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