# Barriers and Facilitators to Accessing and Using Maternal Healthcare Services by Women Living in Rural Bangladesh: A Theory-Guided Narrative Literature Review

## TL;DR

This paper reviews factors affecting maternal healthcare access for rural women in Bangladesh, identifying barriers and facilitators at multiple levels.

## Contribution

A theory-guided synthesis of barriers and facilitators to maternal healthcare access in rural Bangladesh using the Social-Ecological Model.

## Key findings

- Barriers include illiteracy, lack of family support, cultural taboos, and poor access to facilities.
- Facilitators include higher literacy, NGO support, media exposure, and free healthcare services.
- Improving literacy, infrastructure, and healthcare provider skills is recommended to enhance maternal healthcare access.

## Abstract

To identify and synthesize the barriers and facilitators to accessing and using maternal healthcare (MHC) services by women living in rural Bangladesh.

A structured literature search was conducted using six databases in 2024. Studies were synthesized using a thematic approach, underpinned by the Social-Ecological Model.

Searches returned 3,619 studies, of which 37 were included in this review. Findings related to barriers and facilitators were categorized into four themes: individual, family, social and community, and organizational levels. Key barriers to accessing and using MHC services included illiteracy, lack of family support, cultural taboo to pregnancy disclosure, distance to health facilities, and lack of quality services. Key facilitators to accessing and using MHC services were higher literacy levels, family support, NGO support and mass media exposure, and free healthcare services.

Based on the findings of the review, to improve Bangladeshi women’s access to and use of MHC services, improvements in women’s literacy levels, village roads, family support, and service-related skills of healthcare providers are necessary.