Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study
Background: Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. T...
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10361-132112019-12-05T21:01:25Z Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study Nahar, Shamsun Banu, Morsheda Nasreen, Hashima-E- Urban slum Urbanization Women BRAC Slums--Bangladesh--Social conditions. Women in development--Bangladesh. Background: Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi (the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities. This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC. Methods: This cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's chi-square test, r-test and Mann-Whitney test were performed. Results: The median time for making the decision to seek care was significantly longer among women who were referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was significantly shorter in the case of life-threatening complications among those who were referred from DC than home (0 9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial constraints. Role of gender was found to be an important issue in decision making. First delay was significantly higher among elderly women, multiparity, non life-threatening complications and who were not involved in income-generating activities. Conclusions: Manoshi program reduces the first delay for life-threatening conditions but not non-life-threatening complications even though providing financial assistance. Programme should give more emphasis on raising awareness through couple/family-based education about maternal complications and dispel fear of clinical care to accelerate seeking EmOC. 2019-12-05T05:37:25Z 2019-12-05T05:37:25Z 2010 Research report Nahar, S., Banu, M., & Nasreen, H.-E.-. (2010). Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study. Research Reports (2010): Economic Studies, Vol - XXVII, 102–111. http://hdl.handle.net/10361/13211 en application/pdf BRAC |
| institution |
Brac University |
| collection |
Institutional Repository |
| language |
English |
| topic |
Urban slum Urbanization Women BRAC Slums--Bangladesh--Social conditions. Women in development--Bangladesh. |
| spellingShingle |
Urban slum Urbanization Women BRAC Slums--Bangladesh--Social conditions. Women in development--Bangladesh. Nahar, Shamsun Banu, Morsheda Nasreen, Hashima-E- Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study |
| description |
Background: Recognizing the burden of maternal mortality in urban slums, in 2007 BRAC (formally known as
Bangladesh Rural Advancement Committee) has established a woman-focused development intervention, Manoshi
(the Bangla abbreviation of mother, neonate and child), in urban slums of Bangladesh. The intervention
emphasizes strengthening the continuum of maternal, newborn and child care through community, delivery
centre (DC) and timely referral of the obstetric complications to the emergency obstetric care (EmOC) facilities.
This study aimed to assess whether Manoshi DCs reduces delays in accessing EmOC.
Methods: This cross-sectional study was conducted during October 2008 to January 2009 in the slums of Dhaka
city among 450 obstetric complicated cases referred either from DCs of Manoshi or from their home to the EmOC
facilities. Trained female interviewers interviewed at their homestead with structured questionnaire. Pearson's
chi-square test, r-test and Mann-Whitney test were performed.
Results: The median time for making the decision to seek care was significantly longer among women who were
referred from home than referred from DCs (9.7 hours vs. 5.0 hours, p < 0.001). The median time to reach a facility
and to receive treatment was found to be similar in both groups. Time taken to decide to seek care was
significantly shorter in the case of life-threatening complications among those who were referred from DC than
home (0 9 hours vs.2.3 hours, p = 0.002). Financial assistance from Manoshi significantly reduced the first delay in
accessing EmOC services for life-threatening complications referred from DC (p = 0.006). Reasons for first delay
include fear of medical intervention, inability to judge maternal condition, traditional beliefs and financial
constraints. Role of gender was found to be an important issue in decision making. First delay was significantly
higher among elderly women, multiparity, non life-threatening complications and who were not involved in
income-generating activities.
Conclusions: Manoshi program reduces the first delay for life-threatening conditions but not non-life-threatening
complications even though providing financial assistance. Programme should give more emphasis on raising
awareness through couple/family-based education about maternal complications and dispel fear of clinical care to
accelerate seeking EmOC. |
| format |
Research report |
| author |
Nahar, Shamsun Banu, Morsheda Nasreen, Hashima-E- |
| author_facet |
Nahar, Shamsun Banu, Morsheda Nasreen, Hashima-E- |
| author_sort |
Nahar, Shamsun |
| title |
Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study |
| title_short |
Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study |
| title_full |
Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study |
| title_fullStr |
Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study |
| title_full_unstemmed |
Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study |
| title_sort |
women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in bangladesh: a cross-sectional study |
| publisher |
BRAC |
| publishDate |
2019 |
| url |
http://hdl.handle.net/10361/13211 |
| work_keys_str_mv |
AT naharshamsun womenfocuseddevelopmentinterventionreducesdelaysinaccessingemergencyobstetriccareinurbanslumsinbangladeshacrosssectionalstudy AT banumorsheda womenfocuseddevelopmentinterventionreducesdelaysinaccessingemergencyobstetriccareinurbanslumsinbangladeshacrosssectionalstudy AT nasreenhashimae womenfocuseddevelopmentinterventionreducesdelaysinaccessingemergencyobstetriccareinurbanslumsinbangladeshacrosssectionalstudy |
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1814307262691278848 |