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. 2019 Jan 23;8(2):132.
doi: 10.3390/jcm8020132.

Women's Preferences for Maternal Healthcare Services in Bangladesh: Evidence from a Discrete Choice Experiment

Rashidul Alam Mahumud  1   2 , Nadia Ishrat Alamgir  3 , Md Tarek Hossain  4 , Elaine Baruwa  5 , Marufa Sultana  6   7 , Jeff Gow  8   9 , Khorshed Alam  10 , Syed Masud Ahmed  11 , Jahangir A M Khan  12
Affiliations

Women's Preferences for Maternal Healthcare Services in Bangladesh: Evidence from a Discrete Choice Experiment

Rashidul Alam Mahumud et al. J Clin Med. .

Abstract

Despite substantial improvements in several maternal health indicators, childbearing and birthing remain a dangerous experience for many women in Bangladesh. This study assessed the relative importance of maternal healthcare service characteristics to Bangladeshi women when choosing a health facility to deliver their babies. The study used a mixed-methods approach. Qualitative methods (expert interviews, focus group discussions) were initially employed to identify and develop the characteristics which most influence a women's decision making when selecting a maternal health service facility. A discrete choice experiment (DCE) was then constructed to elicit women's preferences. Women were shown choice scenarios representing hypothetical health facilities with nine attributes outlined. The women were then asked to rank the attributes they considered most important in the delivery of their future babies. A Hierarchical Bayes method was used to measure mean utility parameters. A total of 601 women completed the DCE survey. The model demonstrated significant predictive strength for actual facility choice for maternal health services. The most important attributes were the following: consistent access to a female doctor, the availability of branded drugs, respectful provider attitudes, a continuum of maternal healthcare including the availability of a C-section delivery and lesser waiting times. Attended maternal healthcare utilisation rates are low despite the access to primary healthcare facilities. Further implementation of quality improvements in maternal healthcare facilities should be prioritised.

Keywords: Bangladesh; demand for healthcare; discrete choice experiment; healthcare services; maternal healthcare.

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Conflict of interest statement

The authors declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
The study flowchart.
Figure 2
Figure 2
The attributes identified during the literature review.
Figure 3
Figure 3
The hypothetical scenarios of the health facility.
Figure 4
Figure 4
The distribution of discrete choice experiment (DCE) attribute rankings among the rural and urban participants.
See this image and copyright information in PMC

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