Background: Bangladesh has made a significant progress towards Millennium Development Goal (MDG) 5, which specifies a 75% reduction in the maternal mortality ratio (MMR) between 1990 and 2015. In 1990 the MMR was 570 per 100,000 live births and declined to 194 per 100,000 live births in 2010. Progress on the indicator of MDG 5 for example, the use of antenatal care has been remarkable. However, progress on the use skilled assistance at delivery is still farbelow any acceptable standard. Roughly 26% of the women use delivery assistance from medically-trained personnel either at home or at a health facility. Many factors are associated with this low use of skilled assistance at delivery.
Objective: The study aimed to estimate the magnitude of the use of skilled birth attendants at delivery and the effects of predisposing and enabling factors on the use of skilled assistance at delivery by pregnant women of Bangladesh
Methods: The study was a cross sectional analysis of the 2007 Bangladesh Demographic and Health Survey, which is a nationally representative survey of women in the 15-49 years age groups. Women who had at least one birth in the five years preceding the survey were included in this study. To estimate the effects of demographic and socio-economic factors on the use of skilled assistance at delivery, logistic regression analyses were carried out.
Results: A total of 6,132 women fulfilled the study eligibility criteria and were included in the analysis. Only 20.80% of births were attended by skilled birth attendants either at home or at a health facility. Over 36% of urban women
delivered with skilled assistance compared to 12.42% of rural women. In logistic regression analyses parental education, birth order, place of residence, husbands’ occupation, and wealth index were found to be significantly associated with the use of skilled assistance at delivery. Muslim women and women those who were from male-headed household were less likely to use skilled assistance at delivery. Women’s age was not found to be significantly associated with the use of skilled delivery assistance.
Conclusion: The study identified that the use of skilled attendants at delivery was very low in Bangladesh. Parental education and birth order were strong predictors for the use of skilled assistance at delivery. Rural women and women from Muslim religion were at greater disadvantage in the use of skilled assistance at delivery. To improve maternal health and reduce maternal mortality, special efforts and attention to improve both formal and informal education of the girls and boys are needed. Moreover, to explore cultural factors and traditional beliefs related with the use of skilled assistance at delivery, qualitative study needs to be conducted. Extra effort should be given to rural areas so that the rural women can easily access to maternal health services.