Abstract
Background Disrespect and abuse (D&A) during childbirth pose significant barriers to accessing maternal healthcare services, especially in low- and middle-income countries like Bangladesh. This study aimed to assess the prevalence and determinants of D&A among mothers accessing delivery healthcare services in Bangladesh.Methods This study analyzed data collected from 891 mothers through a cross-sectional survey conducted in 12 healthcare facilities across three randomly selected districts in Bangladesh: Rajshahi, Mymensingh, and Rangpur. Disrespect and abuse (D&A) was categorized into three groups: no D&A, moderate D&A, and severe D&A and considered as the outcome variable. Explanatory variables included mothers' socio-demographic characteristics, use of antenatal healthcare services, and the types of healthcare facilities (public or private) from which delivery healthcare services were accessed. Multivariate multinomial logistic regressions were conducted to explore the association between the outcome variable and explanatory variables.Results Over half of the mothers (53%) reported experiencing moderate (33%) and severe (20%) levels of D&A. The prevalence of D&A was higher among mothers accessing services from government healthcare facilities compared to private facilities (73% vs 40%). Lower likelihoods of D&A were found among mothers with higher education levels, no formal employment, mothers residing in households in comparatively high wealth quintiles, mothers who reported a higher number of antenatal healthcare visits, mothers with rural residency, and those accessing healthcare services from private facilities.Conclusion The study underscores a high prevalence of D&A among mothers accessing delivery healthcare services in Bangladesh, especially in government healthcare facilities. Addressing structural challenges within healthcare facilities and implementing training programs for healthcare personnel focused on effective communication and the provision of dignified services for mothers during delivery healthcare services are recommended.