Impact of COVID-19 on the utilisation of maternal health services in Bangladesh: A division-level analysis

Aniqa Tasnim Hossain, Ema Akter, Ridwana Maher Manna, Tasnu Ara, Md Alamgir Hossain, K. M. Tanvir, Md Hafizur Rahman, Abu Sayeed, Abu Bakkar Siddique, Bibek Ahamed, M. Sabbir Haider, Sabrina Jabeen, Shafiqul Ameen, Mohammad Sohel Shomik, Anisuddin Ahmed, Luis Huicho, Alicia Matijasevich, Abdoulaye Maiga, Ahmed Ehsanur Rahman, Nadia AkseerShams El Arifeen, Agbessi Amouzou

Research output: Contribution to journalArticlepeer-review

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic had substantially disrupted maternal health care provision and utilisation in Bangladesh. However, the extent of geographical disparities in service utilisation and how the health system withstood these challenges have not been studied. This study explores the divisional disparities in trends and disruptions in maternal health service utilisation caused by the COVID-19 pandemic. Methods Data was extracted from the District Health Information Software of Bangladesh from January 2017 to December 2021. We assessed the trend of first antenatal care visit, institutional delivery and number of caesarean sections over these years. We explored both the yearly and monthly trends to see the variations in the number of utilisations. Segmented regression with Poisson distribution was used to assess changes in service utilisation during the COVID-19 period. We reported incidence rate ratio (IRR) of service utilisation with a 95% confidence interval (CI) in different divisions during COVID-19 (2020–2021) compared to the reference period (2017–2019). Results Initially, a notable decline in maternal health care utilisation was observed in 2020 compared to the pre-pandemic period of 2017–2019. Divisional disparities were observed in this trend. Overall, compared to the pre-pandemic period, we observed around 30% decline in all three selected indicators of maternal health care. The lowest value was observed in Chattogram in 2020 (IRR = 0.66; 95% CI = 0.55–0.79) and Rajshahi in 2021 (IRR = 0.71; 95% CI = 0.60–0.82). For institutional delivery, Barishal division had the lowest IRR (0.64; 95% CI=0.60–0.68) in 2020 and, in 2021 Rajshahi had the lowest IRR (0.71; 95% CI = 0.60–0.82). For caesarean section, the lowest value was observed in Barishal division (IRR = 0.48; 95% CI = 0.44–0.53) in 2020 and in Mymensingh (IRR=0.37; 95% CI=0.32–0.43) in 2021. By 2021, the three maternal health care utilisation indicators demonstrated recovery.

Original languageEnglish (US)
Article number05040
JournalJournal of global health
Volume14
DOIs
StatePublished - 2024

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Fingerprint

Dive into the research topics of 'Impact of COVID-19 on the utilisation of maternal health services in Bangladesh: A division-level analysis'. Together they form a unique fingerprint.

Cite this