Online Program

Increasing institutional deliveries in Bangladesh: Getting on with what works, what doesn't and how

Wednesday, November 4, 2015

Sabuj C. Bhowmick, M.Sc, MPhilc, Department of Community Medicine, University of Oslo, Oslo, Norway
Muhammad A.B. Chowdhury, M.Sc., MPHc, Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Background: To prevent both maternal and newborn mortality institutional deliveries are recommended. Institutional deliveries in Bangladesh have been increased by 70% from 2007 to 2011.

Objective: To identify the explanations for the observed increase in institutional deliveries in Bangladesh.

Methods:  A qualitative study using in-depth interview was conducted with the key informants of Directorate General of Health Service (DGHS) and service provider in three different Government hospitals in Bangladesh from September to December 2014. Twelve in-depth interviews were conducted at that period including National Program Coordinator of DGHS, program officer of WHO demand side financing (DSF) cell, health care provider and mothers. Mothers who had institutional delivery were included in the interview.

Results: We found comprehensive emergency obstetric care (EmOC), strengthening health facilities, skilled birth attendance at community level, increasing demand side financing for the poor mothers, community awareness program were found as contributing factors for increasing institutional delivery. The policy makers and program officers of (DGHS) suggest some other factors (i.e. economic improvement, education, and social awareness) are also contributing for increasing institutional deliveries in Bangladesh.

Conclusion: Among all factors, emergency obstetric care (EmOC) was found one of the important factors by the policy maker and service provider for increasing the institutional deliveries in Bangladesh. Policy like Demand Side Financing will encourage the mothers to deliver their child at facility. Combination of all programs and policies could increase the institutional deliveries at the coming decades.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related public policy

Learning Objectives:
Identify policies those were implemented since 1990 that aimed at increasing the proportion of deliveries taking place in hospitals. To investigate policymakers perceptions of which policies have been the most instrumental in increasing the rate of hospital deliveries To investigate women’s perceptions about which policies have been the most important for the increase in the rate of hospital deliveries

Keyword(s): Public Health Policy, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a background in statistics, Biostatistics and public health and i worked for John Hopkins Bloomberg School of Public Health's project in Bangladesh as a research statistician. Currently i am working on my master thesis project in policy on institutional deliveries in Bangladesh at the University of Oslo. I have worked on many papers which are in under reviewing process. I also assist in preparing many papers to my supervisors.
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.