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. 2024 Feb 15;4(2):e0002607.
doi: 10.1371/journal.pgph.0002607. eCollection 2024.

Clustering of home delivery in Bangladesh and its predictors: Evidence from the linked household and health facility level survey data

Kaniz Fatima  1 , Shimlin Jahan Khanam  2 , Md Mostafizur Rahman  1 , Md Iqbal Kabir  3 , Md Nuruzzaman Khan  2   4
Affiliations

Clustering of home delivery in Bangladesh and its predictors: Evidence from the linked household and health facility level survey data

Kaniz Fatima et al. PLOS Glob Public Health. .

Abstract

Around half of births in Bangladesh occur at home without skilled birth personnel. This study aims to identify the geographical hot spots and cold spots of home delivery in Bangladesh and associated factors. We analyzed data from the 2017/2018 Bangladesh Demographic and Health Survey and the 2017 Bangladesh Health Facility Survey. The outcome variable was home delivery without skilled personnel supervision (yes, no). Explanatory variables included individual, household, community, and healthcare facility level factors. Moran's I was used to determine hot spots (geographic locations with notably high rates of home delivery) and cold spots (geographic areas exhibiting significantly low rates of home delivery) of home delivery. Geographically weighted regression models were used to identify cluster-specific predictors of home delivery. The prevalence of without skilled personnel supervised home delivery was 53.18%. Hot spots of non-supervised and unskilled supervised home delivery were primarily located in Dhaka, Khulna, Rajshahi, and Rangpur divisions. Cold spots of home delivery were mainly located in Mymensingh and Sylhet divisions. Predictors of higher home births in hot spot areas included women's illiteracy, lack of formal job engagement, higher number of children ever born, partner's agriculture occupation, higher community-level illiteracy, and larger distance to the nearest healthcare facility from women's homes. The study findings suggest home delivery is prevalent in Bangladesh. Awareness-building programs should emphasize the importance of skilled and supervised institutional deliveries, particularly among the poor and disadvantaged groups.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Hot spot and cold spot of non-supervised and unskilled supervised home delivery in Bangladesh (we generated this map using data obtained from the survey, with the base shapefile sourced from freely available source: https://data.humdata.org/dataset/cod-ab-bgd?).
Fig 2
Fig 2
(a-c): Individual level predictors of non-skilled personnel supervised home delivery accessed through using the geographically weighted regression model (we generated these maps using data obtained from the survey, with the base shapefile sourced from freely available source: https://data.humdata.org/dataset/cod-ab-bgd?).
Fig 3
Fig 3
(a-f): Household level predictors of non-skilled personnel supervised home delivery accessed through using the geographically weighted regression model (we generated these maps using data obtained from the survey, with the base shapefile sourced from freely available source: https://data.humdata.org/dataset/cod-ab-bgd?).
Fig 4
Fig 4
(a-b): Community level predictors of non-skilled personnel supervised home delivery accessed through using the geographically weighted regression model (we generated these maps using data obtained from the survey, with the base shapefile sourced from freely available source: https://data.humdata.org/dataset/cod-ab-bgd?).
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