Background: The objectives of this study are to document the trend on
utilisation of four or more (4+) antenatal care (ANC) over the last 22
years period and to explore the determinants and inequity of 4+ ANC
utilisation as reported by the last two Bangladesh Demographic and
Health surveys (BDHS) (2011 and 2014). Methods: The data related to ANC
have been extracted from the BDHS data set which is available online as
an open source. STATA 13 software was used for organising and analysing
the data. The outcome variable considered for this study was
utilisation of 4+ ANC. Trends of 4+ ANC were measured in percentage and
predictors for 4+ ANC were measured through bivariate and multivariable
analysis. The concentration index was estimated for assessing inequity
in 4+ ANC utilisation. Results: Utilisation of 4+ ANC has increased by
about 26% between the year 1994 and 2014. Higher level of education,
residing in urban region and richest wealth quintile were found to be
significant predictors. The utilisation of 4+ ANC has decreased with
increasing parity and maternal age. The inequity indices showed
consistent inequities in 4+ ANC utilisation, and such inequities were
increased between 2011 and 2014. Conclusions: In Bangladesh, the
utilisation of any ANC rose steadily between 1994 and 2014, but
progress in terms of 4+ ANC utilisation was much slower as the
expectation was to achieve the national set target (50%: 4+ ANC
utilisation) by 2016. Socio-economic inequities were observed in groups
that failed to attend a 4+ ANC visit. Policymakers should pay special
attention to increase the 4+ ANC coverage where this study can
facilitate to identify the target groups whom need to be intervened on
priority basis