Investigating the role of health care at birth on inequalities in neonatal survival: evidence from Bangladesh

International Journal for Equity in Health

Research

Zoë Matthews¹  Sarah E Neal¹ 

[1] Centre for Global Health, Population, Poverty and Policy, Department of Social Science, University of Southampton, SO17 1BJ, University Rd, Southampton, Hampshire, United Kingdom;

关键词: Neonatal;    Inequalities;    Developing countries;    Maternal health services;    Poverty;    Access to health care;   

DOI  :  10.1186/1475-9276-12-17

 received in 2012-06-27, accepted in 2013-02-17,  发布年份 2013

来源: Springer

【 摘 要 】

IntroductionIn countries such as Bangladesh many women may only seek skilled care at birth when complications become evident. This often results in higher neonatal mortality for women who give birth in institutions than for those that give birth at home. However, we hypothesise that this apparent excess mortality is concentrated among less advantaged women. The aim of this paper is to examine the association between place of birth and neonatal mortality in Bangladesh, and how this varies by socio-economic status.MethodologyThe study is based on pooled data from four Bangladesh Demographic and Household Surveys, and uses descriptive analysis and binomial multivariate logistic regression. It uses regression models stratified for place of delivery to examine the impact of socio-economic status and place of residence on neonatal mortality.ResultsPoor women from rural areas and those with no education who gave birth in institutions had much worse outcomes than those who gave birth at home. There is no difference for more wealthy women. There is a much stronger socio-economic gradient in neonatal mortality for women who gave birth in institutions than those who delivered at home.ConclusionIn Bangladesh babies from lower socio-economic groups and particularly those in rural areas have very poor outcomes if born in a facility. This suggests poorer, rural and less educated women are failing to obtain the timely access to quality maternal health care services needed to improve newborn outcomes.

【 授权许可】

CC BY   
© Neal and Matthews; licensee BioMed Central Ltd. 2013