Examining regional disparities in maternal and child health in Bangladesh using cluster analysis of MICS 2019 data

Child and maternal health are crucial indicators of the health status of a country's population. However, there is a regional variability among health indicators and the availability of health services. Therefore, this study aims to explore the regional disparities in Bangladesh using maternal and child health indicators from the countrywide Multiple Indicator Cluster Survey (MICS) 2019, focusing on maternal and child health and related socio-demographic variables across the country's 64 districts. Using a hierarchical clustering technique with Euclidean distance, the authors identified natural clusters among districts based on selected health indicators, such as breastfeeding, nutrition, literacy, HIV/AIDS awareness, reproductive health, and access to safe environments. The findings of clustering revealed two main groups: well-performing and underperforming regions. These clusters exhibit regional variations, with underperforming areas predominantly located in Bangladesh's northern and northeastern parts. Key findings indicate that breastfeeding initiation rates are higher than global and regional averages, but significant disparities exist among districts. Underperforming districts also exhibit lower antenatal care coverage, skilled birth attendance, institutional deliveries, and a higher prevalence of undernutrition (stunting, underweight, wasting). Literacy rates and HIV/AIDS awareness are significantly lower in some districts compared to national averages. Additionally, access to clean drinking water, handwashing facilities, and sanitation services remains insufficient in certain regions. This analysis underscores the importance of addressing regional disparities to improve Bangladesh's maternal and child health outcomes. Therefore, appropriate interventions are essential to bridge the health gaps, particularly in disadvantaged areas, by improving healthcare access, quality, and infrastructure. The results give policymakers valuable insights to tailor interventions and allocate resources effectively. Overall, the study highlights the necessity for region-specific strategies to ensure equitable health outcomes across the country.