title: Linkages Within the Reproductive and Maternal Health Continuum of Care in Bangladesh.
abstract: The continuum of care (CoC) is a fundamental approach to reproductive, maternal, newborn, and child health policy and programs, but linkages along the CoC are inadequately understood. This article assesses linkages in reproductive and maternal health (RMH) services in Bangladesh using the 2011 Bangladesh Demographic and Health Survey (n = 7170). Antenatal care (ANC) was positively associated with skilled birth attendance (SBA) among both pre-pregnancy contraceptive users and nonusers. Among women who used pre-pregnancy contraceptives but did not receive skilled ANC, there was a 26% decreased odds of SBA. Pre-pregnancy contraceptive use increased the odds of postpartum contraceptive use, but neither ANC nor SBA was associated with postpartum contraceptive use. There are clear linkages within maternal health services and within reproductive health services, but linkages across life stages were variable. Removing barriers to accessing health services early and addressing barriers in the transitions within RMH care will facilitate sustained engagement along the CoC.
authors.affiliation: Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego, California, USA lmcdouga@ucsd.edu.
authors.forename: Lotus
authors.initials: L
authors.lastname: McDougal
authors.affiliation: University of California San Diego School of Medicine, CA, USA.
authors.forename: Melanie L A
authors.initials: ML
authors.lastname: Rusch
authors.affiliation: Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego, California, USA.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
authors.affiliation: Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego, California, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003268:Contraception Behavior / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration*; D008875:Middle Aged; D008880:Midwifery / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D034121:Reproductive Health Services / Q000458:organization & administration*; D055815:Young Adult
keywords: antenatal care; continuum of care; contraceptive use; maternal health; reproductive health; skilled birth attendance