Exploring the influencing factors for non-utilisation of healthcare facilities during childbirth: a special mixed-method study of Bangladesh and 13 other low- and middle-income countries based on Demographic and Health Survey data.

ABSTRACT

OBJECTIVE: To identify the associated factors affecting the decision regarding institutional delivery for pregnant women in 14 low- and middle-income countries (LMICs). DESIGN: A special mixed-method design was used to combine cross-sectional studies for harmonising data from Bangladesh and 13 other countries to obtain extended viewpoints on non-utilisation of institutional healthcare facilities during childbirth. SETTING: Demographic and Health Survey (DHS) data for 14 LMICs were used for the study. PARTICIPANTS: There are several kinds of datasets in the DHS. Among them 'Individual Women's Records' was used as this study is based on all ever-married women. RESULTS: In the binary logistic and meta-analysis models for Bangladesh, ORs for birth order were 0.57 and 0.51 and for respondents' age were 1.50 and 1.07, respectively. In all 14 LMICs, the most significant factors for not using institutional facilities during childbirth were respondents' age (OR 0.903, 95% CI 0.790 to 1.032) and birth order (OR 0.371, 95% CI 0.327 to 0.421). CONCLUSION: Birth order and respondents' age were the two most significant factors for non-utilisation of healthcare facilities during childbirth in 14 LMICs.