Determinants of antenatal care and skilled birth attendance utilization in Bangladesh: evidence from the 2022 Bangladesh Demographic and Health Survey

Maternal health services, including antenatal care (ANC) and skilled birth attendance (SBA), are crucial for improving maternal and child health outcomes. Despite global efforts, many women in low- and middle-income countries (LMICs), including Bangladesh, do not have adequate access to these services. This study examines the factors associated with ANC and SBA utilization among childbearing women in Bangladesh, using data from the 2022 Bangladesh Demographic and Health Survey (BDHS). This study used a cross-sectional design with data from BDHS 2022 and analyzed 5,018 childbearing women. The main outcomes were the utilization of antenatal care (ANC) and skilled birth attendance (SBA). A multilevel logistic regression model was used to assess factors associated with these outcomes. The results revealed that women with secondary/higher education (AOR = 2.06, 95% CI: 1.43–2.98), those in the richest quintile (AOR = 3.14, 95% CI: 2.38–4.13), those living in urban areas (AOR = 1.57, 95% CI: 1.27–1.94), those making healthcare decisions alone (AOR = 1.37, 95% CI: 1.08–1.74), those with one child (AOR = 2.16, 95% CI: 1.55-3.00), those reading newspapers weekly (AOR = 2.01, 95% CI: 1.29–3.14), and those watching TV weekly (AOR = 1.43, 95% CI: 1.23–1.67) had higher odds of ANC uptake. Additionally, women whose partners had secondary/higher education (AOR = 1.46, 95% CI: 1.17–1.83), who were in the richest quintile (AOR = 4.82, 95% CI: 3.47–6.68), who had one child (AOR = 3.18, 95% CI: 2.28–4.42), who were not working (AOR = 1.39, 95% CI: 1.18–1.64), and who watched TV weekly (AOR = 1.41, 95% CI: 1.20–1.67) were more likely to use SBAs. Wealth quintile, parity, and media exposure were strongly associated with antenatal care and skilled birth attendance utilization in Bangladesh. The findings highlight the need to design community-based interventions on expanding access to maternal health services for women with poorer households, higher parity, lower education, and those residing in disadvantaged areas. Mass media and digital platforms should be leveraged to improve awareness and encourage early and adequate ANC visits and skilled deliveries.