Availability and readiness of health care facilities and their effects on under-five mortality in Bangladesh: Analysis of linked data.

Publisher: International Society of Global Health Country of Publication: Scotland NLM ID: 101578780 Publication Model: Electronic Cited Medium: Internet ISSN: 2047-2986 (Electronic) Linking ISSN: 20472978 NLM ISO Abbreviation: J Glob Health Subsets: MEDLINE

Publication: <2019>-: Edinburgh : International Society of Global Health
Original Publication: Edinburgh : Edinburgh University Global Health Society, 2011-

Maternal Health Services* ; Semantic Web*; Bangladesh/epidemiology ; Child ; Female ; Health Facilities ; Health Services Accessibility ; Humans ; Infant ; Infant, Newborn ; Pregnancy

Background: Under-five mortality is unacceptably high in Bangladesh instead of governmental level efforts to reduce its prevalence over the years. Increased availability and accessibility to the health care facility and its services can play a significant role to reduce its occurrence. We explored the associations of several forms of child mortality with health facility level factors.
Methods: The 2017-18 Bangladesh Demographic and Health Survey (BDHS) data and 2017 Bangladesh Health Facility Survey (BHFS) data were linked and analysed. The outcome variables were neonatal mortality, infant mortality, and under-five mortality. Health facility level factors were considered as major explanatory variables. They were the basic management and administrative system of the nearest health care facility where child health care services are available, degree of availability of the child health care services at the nearest health care facility, degree of readiness of the nearest health care facility (where child health care services are available) to provide child health care services and average distance of the nearest health care facility from mothers' homes where child health care services are available. The associations between the outcome variables and explanatory variables were determined using the multilevel mixed-effect logistic regression model.
Results: Reported under-five, infant and neonatal mortality were 40, 27, and 22 per 10 000 live births, respectively. The likelihood of neonatal mortality was found to be declined by 15% for every unit increase in the score of the basic management and administrative system of the mothers' homes nearest health care facility where child health care services are available. Similarly, degree of availability and readiness of the mothers' homes nearest health care facilities to provide child health care services were found to be linked with 18%-24% reduction in neonatal and infant mortality. On contrary, for every kilometre increased distance between mothers' homes and its nearest health care facility was found to be associated with a 15%-20% increase in the likelihoods of neonatal, infant and under-five mortality.
Conclusions: The availability of health facilities providing child health care services close to mothers' residence and its readiness to provide child health care services play a significant role in reducing under-five mortality in Bangladesh. Policies and programs should be taken to increase the availability and accessibility of health facilities that provide child health care services.
Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.
(Copyright © 2022 by the Journal of Global Health. All rights reserved.)

Patient Prefer Adherence. 2020 Sep 18;14:1649-1658. (PMID: 32982189)
BMJ Glob Health. 2020 Aug;5(8):. (PMID: 32843572)
J Glob Health. 2019 Dec;9(2):020803. (PMID: 31673347)
Lancet Glob Health. 2022 Feb;10(2):e195-e206. (PMID: 35063111)
Arch Dis Child. 2015 Feb;100 Suppl 1:S1. (PMID: 25613958)
Lancet. 2017 Dec 17;388(10063):3027-3035. (PMID: 27839855)
Heliyon. 2020 May 11;6(5):e03950. (PMID: 32420500)
J Pediatr Nurs. 2022 Jul-Aug;65:e43-e48. (PMID: 35216837)
Lancet Glob Health. 2018 May;6(5):e535-e547. (PMID: 29653627)
Trop Med Int Health. 2019 Jan;24(1):31-42. (PMID: 30347129)
Epidemiol Infect. 2014 Dec;142(12):2491-500. (PMID: 24565180)
Semin Perinatol. 2019 Aug;43(5):297-307. (PMID: 31005357)
PLoS One. 2017 Nov 27;12(11):e0188294. (PMID: 29176807)
Int J Equity Health. 2021 Apr 26;20(1):109. (PMID: 33902593)
PLoS One. 2021 Feb 4;16(2):e0246210. (PMID: 33539476)
Bull World Health Organ. 2017 Nov 01;95(11):738-748. (PMID: 29147054)
Int J Epidemiol. 2017 Jun 1;46(3):817-826. (PMID: 27185809)
J Biosoc Sci. 1997 Oct;29(4):385-99. (PMID: 9881143)
BMJ Open. 2020 Oct 12;10(10):e037532. (PMID: 33046466)
Matern Health Neonatol Perinatol. 2019 Jun 18;5:10. (PMID: 31236281)
BMC Public Health. 2017 Nov 21;17(1):889. (PMID: 29162064)
BMJ Glob Health. 2018 Feb 23;3(1):e000510. (PMID: 29527340)
Psyche (Camb Mass). 2019;2019:4954095. (PMID: 33281233)
Glob Health Action. 2012 Nov 09;5:1-9. (PMID: 23151364)
Front Immunol. 2018 Jul 30;9:1759. (PMID: 30105028)
Int J MCH AIDS. 2012;1(1):60-72. (PMID: 27621959)
Lancet. 2017 Sep 16;390(10100):1423-1459. (PMID: 28916366)
Arch Public Health. 2017 Sep 7;75:58. (PMID: 28912949)
BMC Health Serv Res. 2016 Aug 19;16(1):410. (PMID: 27542836)
Health Policy Plan. 2017 Mar 1;32(2):277-282. (PMID: 28207067)
Annu Rev Public Health. 2000;21:171-92. (PMID: 10884951)
Br Med Bull. 2010;93:7-26. (PMID: 20007188)

Date Created: 20220916 Date Completed: 20220920 Latest Revision: 20220921

20240105

PMC9480612

10.7189/jogh.12.04081

36112406