Bangladesh and many other low- and middle-income countries experience a high number of maternal and neonatal deaths; antenatal care (ANC) and hospital delivery are crucial to reducing these deaths. In this cross-sectional study, we investigated the relationship of socioeconomic status with at least 4 ANC visits by medically trained providers and hospital delivery in Bangladesh. We also tested whether antenatal care mediated the association of socioeconomic variables and facility delivery. We used data from the Bangladesh Demographic and Health Survey 2022. After descriptive analysis, generalized structural equation modeling was used to investigate relationships. A total of 4,950 women were included in the analysis (mean age: 25.7 years, 73.2% rural). The proportion of women with at least 4 ANC visits by medically trained providers and hospital delivery was 37.7% and 64.4%, respectively. In adjusted analyses, all socioeconomic variables had significant associations with at least 4 ANC visits by medically trained providers and hospital delivery. For instance, compared to women with the poorest wealth quintile, those with poorer (adjusted odds ratio (AOR): 1.32, 95% confidence interval (CI): 1.07–1.63), middle (AOR: 1.59, 95% CI: 1.28–1.98), richer (AOR: 2.15, 95% CI: 1.71–2.68), and richest (AOR: 3.34, 95% CI: 2.60–4.28) wealth quintiles higher odds of at least 4 ANC visits by medically trained providers. Similarly, for hospital delivery, compared to women with the poorest wealth quintile, those with poorer (AOR: 1.44, 95% CI: 1.18–1.74), middle (AOR: 1.79, 95% CI: 1.46–2.21), richer (AOR: 2.45, 95% CI: 1.95–3.07), and richest (AOR: 3.84, 95% CI: 2.89–5.10) wealth quintiles had higher odds. Women with at least 4 ANC visits by medically trained providers had more than two times higher odds of hospital delivery (AOR: 2.70, 95% CI: 2.32–3.15). When we looked into the mediation, at least 4 ANC visits by medically trained providers mediated 59.7% and 45.9% of the relationships of women’s education and household wealth with hospital delivery, respectively. Considering the lower utilization of at least 4 ANC visits by medically trained providers and its mediating impact on the relationship between socioeconomic status and facility delivery, more community-based programs are required to increase awareness about at least 4 ANC visits and hospital births.
Kibria et al. (Fri,) studied this question.