & Metin Gülmezoglu, A. (2017). WHO recommendations on antenatal care for a positive pregnancy experience-going beyond survival. BJOG: An International Journal of Obstetrics & Gynaecology, 124(6), 860–862. https://doi.org/10.1111/1471-0528.14599

[25] Victora, C. G., Requejo, J. H., Barros, A. J. D., Berman, P., Bhutta, Z., Boerma, T., Chopra, M., de Francisco, A., Daelmans, B., Hazel, E., Lawn, J., Maliqi, B., Newby, H., & Bryce, J. (2016). Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. The Lancet, 387(10032) 2049–2059. https://doi.org/10.1016/S0140-6736(15)00519-X

[26] Yesuf, E. A., & Calderon-Margalit, R. (2013). Disparities in the use of antenatal care service in Ethiopia over a period of fifteen years. BMC Pregnancy and Childbirth, 13. https://doi.org/10.1186/1471-2393-13-131

Abstract

References

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