Exploring Factors Influencing Wealth-Related Disparities in
Institutional Delivery: A Decomposition Analysis Using Bangladesh
Multiple Indicator Cluster Survey (MICS) 2019
- Panna Shil,
- Anaytullah Talukdar,
- Syed Toukir Ahmed Noor,
- Sharmin Aktar,
- Md Jamal Uddin
Panna Shil
Shahjalal University of Science and Technology
Author ProfileAnaytullah Talukdar
Shahjalal University of Science and Technology
Author ProfileSyed Toukir Ahmed Noor
Shahjalal University of Science and Technology
Author ProfileSharmin Aktar
Shahjalal University of Science and Technology
Author ProfileMd Jamal Uddin
Shahjalal University of Science and Technology
Corresponding Author:jamal-sta@sust.edu
Author ProfileAbstract
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Institutional delivery, defined as giving birth in a health facility
with skilled delivery assistants, is essential for reducing maternal
mortality in low- and middle-income countries. This study aimed to
assess wealth-related disparities in the use of institutional delivery
services in Bangladesh using data from the Multiple Indicator Cluster
Survey (MICS) 2019. Multiple logistic regression was used to identify
factors associated with institutional delivery, and a concentration
index (CIX) measured wealth-related disparities. Decomposition analysis
helped identify key contributors to these disparities. Results showed
that 52% of deliveries were institutional. Women from rich and
middle-income households had a 94% (AOR=1.94; 95% CI: 1.62-2.34) and
32% (AOR=1.32; 95% CI: 1.12-1.56) higher likelihood, respectively, of
delivering in a health institution compared to poor women. The CIX value
of 0.170 indicated institutional delivery was more common among
wealthier women. Decomposition analysis revealed that prenatal care
visits (33.11%), parity (11.79%), and wealth index (11.07%) were
significant contributors to wealth-related disparities. In conclusion,
this study highlights the urgent need for pro-poor strategies,
particularly in rural and underserved areas like Mymensingh, to reduce
socio-economic disparities in access to institutional delivery services,
with a focus on improving education and healthcare access for women.09 Nov 2024Submitted to Public Health Challenges 12 Nov 2024Submission Checks Completed
12 Nov 2024Assigned to Editor
25 Nov 2024Reviewer(s) Assigned