JCOGP
Journal of Controversies in Obstetrics & Gynecology and Pediatrics

As of January 2023, our "Journal of Controversies Obstetrics & Gynecology and Pediatrics" has been published under the Medihealth Academy to publish all articles, reviews and case reports on Pediatrics, especially in the field of Obstetrics and Gynecology. In order to facilitate the citation of the articles, to take our place in internationally respected indexes and to reach a wider readership, we will pay attention to the fact that our article language is only English in terms of acceptance.

eISSN: 2980-0579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Barriers to access in maternity healthcare services during the postpartum period: a study in Khulna City, Bangladesh
Abstract
Aims: The main objectives of this study were to identify barriers to accessing maternity healthcare services during the postpartum period.
Methods: This study was conducted by following a quantitative research design, and a survey method was employed. Data were collected from 232 respondents by using multistage stratified random sampling. The respondents were women who gave birth to at least one child during the last year. Data were analyzed by using IBM SPSS Statistics v25.0.
Results: The findings of this study reveal that the majority of the respondents were deprived of basic maternity care. They faced different sorts of barriers, such as individual barriers (lack of education and awareness, occupation); interpersonal barriers (lack of social and economic support from the family); community level barriers (impact of religious beliefs/decision making capacity on postpartum maternity care); Institution-level barriers (lack of sufficient infrastructure and service delivery of the healthcare centre); policy level barriers (lack of the implementation of proper policy). Tukey HSD post hoc analysis indicated a significant difference only between households with heads having 1-5 years and 6-12 years of education (mean difference=-0.304, p=.006). There were no significant differences across the other education groups (all p>.05).
Conclusion: The government should focus on strengthening the maternity health care system and raising awareness among women and the household head in slum areas. Additionally, interventions, instead of broad education-based policies, should be targeted at the lower educated households.

Keywords : Barriers, women, healthcare, coping strategies, postpartum

Download Article


1. World Health Organization. Maternal mortality: key facts 2020.
2. World Health Organization. Postnatal care of the mother and newborn 2013.
3. National Institute of Population Research and Training (NIPORT), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), and MEASURE Evaluation. Bangladesh Maternal Mortality and Health Care Survey 2016: Final Report. Dhaka, Bangladesh, and Chapel Hill, NC, USA: NIPORT, icddr,b, and MEASURE Evaluation; 2019
4. United Nations Population Fund (UNFPA). Bangladesh Annual Report Progress and Highlights 2020.
5. World Health Organization (WHO). Family planning/contraception methods 2021.
6. Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-e333. <a href="https://doi.org/10.1016/S2214-109X(14)70227-X">doi:10.1016/S2214-109X(14)70227-X</a>
7. Banik BK. Barriers to access in maternal healthcare services in the Northern Bangladesh. South East Asia J Public Health. 2016;6(2):23-36. <a href="https://doi.org/10.3329/seajph">doi:10.3329/seajph.</a> v6i2.31832
8. Bonet M, Brizuela V, Abalos E, et al. Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study. Lancet Glob Health. 2020;8(5):e661-e671. <a href="https://doi.org/10.1016/S2214-109X(20)30109-1">doi:10.1016/S2214-109X(20)30109-1</a>
9. Hilde G, Stær-Jensen J, Siafarikas F, Ellström Engh M, Bø K. Postpartum pelvic floor muscle training and urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2013;122(6):1231-1238. doi:10.1097/AOG.0000000000000012
10. Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res. 2018; 104:235-248. <a href="https://doi.org/10.1016/j.jpsychires.2018.08.001">doi:10.1016/j.jpsychires.2018.08.001</a>
11. Lawn JE, Blencowe H, Oza S, et al. Every newborn: progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189-205. <a href="https://doi.org/10.1016/S0140-6736(14)60496-7">doi:10.1016/S0140-6736(14)60496-7</a>
12. Leahy-Warren P, McCarthy G, Corcoran P. First-time mothers: social support, maternal parental self-efficacy and postnatal depression.J Clin Nurs. 2012;21(3-4):388-397. <a href="https://doi.org/10.1111/j.1365-2702.2011.03701.x">doi:10.1111/j.1365-2702.2011.03701.x</a>
13. World Health Organization, UNICEF, UNFPA, World Bank Group, and United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2015.
14. Mohamed AA, Bocher T, Magan MA, et al. Experiences from the field: a qualitative study exploring barriers to maternal and child health service utilization in IDP settings Somalia.Int J Womens Health. 2021; 13:1147-1160. <a href="https://doi.org/10.2147/IJWH.S330069">doi:10.2147/IJWH.S330069</a>
15. Bronfenbrenner U. Toward an experimental ecology of human development. Am Psychol. 1977;32(7):513-531. doi:10.1037/0003-066X.32.7.513
16. Kilanowski JF. Breadth of the socio-ecological model. J Agromedicine. 2017;22(4):295-297. <a href="https://doi.org/10.1080/1059924X.2017.1358971">doi:10.1080/1059924X.2017.1358971</a>
17. Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 10th ed. Philadelphia: Wolters Kluwer; 2017.
18. Saunders M, Lewis P, Thornhill A. Research Methods for Business Students. 7th ed. Harlow: Pearson Education Limited; 2016.
19. Fowler FJ. Survey Research Methods (5th ed.). Sage Publications; 2014.
20. Shah R, Bélanger D. Socioeconomic correlates of utilization of maternal health services by tribal women in India. Can Stud Popul. 2011;38(1-2): 83-98. <a href="https://doi.org/10.25336/P6Z89V">doi:10.25336/P6Z89V</a>
21. Babbie ER. The Practice of Social Research. 12th ed. Belmont, CA: Wadsworth, Cengage Learning; 2010.
22. Choudhury N, Moran AC, Alam MA, Ahsan KZ, Rashid SF, Streatfield PK. Beliefs and Practices during Pregnancy and Childbirth in Urban Slums of Dhaka, Bangladesh. BMC Public Health. 2012;12:791. doi:10.1186/1471-2458-12-791
23. Howlader S, Rahman MA, Rahman MM. Continuation of education after marriage and its relationship with professional maternal healthcare utilization among young adult women in Bangladesh. PLoS One. 2024;19(12):e0316117. doi:10.1371/journal.pone.0316117
24. Moran AC, Winch PJ, Sultana N, et al. Patterns of maternal care seeking behaviours in rural Bangladesh. Trop Med Int Health. 2007;12(7):823-832. doi:10.1111/j.1365-3156.2007.01852.x
25. Bohren MA, Vogel JP, Hunter EC, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med. 2015;12(6):e1001847. <a href="https://doi.org/10.1371/journal.pmed.1001847">doi:10.1371/journal.pmed.1001847</a>
26. Paul BK, Rumsey DJ. Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study.Soc Sci Med. 2002;54(12):1755-1765. <a href="https://doi.org/10.1016/s0277-9536(01)00148-4">doi:10.1016/s0277-9536(01)00148-4</a>
27. Rahman MM, Haque SE, Zahan MS. Factors affecting the utilisation of postpartum care among young mothers in Bangladesh. Health Soc Care Community. 2011;19(2):138-147. doi:10.1111/j.1365-2524.2010.00953.x
28. Islam MR, Odland JO. Determinants of antenatal and postnatal care visits among Indigenous people in Bangladesh: a study of the Mru community. Rural Remote Health. 2011;11(2):1672.
29. Chanda SK, McHugh GA, Horne M. Barriers and facilitators to accessing and using maternal healthcare services by women living in rural Bangladesh: a theory-guided narrative literature review. Public Health Reviews. 2025:46;1608157. doi:10.3389/phrs.2025.1608157
30. Begum T, Ellis C, Sarker M, et al. A qualitative study to explore the attitudes of women and obstetricians towards caesarean delivery in rural Bangladesh. BMC Pregnancy and Childbirth. 2018;18(1):368. doi:10.1186/s12884-018-1993-9
31. Kamal SM, Hassan CH, Kabir MA. Inequality of the use of skilled birth assistance among rural women in Bangladesh: facts and factors. Asia Pac J Public Health. 2015;27(2):NP1321-NP1332. doi:10.1177/1010539513483823
32. Himaz R, Aturupana H. Schooling and household welfare: the case of Sri Lanka from 1990 to 2006. Rev Dev Econ. 2018;22(2):592-609. doi:10.1111/rode.12355
Article available in :
Volume 4, Issue 3, 2026
Page : 51-58
https://doi.org/10.51271/JCOGP-0074
Article Information
Received : 21 May 2026
Accepted : 18 Tem 2026
Published : 30 Tem 2026
Corresponding Author :

Ety Rani Rani: Sociology Discipline, Faculty of Social Sciences, Khulna University, Khulna, Bangladesh

[email protected]
Citation : Mitu MH, Rani E. Barriers to access in maternity healthcare services during the postpartum period: a study in Khulna City, Bangladesh. J Controv Obstetr Gynecol Ped. 2026;4(3):51-58. doi:10.51271/JCOGP-0074

Read: 33
Download : 29
Cited: 0
_Footer