Maternal Health Care Seeking Behaviour of Women from Lower and Upper Socio-Economic Groups of Dhaka, Bangladesh – Fear or Fashion?

Author: Sanzida Akhter

Akhter, Sanzida, 2015 Maternal Health Care Seeking Behaviour of Women from Lower and Upper Socio-Economic Groups of Dhaka, Bangladesh – Fear or Fashion?, Flinders University, School of the Environment

This electronic version is made publicly available by Flinders University in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material and/or you believe that any material has been made available without permission of the copyright owner please contact copyright@flinders.edu.au with the details.

Abstract

This study examines the differences between mothers from upper and lower socio-economic groups of households of Dhaka, Bangladesh in terms of their perception, experience and practice of maternal health care seeking behaviour for childbirth and the post-partum period, and explains the factors responsible for these differences. Using a ‘social constructionist’ approach, this study applies a research method based on in depth interviews among the two groups of women who gave birth in the five years preceding the survey, conducted for this study during July-December 2012. The findings show that mothers from lower socio-economic households express a sense of fear and distrust at receiving health care services for childbirth and the post-partum period from public or private modern maternal health care facilities, even though low cost or free maternity care is available at some health facilities in close proximity to their residence. Conversely, mothers from upper socio-economic groups show an overt sense of trust and dependence on modern maternal health care facilities, particularly the private clinics. The findings further suggest that socio-economic status of the mothers and their households, i.e., income, neighbourhood, social network, migration status (particularly for the mothers of lower socio-economic group of households), employment and empowerment status of the mothers are associated with the health care seeking behaviour of the mothers of both the groups. Each group holds a particular and often paradoxical pattern of perception, experience and cultural attributes that shape their health care seeking behaviour for their childbirth. However, the mothers and their families in both the groups share some common factors in their perceptions and experiences that are deemed crucial in deciding the type, place, and timing of maternal health care received during childbirth and in the post-partum period. These common factors comprise apprehension regarding childbirth, social and authoritative distance between the health care providers and the care receiving mothers, views towards pregnancy and childbirth, choice and control of the childbirth procedure. These factors work in opposing directions in shaping each group’s approach to maternal health care and can turn the modern maternal health care into a matter of fear for the mothers of lower socio-economic households and a matter of fashion, rather than necessity for the mothers of upper socio-economic households.

Keywords: health care seeking behaviour, mothers, maternal health, maternal morbidity, childbirth, Dhaka, fistula, obstetric fistula, caesarean section, socio-economic context, slum, reproductive health
Subject: Environmental Health thesis

Thesis type: Doctor of Philosophy
Completed: 2015
School: School of the Environment
Supervisor: Associate Professor Gour Dasvarma