Exploring the factors behind socioeconomic inequalities in Antenatal Care (ANC) utilization across five South Asian natiaons: A decomposition approach

• Published in: PloS one Vol. 19; no. 8; p. e0304648
• Main Authors: Mahamud Tohan, Mortuja, Islam, Md Amirul, Rahman, Md Ashfikur
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.08.2024
• Subjects: Adolescent; Adult; Bangladesh; Births; Bivariate analysis; Comparative analysis; Data collection; Decomposition; Economic aspects; Education; Female; Health care; Health services; Health Services Accessibility - statistics & numerical data; Health services utilization; Healthcare Disparities - statistics & numerical data; Households; Humans; India; Inequality; Lorenz Curve; Maternal & child health; Maternal Health Services - statistics & numerical data; Maternal mortality; Medical care; Medicine and Health Sciences; Middle Aged; Mortality; Nepal - epidemiology; Obstetrical research; Pakistan; Patient Acceptance of Health Care - statistics & numerical data; People and Places; Postpartum period; Pregnancy; Prenatal care; Prenatal Care - statistics & numerical data; Social aspects; Social Sciences; Socioeconomic Factors; Socioeconomics; Statistical analysis; Utilization; Variables; Womens health; Young Adult; Bangladesh; Pakistan; Nepal; India; Asia; Afghanistan; Maldives; South Asia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0304648

Maternal and child mortality rates remain a significant concern in South Asian countries, primarily due to limited access to maternal care services and socioeconomic disparities. While previous studies have examined the factors influencing the utilization of antenatal care (ANC) services in individual countries, there is a lack of comparative analysis across South Asian nations. This study aims to investigate the factors affecting ANC utilization among women aged 15-49 in Bangladesh, India, Nepal, Maldives, and Pakistan using the latest Demographic and Health Survey data. The study utilized a total weighted sample size of 262,531 women. Simple bivariate statistics and binary logistic regression were employed to identify potential factors influencing ANC utilization. Decomposition analysis and concentration curve (Lorenz curve) were used to assess inequality in ANC service utilization. The prevalence of ANC utilization varied across the countries, with Maldives having the highest (96.83%) and Bangladesh the lowest (47.01%). Women's and husbands' education, household wealth status, BMI, and urban residence were found to significantly influence maternal healthcare services utilization. Higher education levels, affluent wealth quintiles, and urban living were identified as significant contributors to socioeconomic disparities in accessing ANC services. This study highlights the crucial role of socioeconomic factors in the utilization of maternal healthcare services in South Asian countries. Governments should focus on improving healthcare infrastructure, addressing cultural barriers, and promoting education to address these disparities. Identifying context-specific causes of maternal healthcare utilization is essential to inform targeted interventions and policies aimed at improving access to ANC services and reducing maternal mortality rates.