Challenges for Utilization of Antenatal and Delivery Care Services in Urban Setting of Bangladesh

In most developing countries like Bangladesh the health care facilities are not optimally available and usually are underutilized. The study explored the perception of urban poor women regarding pregnancy, childbirth and obstetric care services of the health centers and factors for utilization and/or nonutilization of such services. Focus group discussions were conducted among mothers with a child aged one year or below, their husband and elder female members of the family between May and June 2001 in selected geographical clusters of Dhaka city. It was revealed that women regard pregnancy and child birth as a natural process that needs no medical care unless some dire emergency arises. Taking tetanus toxoid during pregnancy was equated with availing antenatal care. Traditional birth attendant (Dai) was more preferable as birth attendant as they are available at home, like a kin to them, and affordable. Reason for not availing the services were high cost, nonavailability of drugs, hassles to get free bed, ignorance about the complications, negative cultural norm, rude behavior of health care providers, fear of cesarian section and an unfamiliar environment in the hospitals. Utilization of maternity care services can be improved through a combined effort of increasing awareness to avail skilled care and made the services more accessible and with better quality.