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Drivers of Utilization, Quality of Care, and RMNCH-N Services in Bangladesh : A Comparative Analysis of Demand and Supply-Side Determinants Using Machine Learning for Investment Decision-Making (Inglés)

Amid noticeable improvements and achievements in the reproductive, maternal, neonatal, child health, and nutrition landscape in Bangladesh, existing evidence suggests that further accelerated progress hinges on strategic investment decision making. Addressing the top service utilization determinants that are both context- and time-specific is one cost-effective way of improving the unmet reproductive, maternal, neonatal, child health, and nutrition outcomes in a short timeframe. Against this backdrop, using machine learning analysis, the overall aim of this study was to help Bangladesh identify priority investment areas that could accelerate reproductive, maternal, neonatal, child health, and nutrition utilization, quality, and outcomes over the short run, by comparing the relative importance of demand- and-supply-side determinants of key reproductive, maternal, neonatal, child health, and nutrition indicators over the past decade (across two time points). Two rounds of the Bangladesh Health Facility Survey and the Demographic and Health Survey (2014 and 2017) were analyzed. The findings indicate that the relative importance of the demand-side determinants (except wealth and education status) have recently declined. Conversely, investments in key supply-side determinants (for example, availability of skilled staff, readiness for care, and quality of care) could provide a thrust toward further increases in utilization. Immediate attention is needed to address the regressive role of wealth status on utilization through, for example, demand-side financing that goes beyond user fee exemptions. Further, developing strategies to improve the engagement of community health workers in reproductive, maternal, neonatal, child health, and nutrition utilization and tapping into the potential of mobile health technology to support community health workers’ performance and women’s awareness could help to boost utilization patterns.


  • Autor

    Gopalan,Saji Saraswathy, Mohammed-Roberts,Rianna L., Zanetti Matarazzo,Hellen Chrystine

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    Documento de trabajo sobre investigaciones relativas a políticas

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    Asia meridional,

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  • Nom. del doc.

    Drivers of Utilization, Quality of Care, and RMNCH-N Services in Bangladesh : A Comparative Analysis of Demand and Supply-Side Determinants Using Machine Learning for Investment Decision-Making

  • Palabras clave

    Research Support; Demographic and Health Survey; maternal and child health; quality of care; care-seeking behavior; primary health care system; iron and folic acid; private for-profit; Public Facilities; skilled birth attendance; age at marriage; community health worker; availability of service; acute respiratory infection; household wealth status; improved sanitation facilities; contraceptive prevalence rate; behavior change interventions; maternal mortality ratio; lack of knowledge; nationally representative survey; essential health care; public health facility; equipment and supply; improved service delivery; national electricity grid; improved water source; low fertility rate; height for age; antenatal care services; drugs and supplies; blood pressure apparatus; weight for age; millennium development goal; children with diarrhea; accuracy of prediction; safe final disposal; infection control measures; uterine contraceptive device; family planning commodities; availability of contraceptives; child feeding practice; indicator value; artificial intelligence technique; number of women; health sector investment; education status; machine learning; government health; live birth; recent times; community clinics; essential medicines; nutrition indicator; comparative analysis; nutrition status; skilled staff; married woman; investment decision-making; maternal care; basic equipment; employment status; mass media; decision tree; old children; outcome indicator; pregnant woman; Postnatal Care; recent years; older woman; delivery care; nutrition outcome; standard deviation; pregnancy complication; blood sample; diagnostic capacity; birth order; child's age; urine sample; basic vaccinations; wealth quintile; safe delivery; explanatory variable; health outcome; demographic characteristic; collected information; Women Empowerment; care provision; curative care; basic amenity; facility survey; cultural barrier; infectious waste; primary data; service availability; profit sector; laboratory services; household survey; Health Workers; quality care; health index; heavy reliance; utilization rate; child birth; pilot studies; health awareness; birth care; breast feeding; work motivation; total consumption; household income; Birth of Child; public good; Public Goods; private provider; information bias; targeted population; polio vaccine; measles vaccine; Financial Access; improved health; policy strategy; financial constraint; medical procedures; high sensitivity; data quality; household access; data availability; water household; contradictory evidence; qualitative study; nominal charge; weighted average; eye protection; persistent inequality; injectable antibiotics; intravenous fluids; sodium chloride; quality indicators; younger mothers; Higher Education; health condition; latex gloves; integrated management; childhood illness; modern contraceptives; marital status; education level; lower value; programming language; community needs; pocket expense; conventional analysis; light source; diagnostic services; fee exemption; blood grouping; recent studies; positive observation; safe motherhood; index function; Oral Pills; demographic group; reducing inequality; mother's age; sterilization equipment; across province; good performance; young child; running water; secondary data; health status; health indicator; strategic investment; development policy; vaccination coverage; perinatal mortality; rural area; survey data; rural woman; urban counterpart; open access; Mobile Health; Postnatal Health; investment target; demand-side financing; strategic approach; neonatal death; government strategy; comparative assessment; demand-side factor; delivery status; regional factors; living condition; fertility behavior; increased access; medical equipment; sector-wide approaches; Health Service; care seeking; global assessment; maternal death; household asset; postpartum period; cultural factor



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