Evidence map›Paper›PMID 37816563›Full record

ArticleBMJ open2023

Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017-2018.

Md Injamul Haq Methun, Bright Opoku Ahinkorah, Sutopa Roy, Joshua Okyere, Md Ismail Hossain, Iqramul Haq, Shatabdi Shamrita Ume, Md Kamrul Hasan

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Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Md Injamul Haq MethunDepartment of Statistics, Tejgaon College, National University Bangladesh, Dhaka, Bangladesh.ORCID 0000-0001-5985-6653
Bright Opoku AhinkorahFaculty of Health, The Australian Centre for Public and Population Health Research, University of Technology Sydney, Liverpool, New South Wales, Australia.ORCID 0000-0001-7415-895X
Sutopa RoyDepartment of Statistics, Jagannath University, Dhaka, Bangladesh.
Joshua OkyereDepartment of Population and Health, University of Cape Coast, Cape Coast, Ghana.ORCID 0000-0003-4080-7522
Md Ismail HossainDepartment of Statistics, Jagannath University, Dhaka, Bangladesh.
Iqramul HaqDepartment of Agricultural Statistics, Faculty of Agribusiness Management, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh.
Shatabdi Shamrita UmeDepartment of Statistics, Jagannath University, Dhaka, Bangladesh.
Md Kamrul HasanDepartment of Public Health, North South University, Dhaka, Bangladesh kamrul.hasan11@northsouth.edu.ORCID 0000-0002-3032-7640

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study investigated the inequalities in access to maternal healthcare services in Bangladesh. DESIGN AND

settingThis study used cross-sectional data from the nationally representative Bangladesh Demographic and Health Survey conducted in 2017-2018. The survey encompassed diverse regions and households across Bangladesh. The study used the Human Opportunity Index (HOI) and Shapley's decomposition technique to measure the inequality in access to maternal healthcare opportunities.

participantsThis study included 20 127 women aged 15-49 years. Among them, 5012 women had live births in the preceding 3 years of the survey, forming the study sample. PRIMARY AND SECONDARY OUTCOME MEASURES: This study has no secondary outcome variable. The primary dependent variable is 'adequate maternal healthcare', a dichotomous variable.

resultsHousehold wealth status contributed the highest to inequality in accessing adequate maternal healthcare services (41.4%) such as receiving at least four antenatal care (ANC) visits (39.7%), access to proper ANC (50.7% and 44.0%) and health facility birth (43.4%). Maternal educational status contributes the second highest inequality among all factors in accessing adequate maternal healthcare (29.5%). Adequate maternal healthcare presented the lowest coverage rate and opportunity index among all (approximately 24% with HOI=17.2).

conclusionsWe found that attained adequate maternal healthcare had the lowest coverage and widest dissimilarity, while wealth index, education and place of residence are the major factors that contribute to inequalities in accessibility to maternal healthcare services in Bangladesh. These findings underscore a need for pro-poor interventions to narrow the economic inequalities between the poor and rich in terms of accessibility to maternal healthcare services. The results indicate the need for the Bangladeshi government and its health department to strengthen their commitment to improving female education. Investments should be made in initiatives that facilitate the proximity of maternal healthcare services to women in rural areas.

Indexed as

Maternal Health ServicesBangladeshCross-Sectional StudiesDemographyFemaleHealthcare DisparitiesHealth Services AccessibilityHumansPregnancyPrenatal CareSocioeconomic FactorsHealth EquityHealth policyOBSTETRICSPUBLIC HEALTH

Identifiers

PMID37816563
PMCPMC10565284

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.