Mizan, Sharmin
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Does Entitlement Card ensure Utilization of Urban Primary Healthcare Clinic in Bangladesh? Mizan, Sharmin; Rahman, Md Mizanur; Safii, Razitasham binti; Ahmad, Sk Akhtar
Journal of Maternal and Child Health Vol 5, No 2 (2020)
Publisher : Journal of Maternal and Child Health

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Abstract

Background: Although Bangladesh substantial­ly reduced 40% maternal death in the last deca­des, it is still challenging, especially among the ur­ban poor. The achievements are not equitable bet­ween different economic quintiles and bet­ween the rich and the urban poor. This study aims to examine the extent to which the entitle­ment card affects the utilization of maternal and child health care and identifies other factors that influence MCH services.Subjects and Method: This cross-sectional study was carried out in the working areas of the Ur­ban Primary Healthcare Project (UPHCP) in Bang­ladesh. A two-stage cluster sampling tech­ni­que was used to select the participants. A total of 3,949 women aged 15-49 years, having at least one child aged two years or less were selected for this study. The data were collected through face-to-face inter­views. The data were analyzed using multinomial logistic regression.Results: The proportion of utilization of UPH­CC was 49.9%. One-fourth (26.6%) of them fully utilized it and another 23.3% utilized it partially. Stepwise multinomial logistic regression analysis revealed that those who had an Entitlement Card from the UPHC project were 11.75 times (95% CI= 9.481, 14.549; p= 0.001) more likely to fully Utilized and 3.64 times (95% CI= 3.643, 2.911; p= 0.001) likely be utilized partially compared to non-utilizer. Respondents having no formal edu­cation utilized UPHCC fully (AOR=2.32; 95% CI= 1.46, 3.68; p= 0.001) and partially (AOR= 1.76; 95% CI= 1.12, 2.77; p= 0.014) used UPHCC. It was 3.08 (95% CI= 2.03, 4.67; p= 0.001) times for fully and 2.71 (95% CI= 1.82, 4.04; p= 0.001) times for partially utilized UPHCC compared to non-users among the primary level of education. Small family size (≤4) and monthly family in­come in the range of BDT 10,000 above were likely to utilise UPHCC. However, non-Muslims were less likely to Utilized UPHCC.Conclusion: Apart from the entitlement card, other factors such as monthly income BDT> 10,000, small family size, no formal educated mo­ther appeared to be potential predictors for utilization of the Urban Primary Health care clinic.Keywords: entitlement card, maternal care, Utilization, urban primary healthcareCorrespondence: Md Mizanur Rahman. Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sa­rawak. Email: rmmizanur@unimas.my, rmizanur1958@gmail.com.Journal of Maternal and Child Health (2020), 5(2): 213-225https://doi.org/10.26911/thejmch.2020.05.02.12