Skip to main content
Top
Published in: Reproductive Health 1/2014

Open Access 01-12-2014 | Research

Practices and determinants of delivery by skilled birth attendants in Bangladesh

Authors: Nazrul Islam, Mohammad Tajul Islam, Yukie Yoshimura

Published in: Reproductive Health | Issue 1/2014

Login to get access

Abstract

Introduction

Utilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh. Birth attendance by SBAs is considered as the “single most important factor in preventing maternal deaths”. This paper examined the practices and determinants of delivery by SBAs in rural Bangladesh.

Methods

The data come from the post-intervention survey of a cluster-randomized community controlled trial conducted to evaluate the impact of limited post-natal care (PNC) services on healthcare seeking behavior of women with a recent live birth in rural Bangladesh (n = 702). Multivariable logistic regression model was used to identify the potential determinants of delivery by SBAs.

Results

The respondents were aged between 16 and 45, with the mean age of 24.41 (± 5.03) years. Approximately one-third (30.06%) of the women had their last delivery by SBAs. Maternal occupation, parity, complications during pregnancy and antenatal checkup (ANC) by SBAs were the significant determinants of delivery by SBAs. Women who took antenatal care by SBAs were 2.62 times as likely (95% CI: 1.66, 4.14; p < 0.001) to have their delivery conducted by SBAs compared to those who did not, after adjusting for other covariates.

Conclusion

Our findings suggest that ANC by SBAs and complications during pregnancies are significant determinants of delivery by SBAs. Measure should be in place to promote antenatal checkup by SBAs to increase utilization of SBAs at birth in line with achieving the Millennium Development Goal-5. Future research should focus in exploring the unmet need for, and potential barriers in, the utilization of delivery by SBAs.
Appendix
Available only for authorised users
Literature
1.
go back to reference Lawn JE, Kerber K, Enweronu-Laryea C, Cousens S: 3.6 million neonatal deaths–what is progressing and what is Not?. Semin Perinatol. 2010, 34: 371-386. 10.1053/j.semperi.2010.09.011.CrossRefPubMed Lawn JE, Kerber K, Enweronu-Laryea C, Cousens S: 3.6 million neonatal deaths–what is progressing and what is Not?. Semin Perinatol. 2010, 34: 371-386. 10.1053/j.semperi.2010.09.011.CrossRefPubMed
2.
go back to reference Starrs AM: Safe motherhood initiative: 20 years and counting. Lancet. 2006, 368: 1130-1132. 10.1016/S0140-6736(06)69385-9.CrossRefPubMed Starrs AM: Safe motherhood initiative: 20 years and counting. Lancet. 2006, 368: 1130-1132. 10.1016/S0140-6736(06)69385-9.CrossRefPubMed
3.
go back to reference WHO, UNICEF, UNFPA, The World Bank, United Nations: Trends in maternal mortality: 1990 to 2013: Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. 2014, Geneva, Switzerland: World Health Organization WHO, UNICEF, UNFPA, The World Bank, United Nations: Trends in maternal mortality: 1990 to 2013: Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. 2014, Geneva, Switzerland: World Health Organization
4.
go back to reference Gabrysch S, Campbell O: Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 2009, 9: 34-10.1186/1471-2393-9-34.CrossRefPubMedPubMedCentral Gabrysch S, Campbell O: Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 2009, 9: 34-10.1186/1471-2393-9-34.CrossRefPubMedPubMedCentral
5.
go back to reference World Health Organization: Reduction of Maternal Mortality: A Joint WHO/UNFPA/UNICEF/World Bank Statement. 1999, Geneva, Switzerland: World Health Organization World Health Organization: Reduction of Maternal Mortality: A Joint WHO/UNFPA/UNICEF/World Bank Statement. 1999, Geneva, Switzerland: World Health Organization
6.
go back to reference Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: When? Where? Why?. Lancet. 2005, 365: 891-900. 10.1016/S0140-6736(05)71048-5.CrossRefPubMed Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: When? Where? Why?. Lancet. 2005, 365: 891-900. 10.1016/S0140-6736(05)71048-5.CrossRefPubMed
7.
go back to reference Vieira C, Portela A, Miller T, Coast E, Leone T, Marston C: Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review. PLoS ONE. 2012, 7: e47946-10.1371/journal.pone.0047946.CrossRefPubMedPubMedCentral Vieira C, Portela A, Miller T, Coast E, Leone T, Marston C: Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review. PLoS ONE. 2012, 7: e47946-10.1371/journal.pone.0047946.CrossRefPubMedPubMedCentral
8.
go back to reference Bangladesh Bureau of Statistics-UNICEF: Key Findings: Multiple Indicators Clusters Survey Bangladesh 2006. 2007, Dhaka: Bangladesh Bureau of Statistics and UNICEF Bangladesh Bureau of Statistics-UNICEF: Key Findings: Multiple Indicators Clusters Survey Bangladesh 2006. 2007, Dhaka: Bangladesh Bureau of Statistics and UNICEF
9.
go back to reference National Institute of Population Research and Training: Bangladesh Demographic and Health Survey 2011. 2013, Calverton, Maryland, USA: National Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh; Mitra and Associates, Dhaka, Bangladesh; MEASURE DHS, ICF International National Institute of Population Research and Training: Bangladesh Demographic and Health Survey 2011. 2013, Calverton, Maryland, USA: National Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh; Mitra and Associates, Dhaka, Bangladesh; MEASURE DHS, ICF International
10.
go back to reference Rowen T, Prata N, Passano P: Evaluation of a traditional birth attendant training programme in Bangladesh. Midwifery. 2011, 27: 229-236. 10.1016/j.midw.2009.06.003.CrossRefPubMed Rowen T, Prata N, Passano P: Evaluation of a traditional birth attendant training programme in Bangladesh. Midwifery. 2011, 27: 229-236. 10.1016/j.midw.2009.06.003.CrossRefPubMed
11.
go back to reference Directorate General of Health Services Bangladesh, United Nations Population Fund Bangladesh: Evaluation of the Community Based Skilled Birth Attendant (CSBA) Programme-Bangladesh. 2011, Government of the People’s Republic of Bangladesh: Directorate General of Health Services, Ministry of Health and Family Welfare Directorate General of Health Services Bangladesh, United Nations Population Fund Bangladesh: Evaluation of the Community Based Skilled Birth Attendant (CSBA) Programme-Bangladesh. 2011, Government of the People’s Republic of Bangladesh: Directorate General of Health Services, Ministry of Health and Family Welfare
12.
go back to reference Kamiya Y, Yoshimura Y, Islam MT: An impact evaluation of the safe motherhood promotion project in Bangladesh: evidence from Japanese aid-funded technical cooperation. Soc Sci Med. 2013, 83: 34-41.CrossRefPubMed Kamiya Y, Yoshimura Y, Islam MT: An impact evaluation of the safe motherhood promotion project in Bangladesh: evidence from Japanese aid-funded technical cooperation. Soc Sci Med. 2013, 83: 34-41.CrossRefPubMed
13.
go back to reference StataCorp: Stata Statistical Software: Release 12. 2011, College Station, TX: StataCorp LP StataCorp: Stata Statistical Software: Release 12. 2011, College Station, TX: StataCorp LP
14.
go back to reference National Institute of Population Research and Training: Bangladesh Demographic and Health Survey 2007. 2009, Dhaka: National Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh; Mitra and Associates, Dhaka, Bangladesh; MEASURE DHS, ICF International, Calverton, Maryland, USA National Institute of Population Research and Training: Bangladesh Demographic and Health Survey 2007. 2009, Dhaka: National Institute of Population Research and Training (NIPORT), Dhaka, Bangladesh; Mitra and Associates, Dhaka, Bangladesh; MEASURE DHS, ICF International, Calverton, Maryland, USA
15.
go back to reference Bangladesh Bureau of Statistics-UNICEF: Progotir Pathey 2009. 2010, Dhaka: Bangladesh Bureau of Statistics and UNICEF, I: Multiple Indicators Clusters Survey Bangladesh 2009, Technical Report Bangladesh Bureau of Statistics-UNICEF: Progotir Pathey 2009. 2010, Dhaka: Bangladesh Bureau of Statistics and UNICEF, I: Multiple Indicators Clusters Survey Bangladesh 2009, Technical Report
16.
go back to reference Anwar I, Sami M, Akhtar N, Chowdhury M, Salma U, Rahman M, Koblinsky M: Inequity in maternal health-care services: evidence from home-based skilled-birth-attendant programmes in Bangladesh. Bull World Health Organ. 2008, 86: 252-259. 10.2471/BLT.07.042754.CrossRefPubMedPubMedCentral Anwar I, Sami M, Akhtar N, Chowdhury M, Salma U, Rahman M, Koblinsky M: Inequity in maternal health-care services: evidence from home-based skilled-birth-attendant programmes in Bangladesh. Bull World Health Organ. 2008, 86: 252-259. 10.2471/BLT.07.042754.CrossRefPubMedPubMedCentral
17.
go back to reference Gyimah SO, Takyi BK, Addai I: Challenges to the reproductive-health needs of African women: on religion and maternal health utilization in Ghana. Soc Sci Med. 2006, 62: 2930-2944. 10.1016/j.socscimed.2005.11.034.CrossRefPubMed Gyimah SO, Takyi BK, Addai I: Challenges to the reproductive-health needs of African women: on religion and maternal health utilization in Ghana. Soc Sci Med. 2006, 62: 2930-2944. 10.1016/j.socscimed.2005.11.034.CrossRefPubMed
18.
go back to reference Mekonnen Y, Mekonnen A: Factors influencing the use of maternal healthcare services in Ethiopia. J Health Popul Nutr. 2003, 21: 374-382.PubMed Mekonnen Y, Mekonnen A: Factors influencing the use of maternal healthcare services in Ethiopia. J Health Popul Nutr. 2003, 21: 374-382.PubMed
19.
go back to reference Nwakoby BN: Use of obstetric services in rural Nigeria. J R Soc Promot Health. 1994, 114: 132-136. 10.1177/146642409411400304.CrossRef Nwakoby BN: Use of obstetric services in rural Nigeria. J R Soc Promot Health. 1994, 114: 132-136. 10.1177/146642409411400304.CrossRef
20.
go back to reference Burgard S: Race and pregnancy-related care in Brazil and South Africa. Soc Sci Med. 2004, 59: 1127-1146. 10.1016/j.socscimed.2004.01.006.CrossRefPubMed Burgard S: Race and pregnancy-related care in Brazil and South Africa. Soc Sci Med. 2004, 59: 1127-1146. 10.1016/j.socscimed.2004.01.006.CrossRefPubMed
21.
go back to reference Elo IT: Utilization of maternal health-care services in Peru: the role of women’s education. Health Transit Rev. 1992, 2: 49-69.PubMed Elo IT: Utilization of maternal health-care services in Peru: the role of women’s education. Health Transit Rev. 1992, 2: 49-69.PubMed
22.
go back to reference Glei DA, Goldman N, Rodrı́guez G: Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?. Soc Sci Med. 2003, 57: 2447-2463. 10.1016/S0277-9536(03)00140-0.CrossRefPubMed Glei DA, Goldman N, Rodrı́guez G: Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?. Soc Sci Med. 2003, 57: 2447-2463. 10.1016/S0277-9536(03)00140-0.CrossRefPubMed
23.
go back to reference Brentlinger PE, Javier Sánchez-Pérez H, Arana Cedeño M, Guadalupe Vargas Morales L, Hernán MA, Micek MA, Ford D: Pregnancy outcomes, site of delivery, and community schisms in regions affected by the armed conflict in Chiapas, Mexico. Soc Sci Med. 2005, 61: 1001-1014. 10.1016/j.socscimed.2004.12.022.CrossRefPubMed Brentlinger PE, Javier Sánchez-Pérez H, Arana Cedeño M, Guadalupe Vargas Morales L, Hernán MA, Micek MA, Ford D: Pregnancy outcomes, site of delivery, and community schisms in regions affected by the armed conflict in Chiapas, Mexico. Soc Sci Med. 2005, 61: 1001-1014. 10.1016/j.socscimed.2004.12.022.CrossRefPubMed
24.
go back to reference De Broe S: Diversity in the use of pregnancy-related care among ethnic groups in Guatemala. J Fam Plann Reprod Health Care. 2005, 31: 199-205. 10.1783/1471189054483889.CrossRefPubMed De Broe S: Diversity in the use of pregnancy-related care among ethnic groups in Guatemala. J Fam Plann Reprod Health Care. 2005, 31: 199-205. 10.1783/1471189054483889.CrossRefPubMed
25.
go back to reference Short SE, Zhang F: Use of maternal health services in rural China. Popul Stud. 2004, 58: 3-19. 10.1080/0032472032000175446.CrossRef Short SE, Zhang F: Use of maternal health services in rural China. Popul Stud. 2004, 58: 3-19. 10.1080/0032472032000175446.CrossRef
26.
go back to reference Celik Y, Hotchkiss DR: The socio-economic determinants of maternal health care utilization in Turkey. Soc Sci Med. 2000, 50: 1797-1806. 10.1016/S0277-9536(99)00418-9.CrossRefPubMed Celik Y, Hotchkiss DR: The socio-economic determinants of maternal health care utilization in Turkey. Soc Sci Med. 2000, 50: 1797-1806. 10.1016/S0277-9536(99)00418-9.CrossRefPubMed
27.
go back to reference Paul BK, Rumsey DJ: Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study. Soc Sci Med. 2002, 54: 1755-1765. 10.1016/S0277-9536(01)00148-4.CrossRefPubMed Paul BK, Rumsey DJ: Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study. Soc Sci Med. 2002, 54: 1755-1765. 10.1016/S0277-9536(01)00148-4.CrossRefPubMed
28.
go back to reference Gage AJ, Guirlène Calixte M: Effects of the physical accessibility of maternal health services on their use in rural Haiti. Population Studies. 2006, 60: 271-288. 10.1080/00324720600895934.CrossRefPubMed Gage AJ, Guirlène Calixte M: Effects of the physical accessibility of maternal health services on their use in rural Haiti. Population Studies. 2006, 60: 271-288. 10.1080/00324720600895934.CrossRefPubMed
29.
go back to reference Anwar AI, Killewo J, Chowdhury M, Dasgupta S: Bangladesh: Inequalities in Utilization of Maternal Health Care Services: Evidence from Matlab. 2004, Washington, DC: World Bank Anwar AI, Killewo J, Chowdhury M, Dasgupta S: Bangladesh: Inequalities in Utilization of Maternal Health Care Services: Evidence from Matlab. 2004, Washington, DC: World Bank
30.
go back to reference Navaneetham K, Dharmalingam A: Utilization of maternal health care services in Southern India. Soc Sci Med. 2002, 55: 1849-1869. 10.1016/S0277-9536(01)00313-6.CrossRefPubMed Navaneetham K, Dharmalingam A: Utilization of maternal health care services in Southern India. Soc Sci Med. 2002, 55: 1849-1869. 10.1016/S0277-9536(01)00313-6.CrossRefPubMed
31.
go back to reference Stephenson R, Tsui AO: Contextual influences on reproductive health service use in Uttar Pradesh, India. Stud Fam Plann. 2002, 33: 309-320. 10.1111/j.1728-4465.2002.00309.x.CrossRefPubMed Stephenson R, Tsui AO: Contextual influences on reproductive health service use in Uttar Pradesh, India. Stud Fam Plann. 2002, 33: 309-320. 10.1111/j.1728-4465.2002.00309.x.CrossRefPubMed
32.
go back to reference Addai I: Determinants of use of maternal-child health services in rural Ghana. J Biosoc Sci. 2000, 32: 1-15.PubMed Addai I: Determinants of use of maternal-child health services in rural Ghana. J Biosoc Sci. 2000, 32: 1-15.PubMed
33.
go back to reference Pervin J, Moran A, Rahman M, Razzaque A, Sibley L, Streatfield P, Reichenbach L, Koblinsky M, Hruschka D, Rahman A: Association of antenatal care with facility delivery and perinatal survival - a population-based study in Bangladesh. BMC Pregnancy Childbirth. 2012, 12: 111-10.1186/1471-2393-12-111.CrossRefPubMedPubMedCentral Pervin J, Moran A, Rahman M, Razzaque A, Sibley L, Streatfield P, Reichenbach L, Koblinsky M, Hruschka D, Rahman A: Association of antenatal care with facility delivery and perinatal survival - a population-based study in Bangladesh. BMC Pregnancy Childbirth. 2012, 12: 111-10.1186/1471-2393-12-111.CrossRefPubMedPubMedCentral
34.
go back to reference Chowdhury S, Banu L, Chowdhury T, Rubayet S, Khatoon S: Achieving millennium development goals 4 and 5 in Bangladesh. BJOG. 2011, 118: 36-46.CrossRefPubMed Chowdhury S, Banu L, Chowdhury T, Rubayet S, Khatoon S: Achieving millennium development goals 4 and 5 in Bangladesh. BJOG. 2011, 118: 36-46.CrossRefPubMed
35.
go back to reference Koblinsky M, Anwar I, Mridha MK, Chowdhury ME, Botlero R: Reducing maternal mortality and improving maternal health: Bangladesh and MDG 5. J Health Popul Nutr. 2008, 26: 280-PubMedPubMedCentral Koblinsky M, Anwar I, Mridha MK, Chowdhury ME, Botlero R: Reducing maternal mortality and improving maternal health: Bangladesh and MDG 5. J Health Popul Nutr. 2008, 26: 280-PubMedPubMedCentral
36.
go back to reference Government of the People’s Republic of Bangladesh: The Millennium Development Goals: Bangladesh Progress Report 2011. 2012, Dhaka: General Economics Division, Bangladesh Planning Commission, Government of the People’s Republic of Bangladesh Government of the People’s Republic of Bangladesh: The Millennium Development Goals: Bangladesh Progress Report 2011. 2012, Dhaka: General Economics Division, Bangladesh Planning Commission, Government of the People’s Republic of Bangladesh
Metadata
Title
Practices and determinants of delivery by skilled birth attendants in Bangladesh
Authors
Nazrul Islam
Mohammad Tajul Islam
Yukie Yoshimura
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2014
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/1742-4755-11-86

Other articles of this Issue 1/2014

Reproductive Health 1/2014 Go to the issue