The impact of antenatal care, iron-folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh

Tanvir Abir, Felix Akpojene Ogbo, Garry John Stevens, Andrew Nicolas Page, Abul Hasnat Milton, Kingsley Emwinyore Agho

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23 Citations (Scopus)

Abstract

Background Appropriate antenatal care (ANC) is an important preventive public health intervention to ensure women's and newborn health outcomes. The study aimed to investigate the impact of ANC, iron±folic acid (IFA) supplementation and tetanus toxoid (TT) vaccination during pregnancy on child mortality in Bangladesh. Method A cross-sectional study of three datasets from the Bangladesh Demographic and Health Surveys for the years 2004, 2007 and 2011 were pooled and used for the analyses. A total weighted sample of 16,721 maternal responses (5,364 for 2004; 4,872 for 2007 and 6,485 for 2011) was used. Multivariate logistic models that adjusted for cluster and sampling weights were used to examine the impact of ANC, IFA supplementation and TT vaccination during pregnancy on the death of a child aged 0±28 days (neonatal), 1±11 months (post-neonatal) and 12±59 months (child). Results Multivariable analyses revealed that the odds of postnatal and under-5 mortality was lower in mothers who had ANC [Odds Ratio (OR) = 0.60, 95% confidence interval (95% CI): 0.43±0.85], IFA supplementation [OR = 0.66, 95% CI: (0.45±0.98)] and _2 TT vaccinations (OR = 0.43, 95% CI: 0.49±0.78) for post-natal mortality; and for under-5 mortality, any form of ANC (OR = 0.69, 95% CI: 0.51±0.93), IFA supplementation (OR = 0.67, 95% CI: 0.48± 0.94) and _2 TT vaccinations (OR = 0.50, 95% CI: 0.36±0.69). When combined, TT vaccination with IFA supplementation, and TT vaccination without IFA supplementation were protective across all groups. Conclusion The study found that ANC, IFA supplementation, and TT vaccination during pregnancy reduced the likelihood of child mortality in Bangladesh. The findings suggest that considerable gains in improving child survival could be achieved through ensuring universal coverage of ANC, promoting TT vaccination during pregnancy and IFA supplementation among pregnant women in Bangladesh.
Original languageEnglish
Article numbere0187090
Number of pages14
JournalPLoS One
Volume12
Issue number11
Publication statusPublished - Nov 2017

Bibliographical note

Publisher Copyright:
© 2017 Abir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Open Access - Access Right Statement

© 2017 Abir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

  • Bangladesh
  • children
  • folic acid
  • mortality
  • pregnancy
  • prenatal care
  • tetanus
  • vaccination

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