Modes of delivery assistance in Bangladesh.

In Bangladesh, like many other developing countries among the major underlying factors leading to poor maternal situation include very low percentages of women actually seek professional medical assistance for pregnancy related care, deliveries and complications. This paper employs statistical methods to identify the factors associated with modes of delivery assistance in Bangladesh. To reach our goal Bangladesh Demographic and Health Survey of 2004 data for last five years (N = 4873) was used. Descriptive and multivariate logistic regression methods were employed in analyzing the data. It was observed that almost all the deliveries (88.8%) took place at the homes of the women and most of them (85.6%) were assisted by untrained traditional birth attendants, relatives or neighbours in unsafe and unhygienic conditions. Only 14.4% of the deliveries were assisted by the medically trained persons such as registered physicians, nurses or paramedics. The rate of receiving assistance from medically trained personnel was lower among mothers utilizing insufficient antenatal health care services. Middle aged women received delivery assistance more from medically trained personnel than the adolescents and women with higher age group. Multivariate logistic regression analysis shows that higher educated women were two-and-a-half times more likely to receive assistance from medically trained personnel than women with no education. Women whose husbands had a lower status job were less likely to have safe delivery practices. The main contributing factors likely to affect delivery practices were mass media exposure, husband's occupation, education, antenatal care received, type of toilet facilities and household quality index. The results indicate several policy options. The high-risk group such as adolescents and higher aged women need special care and the existing health management system may be strengthened to create awareness among mothers of these groups for seeking appropriate measures from the beginning of pregnancy. There is need to ensure the availability of maternal health care centres for providing antenatal care and expand and improve the quality of normal delivery at home by trained providers and introduce post-partum visits. It is equally important that education for women is emphasised to bring about a lasting impact on the overall health condition of women.