249119 Quality of care in private and public facilities: Making childbirth cherished and safe for women in Bangladesh

Sunday, October 30, 2011

Laila Rahman, MS, MCom , Bangladesh Office, Population Council, Dhaka, Bangladesh
Ubaidur Rob, PhD , Population Council, Dhaka, Bangladesh
Md. Noorunnabi Talukder V , Population Council, Dhaka, Bangladesh
Ismat Ara Hena , Population Council, Dhaka, Bangladesh
Purpose: Bangladesh maternal mortality survey 2010 surprisingly revealed private sector's significant contribution in providing maternal health services. Quality of care is pivotal for making childbirth safe and joyful, but quality in private-sector remains largely unknown. Therefore, this paper compares quality of care between public and private facilities where public establishments had historically been the major institutional provider. Data: Sample constituted 511 females, who delivered in the facilities last year. Sample was drawn using systematic random sampling from 16 upazilas in 2010. Methods: Descriptive statistics and logistic regression using SPSS 14.0 were used. Binary outcomes of the dependent variable included - satisfaction and non-satisfaction in receiving delivery-care. Results: Almost half of the women delivered in private facilities. Waiting time did not vary, but providers were friendlier (c2 (1, N = 508) = 7.09, p =.01), more attentive (c2 (2, N = 506) = 13.10, p =.00), explained elaborately (c2 (2, N = 502) = 15.64, p =.00), maintained privacy (c2 (2, N = 506) = 27.85, p =.00), and carried out more physical examinations in private than public facilities. Logistic regression model, controlling for age and location, revealed that women were 4.82 times (95% CI, 2.96-7.84) more likely to be satisfied with the private than public facilities. Recommendations: Childbirth should be cherished, and exceed beyond mere survival. Private facilities are to be encouraged although there are scopes for improvement. Not to waste the huge infrastructure, public facilities need to significantly improve quality of care through training, monitoring, mentoring, and incentive-based payment-for-providers.

Learning Areas:
Administer health education strategies, interventions and programs
Administration, management, leadership
Planning of health education strategies, interventions, and programs
Program planning
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
•Compare quality of care in providing delivery care between the public and private facilities in Bangladesh. •Discuss quality of care components that bring satisfaction to women giving childbirth.

Keywords: Women's Quality Care, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I coordinated the study, carried out the designing, data analyses and writing of the paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.