title: Practices and determinants of delivery by skilled birth attendants in Bangladesh.
abstract: BACKGROUND
  Utilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh. Birth attendance by SBAs is considered as the "single most important factor in preventing maternal deaths". This paper examined the practices and determinants of delivery by SBAs in rural Bangladesh.
  
  
  METHODS
  The data come from the post-intervention survey of a cluster-randomized community controlled trial conducted to evaluate the impact of limited post-natal care (PNC) services on healthcare seeking behavior of women with a recent live birth in rural Bangladesh (n = 702). Multivariable logistic regression model was used to identify the potential determinants of delivery by SBAs.
  
  
  RESULTS
  The respondents were aged between 16 and 45, with the mean age of 24.41 (± 5.03) years. Approximately one-third (30.06%) of the women had their last delivery by SBAs. Maternal occupation, parity, complications during pregnancy and antenatal checkup (ANC) by SBAs were the significant determinants of delivery by SBAs. Women who took antenatal care by SBAs were 2.62 times as likely (95% CI: 1.66, 4.14; p < 0.001) to have their delivery conducted by SBAs compared to those who did not, after adjusting for other covariates.
  
  
  CONCLUSIONS
  Our findings suggest that ANC by SBAs and complications during pregnancies are significant determinants of delivery by SBAs. Measure should be in place to promote antenatal checkup by SBAs to increase utilization of SBAs at birth in line with achieving the Millennium Development Goal-5. Future research should focus in exploring the unmet need for, and potential barriers in, the utilization of delivery by SBAs.
authors.affiliation: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Room# 417, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada. nazrul.islam@ubc.ca.
authors.forename: Nazrul
authors.initials: N
authors.lastname: Islam
authors.forename: Mohammad Tajul
authors.initials: MT
authors.lastname: Islam
authors.forename: Yukie
authors.initials: Y
authors.lastname: Yoshimura
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D008880:Midwifery; D010298:Parity; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult