TY - JOUR
T1 - Preference for home births in rural Bangladesh
T2 - A qualitative exploratory study
AU - Islam, M. Mazharul
AU - Shahjahan, Mohammed
AU - Rahman, Md Mokhlesur
N1 - Funding Information:
This qualitative study, conducted under the auspices of the Daffodil International University (DIU), Dhaka, Bangladesh, was funded by the Bangladesh Medical Research Council (BMRC)–a research and training institute under the Ministry of Health (MoH), Bangladesh. Department of Public Health of DIU implemented theusy. rve The study was conducted using Focus Group Discussions (FGDs). A total of three groups were conducted with three separate groups of stakeholders. The three FGDs were: (1) women, (2) men, and (3) health service providers. Both men and women participants were selected and mobilized with the help of Family Welfare Assistants (FWAs) - the local health workers, while the health service providers were selected by the research team. FWAs are government-appointed full-time trained female health workers at a community level.
Funding Information:
The authors are indebted to the participants of the FGDs. Special thanks to Madhupur Upazila Health Complex authority for providing a venue to conduct FGDs. This research received funding from the Bangladesh Medical Research Council (BMRC) under World Bank Research Program.
Publisher Copyright:
© 2021, Mahidol University - ASEAN Institute for Health Development. All rights reserved.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Despite the renewed commitment to increase the rate of health facility-based delivery, more than half of all deliveries still take place at home in rural Bangladesh with the support of traditional birth attendants (TBAs), which leads to high maternal mortality as well as poor maternal health and pregnancy outcomes. The aim of this study was to identify the reasons for preferring home delivery among rural communities in Bangladesh. The data were gathered through three Focus Group Discussions (FGDs) among three different groups of stakeholders, viz., nine women, seven men, and nine health service providers. Thus, 25 individuals participated in this study. FGDs were conducted in a rural sub-district of Bangladesh. Thematic analysis was performed. The findings revealed a high preference for home delivery attended by TBAs among rural communities, as it was convenient, easily affordable, comfortable, and suitable for maintaining social rituals during labor and after delivery. Cultural practices and belief systems are the most frequently cited reasons for preferring home delivery with the help of a TBA. Other major reasons for choosing home delivery included financial constraints, inadequate knowledge about services offered by the health care facilities and lack of awareness about service delivery points, poor road conditions, and lack of transportation to reach the nearest health facility. Poor quality of services at the health care facility, perceived fear of undergoing cesarean delivery at the health care facility, and lack of lady doctors at the health care facilities also had a significant impact on the choice of home delivery. To further increase health facility-based delivery in Bangladesh, there is an urgent need to design a comprehensive maternal health program with culturally appropriate interventions, duly addressing the reasons for preferring home delivery that have been identified in this study. In the long run, promoting women’s education, reducing poverty, and improving the quality of all services at the health care facilities, particularly in the rural hinterlands of Bangladesh, would improve maternal health and pregnancy outcomes in the communities and reduce high maternal mortality.
AB - Despite the renewed commitment to increase the rate of health facility-based delivery, more than half of all deliveries still take place at home in rural Bangladesh with the support of traditional birth attendants (TBAs), which leads to high maternal mortality as well as poor maternal health and pregnancy outcomes. The aim of this study was to identify the reasons for preferring home delivery among rural communities in Bangladesh. The data were gathered through three Focus Group Discussions (FGDs) among three different groups of stakeholders, viz., nine women, seven men, and nine health service providers. Thus, 25 individuals participated in this study. FGDs were conducted in a rural sub-district of Bangladesh. Thematic analysis was performed. The findings revealed a high preference for home delivery attended by TBAs among rural communities, as it was convenient, easily affordable, comfortable, and suitable for maintaining social rituals during labor and after delivery. Cultural practices and belief systems are the most frequently cited reasons for preferring home delivery with the help of a TBA. Other major reasons for choosing home delivery included financial constraints, inadequate knowledge about services offered by the health care facilities and lack of awareness about service delivery points, poor road conditions, and lack of transportation to reach the nearest health facility. Poor quality of services at the health care facility, perceived fear of undergoing cesarean delivery at the health care facility, and lack of lady doctors at the health care facilities also had a significant impact on the choice of home delivery. To further increase health facility-based delivery in Bangladesh, there is an urgent need to design a comprehensive maternal health program with culturally appropriate interventions, duly addressing the reasons for preferring home delivery that have been identified in this study. In the long run, promoting women’s education, reducing poverty, and improving the quality of all services at the health care facilities, particularly in the rural hinterlands of Bangladesh, would improve maternal health and pregnancy outcomes in the communities and reduce high maternal mortality.
KW - Bangladesh
KW - Home childbirth
KW - Maternal health
KW - Pregnancy
KW - Rural community
UR - http://www.scopus.com/inward/record.url?scp=85107161435&partnerID=8YFLogxK
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M3 - Article
AN - SCOPUS:85107161435
SN - 2673-0774
VL - 19
SP - 64
EP - 76
JO - Journal of Public Health and Development
JF - Journal of Public Health and Development
IS - 2
ER -
