Levels and determinants of quality of antenatal care in Bangladesh: Evidence from the Bangladesh Demographic and Health Survey

Abstract

AbstractBackgroundAssessing the quality of antenatal care (ANC) is imperative for improving care provisions during pregnancy to ensure the health of mother and baby. In Bangladesh, there is a dearth of research on the quality of ANC using nationally representative data to understand its levels and determinants. The current study aims to assess the quality of ANC and identify the sociodemographic factors associated with the usage of quality ANC services in Bangladesh.MethodsWe conducted secondary data analysis using the last two Bangladesh Demographic and Health Surveys (BDHS) (2014 and 2017–18). A total of 8,277 ever-married women were included in the analysis (3,631 from 2014 and 4,646 from 2017–18 BDHS). We constructed the quality ANC index using a principal component analysis on different ANC components: weight, blood pressure measurement, blood and urine tests, counseling about pregnancy complications and a minimum of four ANC visits of which one is by a medically trained provider. Multinomial logistic regression was used to determine the strength of association.ResultsReceiving all the six components of quality ANC increased from about 13% in 2014 (BDHS 2014) to 18% in 2017/18 (BDHS 2017–18) with a significant difference of p < 0.001. Women from the poorest group, being rural areas, with no education, high birth order and unexposed to media were less likely to receive high-quality ANC than women from the richest group, from urban areas, with a higher level of education, low birth order and exposure to media.ConclusionThere is a need to improve the quality of ANC services in Bangladesh. An education program for women, with regular knowledge-enhancing sessions for pregnant mothers, may help them understand the value of ANC visits. Documentaries about maternal and child healthcare can be broadcast on television, YouTube, Facebook, radio and other digital platforms regularly.