Associations of socioeconomic determinants with community clinic awareness and visitation among women: evidence from Bangladesh Demographic and Health Survey-2011.
BACKGROUND
Although Bangladesh has achieved tremendous success in health care over the last four decades, it still lagged behind in the areas of maternal and child malnutrition and primary health care (PHC). To increase access to PHC, the Bangladesh government established approximately 18,000 community clinics (CCs). The purpose of this study was to examine the associations of socioeconomic determinants of women aged 12-49 years with the CCs awareness and visitation.


METHODS
We analyzed secondary data provided by Bangladesh Demographic and Health Survey-2011. A two-stage cluster sampling was used to collect the data. A total of 18,222 ever married women aged 12-49 years were identified from selected households and 17,842 were interviewed. The main outcome measures of our study were awareness and visitation of CCs. Bivariate logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI) to examine the associations between the awareness and visiting CCs with socioeconomic determinants.


RESULTS
Low prevalence of awareness about CC (18 %) was observed among studied women and only 17 % of them visited CCs. Significant associations (P < 0.05) with CCs awareness and visitation were observed among aged 20-29 years (adjusted OR = 1.18; 95% CI = 1.03-1.35 and adjusted OR = 1.49; 95% CI = 1.05-2.11), primary education (adjusted OR = 1.20; 95% CI = 1.08-1.34 and adjusted OR = 1.37; 95% CI = 1.05-1.78), and poorest family (adjusted OR = 1.21; 95% CI = 1.03-1.42 and adjusted OR = 2.36; 95% CI = 1.56-3.55, respectively), after controlling potential confounders.


CONCLUSIONS
Awareness and visitation of CCs were found to be positively associated with lower economic conditions, young age, and primary education. Awareness and access to CCs might be increased through community activities that involve health care workers. The government should also lower barriers to PHC access through CCs by providing adequate logistics, such as human resources and equipment.
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-Cho, Showa-ku, Nagoya, 466-8550, Japan. basarcmc@yahoo.com.
Mohammad Abul Bashar
MA
Sarker
National Control Laboratory, Institute of Public Health (IPH), Dhaka, Bangladesh. mh_rashid67@yahoo.com.
Md
M
Harun-Or-Rashid
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-Cho, Showa-ku, Nagoya, 466-8550, Japan. reyer@med.nagoya-u.ac.jp.
Joshua A
JA
Reyer
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-Cho, Showa-ku, Nagoya, 466-8550, Japan. tomoyakun@hotmail.com.
Tomoya
T
Hirosawa
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-Cho, Showa-ku, Nagoya, 466-8550, Japan. yoshidayoshitoku@med.nagoya-u.ac.jp.
Yoshitoku
Y
Yoshida
Department of Rehabilitation, Yonaha General Hospital, Mie, Japan. parumon@hotmail.com.
Mohammod Monirul
MM
Islam
Directorate General of Health Services, Dhaka, Bangladesh. dr.furkan.siddique@gmail.com.
Md Ruhul Furkan
MR
Siddique
National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh. hossain.shaila@yahoo.com.
Shaila
S
Hossain
Tokai Central Hospital, Tokai, Japan. sakamjun@med.nagoya-u.ac.jp.
Junichi
J
Sakamoto
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-Cho, Showa-ku, Nagoya, 466-8550, Japan. nhamajim@med.nagoya-u.ac.jp.
Nobuyuki
N
Hamajima
D000328:Adult; D001364:Awareness; D001459:Bangladesh; D002648:Child; D003153:Community Health Services / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D009819:Office Visits / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors