Patterns and determinants of care seeking for obstetric complications in rural northwest Bangladesh: Analysis from a prospective cohort study Health systems and services in low and middle income settings

Shegufta S. Sikder, Alain B Labrique, Ian M. Craig, Mohammad Abdul Wakil, Abu Ahmed Shamim, Hasmot Ali, Sucheta Mehra, Lee Shu Fune Wu, Saijuddin Shaikh, Keith West, Parul S Christian

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Abstract

Background: In communities with low rates of institutional delivery, little data exist on care-seeking behavior for potentially life-threatening obstetric complications. In this analysis, we sought to describe care-seeking patterns for self-reported complications and near misses in rural Bangladesh and to identify factors associated with care seeking for these conditions. Methods: Utilizing data from a community-randomized controlled trial enrolling 42,214 pregnant women between 2007 and 2011, we used multivariable multinomial logistic regression to explore the association of demographic and socioeconomic factors, perceived need, and service availability with care seeking for obstetric complications or near misses. We also used multivariable multinomial logistic regression to analyze the factors associated with care seeking by type of obstetric complication (eclampsia, sepsis, hemorrhage, and obstructed labor). Results: Out of 9,576 women with data on care seeking for obstetric complications, 77% sought any care, with 29% (n∈=∈2,150) visiting at least one formal provider and 70% (n∈=∈5,149) visiting informal providers only. The proportion of women seeking at least one formal provider was highest among women reporting eclampsia (57%), followed by hemorrhage (28%), obstructed labor (22%), and sepsis (17%) (p∈

Original languageEnglish (US)
Article number166
JournalBMC Health Services Research
Volume15
Issue number1
DOIs
StatePublished - Dec 12 2015

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Bangladesh
Obstetrics
Health Services
Cohort Studies
Prospective Studies
Eclampsia
Sepsis
Logistic Models
Hemorrhage
Pregnant Women
Randomized Controlled Trials
Regression Analysis
Demography

Keywords

  • Care seeking
  • Cohort study
  • Global health
  • Maternal health
  • Rural Bangladesh

ASJC Scopus subject areas

  • Health Policy

Cite this

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title = "Patterns and determinants of care seeking for obstetric complications in rural northwest Bangladesh: Analysis from a prospective cohort study Health systems and services in low and middle income settings",
abstract = "Background: In communities with low rates of institutional delivery, little data exist on care-seeking behavior for potentially life-threatening obstetric complications. In this analysis, we sought to describe care-seeking patterns for self-reported complications and near misses in rural Bangladesh and to identify factors associated with care seeking for these conditions. Methods: Utilizing data from a community-randomized controlled trial enrolling 42,214 pregnant women between 2007 and 2011, we used multivariable multinomial logistic regression to explore the association of demographic and socioeconomic factors, perceived need, and service availability with care seeking for obstetric complications or near misses. We also used multivariable multinomial logistic regression to analyze the factors associated with care seeking by type of obstetric complication (eclampsia, sepsis, hemorrhage, and obstructed labor). Results: Out of 9,576 women with data on care seeking for obstetric complications, 77{\%} sought any care, with 29{\%} (n∈=∈2,150) visiting at least one formal provider and 70{\%} (n∈=∈5,149) visiting informal providers only. The proportion of women seeking at least one formal provider was highest among women reporting eclampsia (57{\%}), followed by hemorrhage (28{\%}), obstructed labor (22{\%}), and sepsis (17{\%}) (p∈",
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author = "Sikder, {Shegufta S.} and Labrique, {Alain B} and Craig, {Ian M.} and Wakil, {Mohammad Abdul} and Shamim, {Abu Ahmed} and Hasmot Ali and Sucheta Mehra and Wu, {Lee Shu Fune} and Saijuddin Shaikh and Keith West and Christian, {Parul S}",
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T1 - Patterns and determinants of care seeking for obstetric complications in rural northwest Bangladesh

T2 - Analysis from a prospective cohort study Health systems and services in low and middle income settings

AU - Sikder, Shegufta S.

AU - Labrique, Alain B

AU - Craig, Ian M.

AU - Wakil, Mohammad Abdul

AU - Shamim, Abu Ahmed

AU - Ali, Hasmot

AU - Mehra, Sucheta

AU - Wu, Lee Shu Fune

AU - Shaikh, Saijuddin

AU - West, Keith

AU - Christian, Parul S

PY - 2015/12/12

Y1 - 2015/12/12

N2 - Background: In communities with low rates of institutional delivery, little data exist on care-seeking behavior for potentially life-threatening obstetric complications. In this analysis, we sought to describe care-seeking patterns for self-reported complications and near misses in rural Bangladesh and to identify factors associated with care seeking for these conditions. Methods: Utilizing data from a community-randomized controlled trial enrolling 42,214 pregnant women between 2007 and 2011, we used multivariable multinomial logistic regression to explore the association of demographic and socioeconomic factors, perceived need, and service availability with care seeking for obstetric complications or near misses. We also used multivariable multinomial logistic regression to analyze the factors associated with care seeking by type of obstetric complication (eclampsia, sepsis, hemorrhage, and obstructed labor). Results: Out of 9,576 women with data on care seeking for obstetric complications, 77% sought any care, with 29% (n∈=∈2,150) visiting at least one formal provider and 70% (n∈=∈5,149) visiting informal providers only. The proportion of women seeking at least one formal provider was highest among women reporting eclampsia (57%), followed by hemorrhage (28%), obstructed labor (22%), and sepsis (17%) (p∈

AB - Background: In communities with low rates of institutional delivery, little data exist on care-seeking behavior for potentially life-threatening obstetric complications. In this analysis, we sought to describe care-seeking patterns for self-reported complications and near misses in rural Bangladesh and to identify factors associated with care seeking for these conditions. Methods: Utilizing data from a community-randomized controlled trial enrolling 42,214 pregnant women between 2007 and 2011, we used multivariable multinomial logistic regression to explore the association of demographic and socioeconomic factors, perceived need, and service availability with care seeking for obstetric complications or near misses. We also used multivariable multinomial logistic regression to analyze the factors associated with care seeking by type of obstetric complication (eclampsia, sepsis, hemorrhage, and obstructed labor). Results: Out of 9,576 women with data on care seeking for obstetric complications, 77% sought any care, with 29% (n∈=∈2,150) visiting at least one formal provider and 70% (n∈=∈5,149) visiting informal providers only. The proportion of women seeking at least one formal provider was highest among women reporting eclampsia (57%), followed by hemorrhage (28%), obstructed labor (22%), and sepsis (17%) (p∈

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KW - Cohort study

KW - Global health

KW - Maternal health

KW - Rural Bangladesh

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