Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh

Abstract One of the most important approaches to improving the health of mothers and newborns has been the continuum of care (CoC) for maternal health. Women's lack of empowerment may be an obstacle to accessing CoC in male-dominated societies. However, research often defines empowerment narrow...

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Autores principales:	Rushdana Rahman, Mosiur Rahman, Syed Emdadul Haque
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/55f8192a827c479e8f7621088db53c3d
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spelling	oai:doaj.org-article:55f8192a827c479e8f7621088db53c3d2021-12-02T17:26:49ZEmpowerment dimensions and their relationship with continuum care for maternal health in Bangladesh10.1038/s41598-021-98181-82045-2322https://doaj.org/article/55f8192a827c479e8f7621088db53c3d2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98181-8https://doaj.org/toc/2045-2322Abstract One of the most important approaches to improving the health of mothers and newborns has been the continuum of care (CoC) for maternal health. Women's lack of empowerment may be an obstacle to accessing CoC in male-dominated societies. However, research often defines empowerment narrowly, despite the fact that multiple components of empowerment can play a role. The aim of this study was to look at the relationship between CoC for maternal health and measures of empowerment among Bangladeshi women. The data for this analysis came from the Bangladesh Demographic and Health Survey 2017–2018. The research centered on a subset of 4942 married women of reproductive age who had at least one live birth in the 3 years preceding the survey. Women's empowerment was measured using SWPER Global, a validated measure of women's empowerment for low- and middle-income countries. CoC for maternal health was measured at three stages of pregnancy, pregnancy, delivery, and the postpartum period. To estimate adjusted odds ratios, we specified three-level logistic regression models for our three binary response variables after descriptive analysis. Just 30.5% of mothers completed all phases of the CoC (ANC 4+, SBA, and PNC). After adjusting for individual, household, and community level variables, women with high social independence (adjusted odds ratio [AOR] 1.97; 95% confidence interval [CI] 1.58–2.47) had 97% more ANC 4+ visits, 176% higher retention in SBA (AOR 2.76; 95% CI 1.94–3.94), and 137% higher completion of full CoC (AOR 2.37; 95% CI 1.16–4.88) than women with low social independence. Frequency of reading newspapers or magazines, woman's education, age at first cohabitation, and age of the woman at first birth were significant predictors of CoC at all three stages, namely pregnancy, delivery, and postpartum, among the various indicators of social independence domain. Moreover, the intraclass correlation showed that about 16.20%, 8.49%, and 25.04%, of the total variation remained unexplained even after adjustments of individual, household and community level variables for models that predicted ANC 4+ visits, CoC from pregnancy to SBA, and CoC from delivery to the early postnatal period. The low completion rate of complete CoC for maternal health imply that women in Bangladesh are not getting the full health benefit from existing health services. Health promotion programs should target mothers with low levels of education, mothers who are not exposed to print media, and mothers who are younger at the time of birth and their first cohabitation to raise the rate of completing all levels of CoC for maternal health.Rushdana RahmanMosiur RahmanSyed Emdadul HaqueNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rushdana Rahman Mosiur Rahman Syed Emdadul Haque Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh
description	Abstract One of the most important approaches to improving the health of mothers and newborns has been the continuum of care (CoC) for maternal health. Women's lack of empowerment may be an obstacle to accessing CoC in male-dominated societies. However, research often defines empowerment narrowly, despite the fact that multiple components of empowerment can play a role. The aim of this study was to look at the relationship between CoC for maternal health and measures of empowerment among Bangladeshi women. The data for this analysis came from the Bangladesh Demographic and Health Survey 2017–2018. The research centered on a subset of 4942 married women of reproductive age who had at least one live birth in the 3 years preceding the survey. Women's empowerment was measured using SWPER Global, a validated measure of women's empowerment for low- and middle-income countries. CoC for maternal health was measured at three stages of pregnancy, pregnancy, delivery, and the postpartum period. To estimate adjusted odds ratios, we specified three-level logistic regression models for our three binary response variables after descriptive analysis. Just 30.5% of mothers completed all phases of the CoC (ANC 4+, SBA, and PNC). After adjusting for individual, household, and community level variables, women with high social independence (adjusted odds ratio [AOR] 1.97; 95% confidence interval [CI] 1.58–2.47) had 97% more ANC 4+ visits, 176% higher retention in SBA (AOR 2.76; 95% CI 1.94–3.94), and 137% higher completion of full CoC (AOR 2.37; 95% CI 1.16–4.88) than women with low social independence. Frequency of reading newspapers or magazines, woman's education, age at first cohabitation, and age of the woman at first birth were significant predictors of CoC at all three stages, namely pregnancy, delivery, and postpartum, among the various indicators of social independence domain. Moreover, the intraclass correlation showed that about 16.20%, 8.49%, and 25.04%, of the total variation remained unexplained even after adjustments of individual, household and community level variables for models that predicted ANC 4+ visits, CoC from pregnancy to SBA, and CoC from delivery to the early postnatal period. The low completion rate of complete CoC for maternal health imply that women in Bangladesh are not getting the full health benefit from existing health services. Health promotion programs should target mothers with low levels of education, mothers who are not exposed to print media, and mothers who are younger at the time of birth and their first cohabitation to raise the rate of completing all levels of CoC for maternal health.
format	article
author	Rushdana Rahman Mosiur Rahman Syed Emdadul Haque
author_facet	Rushdana Rahman Mosiur Rahman Syed Emdadul Haque
author_sort	Rushdana Rahman
title	Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh
title_short	Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh
title_full	Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh
title_fullStr	Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh
title_full_unstemmed	Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh
title_sort	empowerment dimensions and their relationship with continuum care for maternal health in bangladesh
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/55f8192a827c479e8f7621088db53c3d
work_keys_str_mv	AT rushdanarahman empowermentdimensionsandtheirrelationshipwithcontinuumcareformaternalhealthinbangladesh AT mosiurrahman empowermentdimensionsandtheirrelationshipwithcontinuumcareformaternalhealthinbangladesh AT syedemdadulhaque empowermentdimensionsandtheirrelationshipwithcontinuumcareformaternalhealthinbangladesh
_version_	1718380788769095680

Empowerment dimensions and their relationship with continuum care for maternal health in Bangladesh

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