Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study

The majority of births in rural Bangladesh are carried out in unhygienic conditions by relatives and traditional birth attendants (TBAs). This results in a high incidence of maternal and infant mortality that could be reduced if childbirth were to occur in health centers or under the supervision of trained TBAs (TTBAs). In this paper, we examined factors associated with utilization of modern health resources for childbirth in 39 villages of Bangladesh. We followed a retrospective survey research design to collect relevant information from couples who experienced childbirth during a two-year period from July 1, 1995 to June 1997. The data indicate that slightly over 11% of the deliveries were performed by trained personnel with the rest attended by TBAs. Multivariate analysis clearly shows that delivery complications was the most significant factor determining the use of modern health care resources for childbirth, followed by parental education, and pre-natal care. We conclude that quick response to delivery complications and improved access to hospitals and TTBAs can reduce the risk of infant and maternal mortality and morbidity in rural Bangladesh.