Mahabub-Ul-Anwar Md, Rob Ubaidur, Talukder Md Noorunnabi
The Population Council, Dhaka, Bangladesh.
Int Q Community Health Educ. 2006;27(4):281-97. doi: 10.2190/IQ.27.4.b.
The article examines the inequalities in utilization of maternal health care in rural areas of Bangladesh. It also attempts to identify the expenditure pattern for these services. Findings suggest that large disparities in the maternal health care utilization exist between the poorest and the richest population in Bangladesh. Two in three women in the highest wealth group receive antenatal care from qualified doctors as opposed to one in five women in the lowest wealth group. Almost all the deliveries occur at home among the lowest wealth group, whereas 16% of deliveries occur at health facilities among the highest wealth group. Wealth is also associated with the seeking of care for delivery-related complications. The practice of seeking services during post-natal period is not common and it varies positively with economic condition. Family savings is found to be the dominant source of paying the maternal health care services among the women in the highest wealth group. Cost has been found to be the most commonly cited reason for not seeking care for delivery complications. Eighty-four percent of women in the lowest wealth group compared to 13% of women in the highest wealth group did not seek treatment for delivery complications due to cost. Lack of perceived need of antenatal care (ANC) and postnatal care is the most pressing reason for not seeking these services. The study findings contain a number of implications for policy purposes that could be useful in devising ways to increase the utilization of maternal health care services.
本文探讨了孟加拉国农村地区孕产妇保健服务利用方面的不平等现象。它还试图确定这些服务的支出模式。研究结果表明，孟加拉国最贫困和最富裕人群在孕产妇保健服务利用方面存在巨大差距。在最富裕群体中，三分之二的妇女接受合格医生的产前护理，而在最贫困群体中，这一比例为五分之一。几乎所有最贫困群体的分娩都在家中进行，而最富裕群体中有16%的分娩在医疗机构进行。财富状况还与寻求分娩相关并发症护理有关。产后寻求服务的做法并不常见，且与经济状况呈正相关。研究发现，家庭储蓄是最富裕群体中妇女支付孕产妇保健服务费用的主要来源。成本被发现是不寻求分娩并发症护理的最常见原因。由于成本原因，最贫困群体中84%的妇女未寻求分娩并发症治疗，而最富裕群体中这一比例为13%。缺乏对产前护理和产后护理的认知需求是不寻求这些服务的最紧迫原因。该研究结果对政策制定具有若干启示，有助于设计提高孕产妇保健服务利用率的方法。
