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BackgroundHigh maternal mortality rates still today remain a significant public health concern in South Asian countries. The majority of maternal deaths occur during pregnancy, and these deaths may typically be avoided by ensuring that women have access to reliable maternity care such as antenatal care (ANC) and facility delivery. The objectives of this research were to assess socioeconomic disparities in the utilization of health care services by mothers and to determine the factors influencing this utilization among women aged 15 to 49 in five South Asian countries.MethodsFor this study, nationally representative data from the Demographic and Health Survey (DHS) were analyzed. This research included a total of 262,531 women between the ages of 15 and 49. To determine the likely causes of maternal health care utilization, simple bivariate statistics and binary logistic regression were applied, and decomposition analysis and the concentration curve were used to quantify disparity (Lorenz curve).ResultsANC and institutional delivery were both prevalent in 59.27% and 86.52% of cases, respectively. Among the five nations, Maldives has the greatest ANC (96.83%) and institutional delivery (99.39%), while Bangladesh has the lowest ANC (47.01%) and institutional delivery (49.81%). Women's and husbands' education, household wealth status, BMI, and urban residents are the most important factors influencing maternal health service utilization, whereas higher education level, affluent wealth quintiles, and place of residence are the major contributors to socioeconomic inequalities in access to maternal health care that favor the wealthy.ConclusionMaternal health care services must be utilized properly in order to promote optimal health and prevent maternal mortality. Several socioeconomic and sociodemographic variables of the individual population, as well as policy issues, all have an impact on maternal mortality. This research recommends for concerted action to enhance how successfully women use maternity care services.

BackgroundAnaemia is a significant public health problem in most South-Asian countries, causing increased maternal and child mortality and morbidity. This study aimed to estimate the prevalence of and factors associated with anaemia in women of reproductive age in Bangladesh, Maldives, and Nepal.MethodsWe used the nationally-representative Demographic and Health Surveys Program data collected from women of reproductive age (15-49 years) in 2011 in Bangladesh (n = 5678), 2016 in Maldives (n = 6837), and 2016 in Nepal (n = 6419). Anaemia was categorized as mild (haemoglobin [Hb] of 10.0-10.9 g/dL for pregnant women and 11.0-11.9 g/dL for non-pregnant women), moderate (Hb of 7.0-9.9 g/dL for pregnant women and 8.0-10.9 g/dL for non-pregnant women), and severe (Hb ResultsThe prevalence of anaemia was 41.8% in Bangladesh, 58.5% in Maldives, and 40.6% in Nepal. In Bangladesh, postpartum amenorrhoeic, non-educated, and pregnant women were more likely to have moderate/severe anaemia compared to women who were menopausal, had secondary education, and were not pregnant, respectively. In Maldives, residence in urban areas, underweight, having undergone female sterilization, current pregnancy, and menstruation in the last six weeks were associated with increased odds of moderate/severe anaemia. In Nepal, factors associated with increased odds of moderate/severe anaemia were having undergone female sterilization and current pregnancy.ConclusionAnaemia remains a significant public health issue among 15-49-year-old women in Bangladesh, Maldives, and Nepal, which requires urgent attention. Effective policies and programmes for the control and prevention of anaemia should take into account the unique factors associated with anaemia identified in each country. In all three countries, strategies for the prevention and control of anaemia should particularly focus on women who are pregnant, underweight, or have undergone sterilization.

BackgroundHigh maternal mortality is still a significant public health challenge in many countries of the South-Asian region. The majority of maternal deaths occur due to pregnancy and delivery-related complications, which can mostly be prevented by safe facility delivery. Due to the paucity of existing evidence, our study aimed to examine the factors associated with place of delivery, including women's preferences for such in three selected South-Asian countries.MethodsWe extracted data from the most recent demographic and health surveys (DHS) conducted in Bangladesh (2014), Nepal (2016), and Pakistan (2017-18) and analyzed to identify the association between the outcome variable and socio-demographic characteristics. A total of 16,429 women from Bangladesh (4278; mean age 24.57 years), Nepal (3962; mean age 26.35 years), and Pakistan (8189; mean age 29.57 years) were included in this study. Following descriptive analyses, bivariate and multivariate logistic regressions were conducted.ResultsOverall, the prevalence of facility-based delivery was 40%, 62%, and 69% in Bangladesh, Nepal, and Pakistan, respectively. Inequity in utilizing facility-based delivery was observed for women in the highest wealth quintile. Participants from Urban areas, educated, middle and upper household economic status, and with high antenatal care (ANC) visits were significantly associated with facility-based delivery in all three countries. Interestingly, watching TV was also found as a strong determinant for facility-based delivery in Bangladesh (aOR = 1.31, 95% CI:1.09-1.56, P = 0.003), Nepal (aOR = 1.42, 95% CI:1.20-1.67, PConclusionOur findings suggest that the educational status of both women and their husbands, household economic situation, and the number of ANC visits influenced the place of delivery. There is an urgent need to promote facility delivery by building more birthing facilities, training and deployment of skilled birth attendants in rural and hard-to-reach areas, ensuring compulsory female education for all women, encouraging more ANC visits, and providing financial incentives for facility deliveries. There is a need to promote facility delivery by encouraging health facility visits through utilizing social networks and continuing mass media campaigns. Ensuring adequate Government funding for free maternal and newborn health care and local community involvement is crucial for reducing maternal and neonatal mortality and achieving sustainable development goals in this region.