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. 2019 Aug 14;16(1):123.
doi: 10.1186/s12978-019-0785-7.

Prevalence and determinants of menstrual regulation among ever-married women in Bangladesh: evidence from a national survey

Juwel Rana  1 , Kanchan Kumar Sen  2 , Toufica Sultana  3 , Mohammad Bellal Hossain  4 , Rakibul M Islam  5
Affiliations

Prevalence and determinants of menstrual regulation among ever-married women in Bangladesh: evidence from a national survey

Juwel Rana et al. Reprod Health. .

Abstract
in English, Spanish

Background: Despite the remarkable reduction of maternal mortality, unsafe and untimely menstrual regulation (MR) remains a major maternal health problem in Bangladesh. This study aimed to determine the prevalence and identify determinants of MR among ever-married women in Bangladesh.

Methods: Data for this study have been extracted from Bangladesh Demographic and Health Survey (BDHS) 2014. The survey followed a two-stage stratified sampling procedure and the study used a sub-sample of 8084 ever-married women aged 15 to 49 years extracted from survey sample of 17,863. Univariate and multivariate mixed-effect logistic regression analyses were used to identify risk factors for MR accounting for potential between-clusters variations.

Results: The weighted prevalence of MR was 12.3% (95% CI: 11.1-13.4%) among (991/8084) ever-married women. Women were less likely to have MR if they were from Chittagong (AOR 0.74, 95% CI: 0.57-0.96; p = 0.026) and Sylhet (AOR 0.53, 95% CI: 0.36-0.77; p = 0.001) divisions. Women were more likely to have MR if they were from high (AOR 1.47, 95% CI: 1.18-1.83; p = 0.001) and the highest (AOR 1.62, 95% CI: 1.27-2.05; p < 0.001) socioeconomic status (SES) group; being employed (AOR 1.35, 95% CI: 1.16-1.56; p < 0.001), having one or two children (AOR 1.73, 95% CI: 1.24-2.40: p = 0.001) and ≥ 3 children (AOR 2.56, 95% CI: 1.82-3.58; p < 0.001), and having membership of non-government organization (NGO) (AOR 1.18, 95% CI: 1.02-1.38; p = 0.030).

Conclusion: MR is prevalent among Bangladeshi women and independently associated with geographic location, SES, parity, employment and NGO membership status. Health policy should prioritize in reducing spatial and socioeconomic inequalities in relation to MR services by ensuring accessibility and availability of MR services, especially in suburban divisions. Furthermore, abortion should be legalized in Bangladesh that will ultimately reduce the morbidity and mortality associated with unsafe abortion.

Antecedentes: a pesar de la notable reducción de la mortalidad materna, la regulación menstrual (RM) insegura y prematura sigue siendo un problema importante de salud materna en Bangladesh. El objetivo de este estudio fue determinar la prevalencia e identificar los determinantes de la RM en mujeres que han estado casadas en Bangladesh.

Métodos: los datos para este estudio se extrajeron de la Encuesta Demográfica y de Salud de Bangladesh (BDHS) de 2014. La encuesta siguió un procedimiento de muestreo estratificado en dos etapas y el estudio utilizó una sub-muestra de 8.084 mujeres casadas de 15 a 49 años de edad extraídas de la muestra de la encuesta de 17.863. Se utilizaron análisis de regresión logística de efectos mixtos univariados y multivariados para identificar los factores de riesgo de la RM tomando en cuenta las variaciones potenciales entre los grupos.

Resultados: La prevalencia ponderada de la RM fue de 12.3% (IC 95%: 11.1–13.4%) entre (991/8.084) mujeres casadas. Las mujeres tenían menos probabilidades de tener una RM si eran de Chittagong (AOR 0.74, IC 95%: 0.57–0.96; p = 0.026) y Sylhet (AOR 0.53, IC 95%: 0.36–0.77; p = 0.001). Las mujeres eran más propensas a tener una RM si pertenecían al estatus socioeconómico (ESE) alto (AOR 1.47, IC 95%: 1.18–1.83; p = 0.001) y más alto (AOR 1.62, IC 95%: 1.27–2.05; p < 0.001); estar empleada (AOR 1.35, IC 95%: 1.16–1.56; p < 0.001), tener uno o dos hijos (AOR 1.73, IC 95%: 1.24–2.40: p = 0.001) y ≥ 3 niños (AOR 2.56, 95% IC: 1.82–3.58; p < 0.001), y pertenecer a una organización no gubernamental (ONG) (AOR 1.18, IC 95%: 1.02–1.38; p = 0.030).

Conclusión: la RM prevalece entre las mujeres de Bangladesh y está asociada de forma independiente con la ubicación geográfica, ESE, paridad, empleo y condición de miembro de una ONG. Las políticas de salud deben priorizar la reducción de las desigualdades espaciales y socioeconómicas en relación con los servicios de RM, garantizando la accesibilidad y disponibilidad de los servicios de RM, especialmente en las divisiones suburbanas. Además, el aborto debería legalizarse en Bangladesh, lo que en última instancia reducirá la morbilidad y la mortalidad asociadas con el aborto inseguro.

Keywords: Bangladesh; Determinants; Maternal health; Menstrual regulation; Prevalence.

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Conflict of interest statement

The authors declare that they have no competing interests.

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