Bangladesh 1993-1994 Demographic and Health ... - Measure DHS

CHAPTER 8MATERNALAND CHILD HEALTHThe topics under discussion in this chapter are maternal care, childhood vaccinations, commonchildhood diseases and their treatment, and infant feeding practices. This information can be used to identifygroups of women whose babies are "at risk" because of nonuse of maternal health services. The informationwill assist policymakers in the planning of appropriate strategies to improve maternal and child care. Datawere obtained from women who had bad a live birth in the three years preceding the survey.8.1 Antenatal CareIdeally, antenatal care facilitates detection and treatment of problems during pregnancy, such asanemia and infections, and provides an opportunity to give information to women and their families. Inaddition, this early contact with the health care system can increase use of delivery care if problems occur.Prevalence and Source of Antenatal CareTable 8.1 shows the percent distribution of births in the three years preceding the survey by sourceof antenatal care received during pregnancy, according to matemal and background characteristics.Interviewers were instructed to record all persons a woman may have seen for care, but in the table, only theprovider with the highest qualifications is considered, if more than one person was seen.The data indicate that many mothers do not seek antenatal care, Among births that occurred in thethree years before the survey, almost three-quarters (73 percent) received no antenatal care during pregnancy.Those women who do receive care tend to receive it from doctors (19 percent) or from nurses, midwives, orfamily welfare visitors (7 percent). Only a fraction of pregnant women receive antenatal care from traditionalbirth attendants (dai).The survey results show that there are sharp differences in antenatal care coverage among subgroupsin Bangladesh. Antenatal care is much more common for births to younger women and those of lower birthorder. Births to women in urban areas are more than twice as likely to have received antenatal care (56percent) as births in rural areas (24 percent). The urban-rural difference is due largely to the greaterproportion of urban births for which doctors provide antenatal care. Differences in antenatal care coverageby division are minimal; it is only in Dhaka that a greater proportion of pregnant women receive antenatalcare. However, differences by education level of the mother are substantial: while only 18 percent of birthsto women with no education receive care during pregnancy, the level increases to 60 percent of births towomen with at least some secondary school.Although the level of antenatal care in Bangladesh is still relatively low, there is evidence that it hasbeen increasing over time. The 1989 BFS included a question as to whether women had gone to a doctor orfamily welfare visitor for a check on her recent pregnancies (Huq and Cleland, 1990:111). Mothersresponded affirmatively for less than 10 percent of the births in the years immediately prior to the survey.Although differences in the questions could account for some of the increase over time, it seems likely thatthere has been an increase in the extent of antenatal care received.99