Inequalities in reproductive healthcare utilization: evidence from Bangladesh Demographic and Health Survey 2004.

Utilization of reproductive healthcare services such as antenatal care (ANC), delivery place facilities and postnatal care (PNC) is essential and a basic need for mothers around the globe. However, in Bangladesh inequalities in many forms affect the use of these facilities. These inequalities include socio-economic status, age, education, household size, existence of living children, occupation and household location. Using the database from the Bangladesh Demographic and Health Survey (BDHS) 2004, this study investigated the inequalities and implications of receiving facility-based maternity care such as ANC, delivery place and PNC in Bangladesh. Based on our findings, it is assumed that with the current inequalities in wealth and education, less attention to mothers with bigger family size and to mothers those existing children, lack of facilities and awareness, in rural areas, increased use of reproductive healthcare is unlikely without a change in wealth inequalities and attention to more equity in the health sector. Bivariate and multivariate analyses were done for the study, including tests of significance. Overall, findings revealed significant socio-economic inequalities in the use of reproductive healthcare services. Use of services was much lower among the poor than the rich. These socio-economic inequalities may be reduced by expanding outreach health programs and bringing services closer to the disadvantaged (poor people). The study concluded that many of these inequalities are social constructs that can be reduced by prioritizing the needs of the poor and disadvantaged and adopting appropriate policy change options.