Women’s Preferences for Maternal Healthcare Services in Bangladesh: Evidence from a Discrete Choice Experiment

Despite substantial improvements in several maternal health indicators, childbearing and birthing remain a dangerous experience for many women in Bangladesh. This study assessed the relative importance of maternal healthcare service characteristics to Bangladeshi women when choosing a health facility to deliver their babies. The study used a mixed-methods approach. Qualitative methods (expert interviews, focus group discussions) were initially employed to identify and develop the characteristics which most influence a women’s decision making when selecting a maternal health service facility. A discrete choice experiment (DCE) was then constructed to elicit women’s preferences. Women were shown choice scenarios representing hypothetical health facilities with nine attributes outlined. The women were then asked to rank the attributes they considered most important in the delivery of their future babies. A Hierarchical Bayes method was used to measure mean utility parameters. A total of 601 women completed the DCE survey. The model demonstrated significant predictive strength for actual facility choice for maternal health services. The most important attributes were the following: consistent access to a female doctor, the availability of branded drugs, respectful provider attitudes, a continuum of maternal healthcare including the availability of a c-section delivery and lower waiting times. Attended maternal healthcare utilisation rates are low despite the access to primary healthcare facilities. Further implementation of quality improvements in maternal healthcare facilities should be prioritised

Well-being of children affected by HIV/AIDS in Bangladesh: across-sectional study

Children affected by HIV or AIDS (CABA) are vulnerable to social consequences such as neglect, stigma, and exclusion, leading to poor child well-being. We assessed the well-being of CABA and the factors associated with it. Our sample included 288 CABA, aged10–18 years, from four divisions of Bangladesh – Dhaka, Chittagong, Sylhet, and Khulna. The mean age of the children was 12.93 (±2.36)years. Among the children, 58% were boys, 78% were from rural areas, and 48.6% were receiving some form of HIV-sensitive social protection services from different non-governmental organizations. Around 91% of the children were continuing their education, 93%were vaccinated according to the national immunization schedule, and 13% were infected with HIV. We found that child well-being was not significantly associated with HIV-sensitive social protection services (OR: 0.88, 95% CI: 0.40–1.95), but with family wealth (OR:5.23, 95% CI: 1.88–14.51). Therefore, we argue for HIV-sensitive social protection services that consider the economic well-being of the families of the CABA along with other well-being aspects