Does Entitlement Card ensure Utilization of Urban Primary Healthcare Clinic in Bangladesh?

Sharmin, Mizan and Md Mizanur, Rahman and Razitasham, Safii and Sk Akhtar, Ahmad (2020) Does Entitlement Card ensure Utilization of Urban Primary Healthcare Clinic in Bangladesh? Journal of Maternal and Child Health, 5 (2). pp. 213-225. ISSN 2549-0257

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Abstract

Background:Although Bangladesh substantial-ly reduced 40% maternal death in the last deca-des, it is still challenging, especially among the urban poor. The achievements are not equitable between different economic quintiles and bet-ween the rich and the urban poor. This study aims to examine the extent to which the entitle-ment card affects the utilizationof maternal and child health care and identifies other factors that influence MCH services.Subjects and Method:This cross-sectional study was carried out in the working areas of the Urban Primary Healthcare Project (UPHCP) in Bangladesh. A two-stage cluster sampling techni-que was used to select the participants. Atotal of3,949 women aged 15-49 years, having at least one child aged two years or lesswere selected for this study. The data were collected through face-to-face interviews. The data were analyzed using multinomial logistic regression.Results:The proportion of utilizationof UPHCC was 49.9%. One-fourth (26.6%) of them fully utilized it and another 23.3% utilized it partially. Stepwise multinomial logistic regression analysis revealed that those who had an Entitlement Card from the UPHC project were 11.75 times (95% CI= 9.481, 14.549; p= 0.001) more likely to fully Utilized and 3.64 times (95% CI= 3.643, 2.911; p= 0.001) likely be utilized partially compared to non-utilizer. Respondents having no formal edu-cation utilized UPHCC fully (AOR=2.32; 95% CI= 1.46, 3.68; p= 0.001) and partially (AOR=1.76; 95% CI= 1.12, 2.77; p= 0.014) used UPHCC. It was 3.08 (95% CI= 2.03, 4.67; p= 0.001) times for fully and 2.71 (95% CI= 1.82, 4.04;p= 0.001) times for partially utilized UPHCC compared to non-users among the primary level of education. Small family size (≤4) and monthly family in-come in the range of BDT 10,000 above were likely to utilise UPHCC. However, non-Muslims were less likelyto Utilized UPHCC.Conclusion:Apart from the entitlement card, other factors such as monthly income BDT>10,000, small family size, no formal educated mother appeared to be potential predictors for utilizationof the Urban Primary Health care clinic.

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