Stillbirth, perinatal mortality, and the effect of prenatal care services on child mortality in Bangladesh

Abstract

Stillbirth, neonatal mortality and child mortality have remained a public health concern in low income and middle income countries, including Bangladesh. Steps taken to minimise this burden include antenatal care, and offering of drugs such as iron and folic acid supplements and tetanus toxoid vaccinations. This thesis utilises data from the 2004, 2007, 2011 and 2014 Bangladesh Demographic and Health Surveys, and carried out multilevel modelling for all analyses. This thesis first examines the factors associated with stillbirth in Bangladesh. It then explores the factors associated with perinatal mortality in the country. The thesis further examines the impact of antenatal care, iron folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh. Finally, the factors associated with under-5 mortality are examined. Chapter 5 presents the results of analysis of factors associated with stillbirth in Bangladesh. Findings in this chapter identifies some of the determinants of stillbirth to include low levels of maternal education, lack of husbands for mothers, household poverty, number of children per mother, and mother's limited access to newspapers. Chapter 6 identifies factors associated with perinatal mortality in Bangladesh, and identified high body mass index of mothers, male infants, mother's delivery complications and non-use of contraceptives as significant determinants. Chapter 7 identifies that mothers who were given no iron and folic acid (IFA) supplements and had less than two tetanus toxoid (TT) vaccinations, mothers who received no IFA supplements and had less than two TT vaccinations, and mothers who did not have any antenatal care, visits and did not receive any IFA supplements were significantly associated with under-5 mortality in Bangladesh. Chapter 8 identifies mothers from the Sylhet region, older mothers, and mothers' low level of education as some of the factors associated with neonatal deaths. Non-working mothers and those with no schooling were some of factors associated with post-neonatal deaths. Almost similar factors were identified to be associated with infant, child, and under-5 deaths.

Date of Award	2017
Original language	English