Abstract:
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OBJECTIVE: To identify the determinants and measure the trends
in health facility-based deliveries and caesarean sections among
married adolescent girls in Bangladesh. METHODS: In order to
measure the trends in health facility-based deliveries and
caesarean sections, Bangladesh Demographic Health Survey (BDHS)
data sets were analysed (BDHS; 1993-1994, 1996-1997, 1999-2000,
2004, 2007, 2011). The BDHS 2011 data sets were analysed to
identify the determinants of health facility-based deliveries
and caesarean sections. A total of 2813 adolescent girls (aged
10-19 years) were included for analysis. Bivariate and
multivariate analyses were performed. RESULTS: Health
facility-based deliveries have continuously increased among
adolescents in Bangladesh over the past two decades from 3% in
1993-1994 to 24.5% in 2011. Rates of population-based and
facility-based caesarean sections have increased linearly among
all age groups of women including adolescents. Although the
country's overall (population-based) caesarean section rate
among adolescents was within acceptable range (11.6%), a rate of
nearly 50% health facility level caesarean sections among
adolescent girls is alarming. Among adolescent girls, use of
antenatal care (ANC) appeared to be the most important predictor
of health facility-based delivery (OR: 4.04; 95% CI 2.73 to
5.99), whereas the wealth index appeared as the most important
predictor of caesarean sections (OR: 5.7; 95% CI 2.74 to 12.1).
CONCLUSIONS: Maternal health-related interventions should be
more targeted towards adolescent girls in order to encourage
them to access ANC and promote health facility-based delivery.
Rising trends of caesarean sections require further
investigation on indication and provider-client-related
determinants of these interventions among adolescent girls in
Bangladesh. |