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Role of National Nutrition Program on Utilization of Antenatal Care Service in Rural Bangladesh

Role of National Nutrition Program on Utilization of Antenatal Care Service in Rural Bangladesh. Kaji Tamanna Keya 1 Pronob Kumar Mozumder 2 1 Population Council, Dhaka 2 University of Dhaka, Dhaka, Bangladesh COHEA 2012 , Jakarta, Indonesia, 12-13 December, 2012. Background.

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Role of National Nutrition Program on Utilization of Antenatal Care Service in Rural Bangladesh

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  1. Role of National Nutrition Program on Utilization of Antenatal Care Service in Rural Bangladesh Kaji Tamanna Keya1 Pronob Kumar Mozumder2 1Population Council, Dhaka 2University of Dhaka, Dhaka, Bangladesh COHEA 2012, Jakarta, Indonesia, 12-13 December, 2012

  2. Background • Yearly 7000 women die due to child birth. • More than half deliveries had complication at any stage of pregnancy • 54% pregnant women seek ANC from medically trained providers. • One-fourth pregnant women make 4 ANC visits. • 77% deliveries conducted at home. • 27% receive PNC from medically trained providers. • Rural-urban differential in ANC coverage by skilled provider is high i.e.74% vs. 49% • BMMS-2010 BDHS 2011

  3. Barriers of ANC access • Lack of trained service providers • Lack of awareness about the importance of ANC service • Attitude of the providers • Poverty or low socio-economic condition • Geographical situation Initiation of GOB operated National Nutrition ProgramImplementation period: 2002-2011Coverage: 30 percent population Provider: Volunteer Community Nutrition Promoter(CNP) Place: Community Nutrition CenterFocus: Nutritional status of mother and child

  4. ANC services under NNP- • Height measurement • Weight measurement • Iron tablet distribution • Nutrition packet • Health knowledge on danger-signs of pregnancy and delivery • Preventive and curative care during pregnancy and delivery • Referral services for TT vaccine and complication management • BCC materials for pregnant mothers

  5. Objectives • To see the utilization of ANC care • To see the quality of ANC care Methodology • Cross-sectional study. • Data was collected through face to face interview using a structured questionnaire Study area Sadarupazila of Barisal district Nolsityupazila of Jhalokathi district uderNNP program

  6. Methodology continue… Study area selection-Multistage • 2 upazila from 2 district under NNP • program • 1 random union from each upazila • 3 random villages from each union Study period- From April-May 2008 Sample size-415 ever-married women aged 15-49 years experienced at least one pregnancy in 3 years preceding the survey Sample selection process-Women were selected randomly from the list of mothers prepared by Community Nutrition Promoter(CNP)

  7. Findings

  8. Findings continue…

  9. Reproductive History and access to health facility

  10. Place of ANC visit * Multiple response

  11. Type of ANC services • Height measured- 80% • Weight measured- 85% • Tetanus texoide vaccine-81% • Iron tablets- 43% • Urine test-41% • Blood pressure measurement-27% • Blood test-23% • Ultrasonogram-23%

  12. Type of provider consulted for ANC • 50% percent from a professional doctor • 12% from a nurse or a paramedic • 6% from family welfare visitors (FWV) • 6% from family welfare assistants(FWA) • 6% from health assistants(HA) • 4% from trained midwives • 41% received ANC from the Community Nutrition Promoter [Multiple responses]

  13. determinants of ANC Higher educated women are more likely to receive ANC than uneducated (p value .012) Young women are more likely to receive ANC than younger (p value .003) Media exposure(TV) has effect on ANC (p value .04) Women’s better knowledge on ANC services increase the use of ANC use (p value .000) Women having fewer children are more likely to receive ANC services (p value .001) Women having adverse reproductive history receives ANC care from trained service provider (p value .042)

  14. Conclusion • Home visit of CNPs found effect • Frequent health message on danger signs of pregnancy and delivery • Preventive and curative care of NNP is effective • Provision of referral services- -Services from medically trained provider -complicated management of pregnancy -Institutionalized delivery or delivery by a skilled provider • The availability and accessibility of ANC services through the NNP support increased the use of ANC services • Service of CNP could not ensure the physical or medical tests of ANC and therefore lack the quality of ANC service.

  15. Thank You!

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