Adopting Andersen’s behavior model to identify factors influencing maternal healthcare service utilization in Bangladesh

Md Ruhul Kabir

Research output: Contribution to journalJournal articlepeer-review

14 Citations (Scopus)


Background: Equitable maternal healthcare service access and it’s optimum utilization remains a challenge for many developing countries like Bangladesh, and different predisposing, enabling, and need-based factors affect the level of maternal healthcare use. The evidently poor maternal healthcare service utilization and disparities among groups in Bangladesh are concerning considering its effect on maternal health outcomes. The study aimed to identify the factors that influence maternal healthcare service (MHS) utilization in Bangladesh by adopting Andersen’s behavior model of health service use as the theoretical framework.

Methods: The 2017–18 Bangladesh Demographic Health Survey (2017–18 BDHS) data were used which is nationally representative. The survey study used two-stage stratified sampling to select study households, and data were collected through face-to-face interviews. The desirable, moderate, and undesirable maternal health service (MHS) package was developed based on antenatal, and delivery care services use during pregnancy and childbirth. Multinomial logistic regression and discriminant analysis were performed to analyze the factors that affect MHS use.

Results: Out of 5,011 ever-married women, only 31.2% of women utilized the desirable level of MHS. The likelihood of using the desirable level of MHS package, relative to the undesirable category, was 9.38 times (OR: 9.38, 95% CI: 4.30–20.44) higher for women with a higher level of education compared to illiterate women, and the same trend was noticed for husband’s education. The wealth index had the highest standardized function coefficients (Beta coefficient: 0.49) in discriminatory function. Women with the richest wealth index were more than 23 times (OR: 23.27, 95% CI: 12.69–42.68) likely to have utilized desirable MHS than their poorest counterparts. The likelihood of service uses also varied according to the child’s birth order, administrative regions, and area of residence (rural vs. urban).

Conclusions: Policies and interventions directed towards poverty reduction, universal education, and diminishing geographical disparities of healthcare access might influence the desirable use of maternal healthcare services in Bangladesh.
Original languageEnglish
Article numbere0260502
Number of pages18
JournalPLoS ONE
Issue number11
Publication statusPublished - 29 Nov 2021

Scopus Subject Areas

  • Public Health, Environmental and Occupational Health

User-Defined Keywords

  • Maternal health
  • Healthcare service use
  • Andersen model
  • public health


Dive into the research topics of 'Adopting Andersen’s behavior model to identify factors influencing maternal healthcare service utilization in Bangladesh'. Together they form a unique fingerprint.

Cite this