# Quality of antenatal care and its potential impacts on delivery services and postnatal care compliance among reproductive women in Bangladesh: A situation analysis from the Bangladesh Demographic and Health Survey 2017

## TL;DR

This study examines how quality antenatal care in Bangladesh affects delivery services and postnatal care compliance, revealing low rates of quality care and its positive impact on maternal and neonatal outcomes.

## Contribution

The study provides empirical evidence on the relationship between quality antenatal care and improved delivery and postnatal care compliance in Bangladesh.

## Key findings

- Only 18% of women received quality antenatal care, with low rates of pregnancy-related counseling.
- Quality antenatal care was associated with increased facility delivery, skilled birth attendance, and postnatal care compliance.
- Higher education and wealth were linked to better maternal and neonatal health outcomes.

## Abstract

Ensuring quality antenatal care (ANC) and postnatal care (PNC) is crucial for reducing maternal and neonatal mortality rates. However, there are gaps in assessing the quality of ANC, leading to the proposal of standards by the World Health Organization. The study aims to examine the impact of quality ANC on delivery services and PNC compliance in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS), providing insights for policymakers to improve maternal and neonatal health outcomes.

This study used data from 2017 Bangladesh Demographic and Health Survey (BDHS) to investigate the impact of quality antenatal care (qANC) on delivery services and PNC in Bangladesh. The study population included ever-married women aged 15–49 years who had experienced a recent pregnancy. The analysis assessed the relationship between qANC and facility delivery, skilled birth attendant (SBA)-assisted delivery, and PNC services within 48 hours of delivery. The study employed a two-stage stratified cluster sampling design, and data analysis was conducted using generalized linear models and considered various demographic and socioeconomic factors.

Key findings include a low rate of qANC services (18%), with pregnancy-related counseling being the lowest component. About 82% received at least one ANC visit, but only 18.3% received a quality visit. Higher compliance with facility delivery (ARR: 1.3; 95% CI: 1.27–1.41), SBA-conducted delivery (ARR: 1.3; 95% CI: 1.24–1.35), and PNC services for both mother (ARR: 1.3; 95% CI: 1.24–1.35) and child (ARR: 1.3; 95% CI: 1.23–1.35) within 48 hours were observed when quality ANC was received. Factors such as completing secondary education, engaging in skilled/unskilled manual labor and higher wealth quintile were associated with better delivery and post-delivery outcomes.

Ensuring qANC and expanding PNC service use remain challenging in Bangladesh. Increasing the provision of qANC is crucial, as it is associated with higher adherence to PNC.