Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna 9208, Bangladesh.
Economics Discipline, Khulna University, Khulna 9208, Bangladesh.
Int J Clin Pract. 2022 Mar 26;2022:3340578. doi: 10.1155/2022/3340578. eCollection 2022.
Improving maternal mortality attracts considerable interest with the critical invention through institutional delivery services (IDS) in reducing maternal death during delivery and ensuring safe childbirth. The influence of both individual and community-level factors is essential to using IDS. Maternal death may occur at any time, but delivery without designated healthcare is by far the most dangerous time for both woman and her baby. Therefore, to combat the global burden of maternal mortality, it is necessary to ensure IDS worldwide.
This study explores the current knowledge of individual and community-level covariates and examines their extent of influence on the utilization of IDS in Bangladesh.
Utilizing Bangladesh Demographic and Health Survey (BDHS) data, this study has used two-level random intercept binary logistic regression, together with the average annual rate of increase (AARI) in the utilization of IDS and related variables.
This study found appreciable changes in seeking IDS, increases from 3.4% in 2007 to 51.9% in 2017, and half of the total deliveries (51%) took place in healthcare. About 26% of the total variation in the utilization of IDS is owing to differences across communities. Further, covariates including communities with higher educated women, higher utilization of ANC and access to media and at individual level, religion, maternal and parental education, wealth index, and mother-level factors (i.e., age at birth, BMI, occupation, ANC visit, birth order, own health care decision, pregnancy intention, and exposure to media) showed significant association with the utilization of IDS.
This study observed the association between individual and community-level factors and IDS uptake. Thus, any future strategies must address individual level and community-level challenges and undertake a multisectoral approach to enhance the uptake of IDS.
通过提供机构分娩服务（IDS）来改善产妇死亡率，这一重要发明引起了人们的极大关注，因为它可以降低分娩期间的产妇死亡风险，确保母婴安全分娩。个人和社区层面因素的影响对于利用 IDS 至关重要。产妇死亡可能随时发生，但在没有指定医疗保健的情况下分娩，迄今为止对妇女及其婴儿来说是最危险的时刻。因此，为了应对全球产妇死亡率的负担，有必要在全球范围内确保提供 IDS。
本研究旨在探讨个人和社区层面的协变量的现有知识，并研究它们对孟加拉国 IDS 利用的影响程度。
本研究利用孟加拉国人口与健康调查（BDHS）数据，采用两水平随机截距二元逻辑回归，以及 IDS 利用及相关变量的平均年增长率（AARI）。
本研究发现，寻求 IDS 的情况发生了可观的变化，从 2007 年的 3.4%增加到 2017 年的 51.9%，并且一半的总分娩量（51%）发生在医疗保健机构中。IDS 利用的总差异中有大约 26%是由于社区之间的差异造成的。此外，包括社区中受过更高教育的妇女比例较高、更高的 ANC 利用率以及更容易接触媒体等个人层面的协变量，与 IDS 的利用具有显著相关性。
本研究观察到了个人和社区层面因素与 IDS 利用率之间的关联。因此，任何未来的策略都必须解决个人层面和社区层面的挑战，并采取多部门方法来提高 IDS 的利用率。
