ArticleInternational journal for equity in health2013
"Can community level interventions have an impact on equity and utilization of maternal health care" - evidence from rural Bangladesh.
Article in International journal for equity in health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 6 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Inequity in uptake of maternal health care services in developing countries: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Community health workers at the dawn of a new era: 6. Recruitment, training, and continuing education.Health research policy and systems · 2021Pooled it
- Effects of community health worker interventions on socioeconomic inequities in maternal and newborn health in low-income and middle-income countries: a mixed-methods systematic review.BMJ global health · 2019Pooled it
- How equitable are community health worker programmes and which programme features influence equity of community health worker services? A systematic review.BMC public health · 2016Pooled it
- Equity in maternal health care service utilization: a systematic review for developing countries.International journal of public health · 2015Pooled it
- What interventions are effective on reducing inequalities in maternal and child health in low- and middle-income settings? A systematic review.BMC public health · 2014Pooled it
- Effects of community health volunteers on infectious diseases of children under five in Volta Region, Ghana: study protocol for a cluster randomized controlled trial.BMC public health · 2017Trial
- Is essential newborn care provided by institutions and after home births? Analysis of prospective data from community trials in rural South Asia.BMC pregnancy and childbirth · 2014Trial
- Article
- Distribution of government health financing benefits among women who delivered in public institutions in Bangladesh: a nationally representative cross-sectional study.The Lancet regional health. Southeast Asia · 2025Article
- Are populations of postpartum women differentially served by community health worker programs: an observational cohort study from Zanzibar, Tanzania.BMC pregnancy and childbirth · 2024Observational
- Water, sanitation and hygiene (WASH) practices and deworming improve nutritional status and anemia of unmarried adolescent girls in rural Bangladesh.Journal of health, population, and nutrition · 2023Article
- Article
- Referral care for high-risk pregnant women in rural Rajasthan, India: a qualitative analysis of barriers and facilitators.BMC pregnancy and childbirth · 2022Article
- Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa.BMC pregnancy and childbirth · 2021Article
- Article
- Article
- Inequities in the Uptake of Reproductive and Maternal Health Services in the Biggest Regional State of Ethiopia: Too Far from "Leaving No One Behind".ClinicoEconomics and outcomes research : CEOR · 2020Article
- Strengthening referral systems in community health programs: a qualitative study in two rural districts of Maputo Province, Mozambique.BMC health services research · 2019Article
- Inequities and their determinants in coverage of maternal health services in Burkina Faso.International journal for equity in health · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundEvidence from low and middle income countries (LMICs) suggests that maternal mortality is more prevalent among the poor whereas access to maternal health services is concentrated among the rich. In Bangladesh substantial inequities exist both in the use of facility-based basic obstetric care and for home births attended by skilled birth attendant. BRAC initiated an intervention on Improving Maternal, Neonatal, and Child Survival (IMNCS) in the rural areas of Bangladesh in 2008. One of the objectives of the intervention is to improve the utilization of maternal and child health care services among the poor. This study aimed to look at the impact of the intervention on utilization and also on equity of access to maternal health services.
methodsA quasi-experimental pre-post comparison study was conducted in rural areas of five districts comprising three intervention (Gaibandha, Rangpur and Mymensingh) and two comparison districts (Netrokona and Naogaon). Data on health seeking behaviour for maternal health were collected from a repeated cross sectional household survey conducted in 2008 and 2010.
resultsResults show that the intervention appears to cause an increase in the utilization of antenatal care. The concentration index (CI) shows that this has become pro-poor over time (from CI: 0.30 to CI: 0.04) in the intervention areas. In contrast the use of ANC from medically trained providers has become pro-rich (from, CI: 0.18 to CI: 0.22). There was a significant increase in the utilisation of trained attendants for home delivery in the intervention areas compared to the comparison areas and the change was found to be pro-poor. Use of postnatal care cervices was also found to be pro-poor (from CI: 0.37 to CI: 0.14). Utilization of ANC services provided by medically trained provider did not improve in the intervention area. However, where the intervention had a positive effect on utilization it also seemed to have had a positive effect on equity.
conclusionsTo sustain equity in health care utilization, the IMNCS programme needs to continue providing free home based services. In addition to this, the programme should also continue to provide funding to bear the cost to those mothers who are not able to have the comprehensive ANC from medically trained providers.
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