Bulletin of the World Health Organization

Inequity in maternal health-care services: evidence from home-based skilled-birth-attendant programmes in Bangladesh

I Anwar, M Sami, N Akhtar, ME Chowdhury, U Salma, M Rahman, M Koblinsky

Volume 86, Number 4, April 2008, 252-259

Table 1. Determinants for use of SBAs, caesarean-section delivery, and use of postnatal care service

Predictors N2164 SBA at delivery
 Delivery by caesarean section
 Received postnatal care
%used Univariate model OR (95% CI) Multivariate modela OR (95% CI) %used Univariate model OR (95% CI) Multivariate modela OR (95% CI) %used Univariate model OR (95% CI) MultivariateModela OR (95% CI)
Women’s education
None 428 18.2 1.00 1.00 4.0 1.00 1.00 22.7 1.00 1.00
1–4 years 378 20.9 1.19 (0.84–1.68) 0.95 (0.65–1.41) 2.4 0.59 (0.26–1.34) 0.47 (0.20–1.13) 30.4 1.49 (1.09–2.05) 1.25 (0.89–1.76)
5–9 years 1 066 36.2 2.55 (1.93–3.35) 1.35 (0.96–1.92) 9.8 2.64 (1.56–2.47) 1.24 (0.65–2.37) 26.0 1.19 (0.92–1.55) 0.90 (0.65–1.24)
≥ 10 years
 292
 74.3
 12.98 (9.06–18.60)
 2.69 (1.66–4.38)
 34.9
 12.98 (7.55–22.31)
 1.98 (0.93–4.26)
 43.0
 2.52 (1.82–3.48)
 1.19 (0.75–1.87)
Asset quintile
Lowest 423 15.6 1.00 1.00 3.3 1.00 1.00 22.2 1.00 1.00
Second 442 23.1 1.62 (1.15–2.29) 1.47 (1.01–2.13) 2.9 0.86 (0.41–1.91) 0.63 (0.28–1.41) 27.1 1.30 (0.96–1.78) 1.24 (0.89–1.72)
Middle 433 28.6 2.17 (1.55–3.03) 1.51 (1.03–2.19) 5.3 1.64 (0.83–3.23) 0.88 (0.42–1.86) 24.2 1.12 (0.82–1.54) 0.97 (0.69–1.37)
Fourth 433 44.8 4.39 (3.18–6.07) 2.32 (1.60–3.39) 13.9 4.70 (2.58–8.55) 1.76 (0.89–3.50) 29.0 1.45 (1.04–1.94) 1.16 (0.81–1.65)
Highest
 433
 63.3
 9.32 (6.71–12.93)
 2.89 (1.91–4.38)
 28.4
 11.59 (6.54–20.54)
 2.64 (1.30–5.37)
 39.0
 2.22 (1.64–3.00)
 1.54 (1.05–2.25)
Husband’s education
None 592 18.9 1.00 1.00 3.5 1.00 1.00 23.0 1.00 1.00
1–4 years 311 21.5 1.18 (0.84–1.65) 1.01 (0.69–1.47) 2.6 0.72 (0.31–1.64) 0.71 (0.30–1.70) 30.0 1.42 (1.04–1.94) 1.38 (0.99–1.92)
5–9 years 782 34.5 2.26 (1.76–2.91) 1.22 (0.90–1.66) 9.1 2.72 (1.65–4.47) 1.31 (0.73–2.37) 26.0 1.18 (0.92–1.51) 1.06 (0.79–1.42)
≥ 10 years
 479
 64.9
 7.93 (6.01–10.48)
 2.25 (1.54–3.28)
 27.8
 10.45 (6.47–16.88)
 2.01 (1.04–3.87)
 38.2
 2.09 (1.60–2.73)
 1.32 (0.90–1.92)
Distance to hospital
0–5 km 1 104 41.8 1.00 1.00 14.3 1.00 1.00 28.5 1.00 1.00
> 5 km
 1 160
 28.2
 0.55 (0.46–0.66)
 0.66 (0.53–0.82)
 7.1
 0.46 (0.34–0.61)
 0.79 (0.56–1.09)
 28.2
 0.99 (0.81–1.20)
 1.21 (0.98–1.50)
Reported complication(s)
No 1 123 23.2 1.00 1.00 3.7 1.00 1.00 21.0 1.00 1.00
Yes
 1 041
 48.0
 3.07 (2.55–3.69)
 2.40 (1.94–2.97)
 18.3
 5.78 (4.09–8.17)
 4.12 (2.84–5.98)
 36.1
 2.13 (1.76–2.57)
 1.75 (1.43–2.15)
Religion
Muslim 2045 33.6 1.00 1.00 9.8 1.00 1.00 28.1 1.00 1.00
Other
119
 61.3
 3.14 (2.15–4.59)
 2.05 (1.31–3.19)
 27.7
 3.54 (2.31–5.43)
 2.05 (1.22–3.43)
 31.1
 1.15 (0.77–1.72)
 0.87 (0.57–1.33)
Number ANC visit
No visit 157 7.6 1.00 1.00 0.6 1.00 1.00 14.6 1.00 1.00
1 visit 231 15.6 2.23 (1.12–4.44) 1.70 (0.83–3.48) 4.8 7.78 (1.00–60.71) 5.00 (0.63–39.98) 17.7 1.26 (0.72–2.19) 1.26 (0.71–2.23)
2 visits 340 24.4 3.90 (2.06–7.39) 2.37 (1.22–4.61) 4.4 7.18 (0.94–54.70) 2.94 (0.37–23.05) 20.3 1.48 (0.89–2.48) 1.38 (0.81–2.34)
3 visits 353 31.2 5.47 (2.91–10.27) 2.86 (1.48–5.53) 7.6 12.88 (1.74–95.42) 4.38 (0.57–33.58) 22.9 1.73 (1.04–2.88) 1.62 (0.96–2.74)
≥ 4 visits 1 083 47.9 11.12 (6.10–20.27) 3.82 (2.03–7.19) 16.5 30.80 (4.30–220.88) 5.30 (0.71–39.47) 36.7 3.38 (2.14–5.36) 2.74 (1.68–4.47)

ANC, antenatal care; CI, confidence interval; OR, odds ratio; SBA, skilled birth attendant.a Controlled for all covariates in the model and age and parity of mothers.