The Relationship Between Maternal Healthcare Service Utilization, Experiences of Violence, and Mental Health in the Tea Gardens of Bangladesh Open Access

Anderson, Sarah (Spring 2020)

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Objective: To determine the relationship between maternal healthcare service utilization, experiences of violence, and mental health in the tea gardens of Bangladesh.

Methods: Data from a cross-sectional survey collected June-July 2019 were analyzed. 100 women were recruited using convenience sampling, 20 women from five tea gardens participating in the Bagan Mayer Jonno Initiative. Descriptive statistics, cross tabulations, and odds ratios were generated using SAS 9.4 Software (Cary, NC).

Conclusions: Maternal healthcare service utilization was higher than among women surveyed at baseline in 2016. Women’s perceived autonomy is low, the burden of mental health and experiences of violence are high, but there was no clear relationship between the exposures of interest and maternal healthcare service utilization.

Public Health Implications: Though not associated with low service utilization in this sample, violence against women, poor mental health, and low levels of women’s autonomy in the tea gardens require further attention.

Table of Contents

Acronyms 9

Literature Review 10

Introduction 10

Methods 10-11

Overview of Maternal Health in Bangladesh 11-12

Maternal Health in the Tea Gardens of Bangladesh 13

Background: Tea Gardens of Northern Bangladesh 13-14

Maternal Health in the Tea Gardens 14-16

Bagan Mayer Jonno Intervention 16-17

Outcome of Interest: Maternal Healthcare Service Utilization 17-19

Exposures of Interest 19

Experiences of Violence and Maternal Health 19

Maternal Mental Health  20-21

Conclusion 21

Manuscript 22

Introduction 22-24

Methodology and Data 25

Survey Development 25

Data Collection 25

Recruitment 25-26

Procedures 26

Data Analysis 26

Variables of Interest 27

Statistical Analysis 28

Ethical Considerations 28

Results 28

           Demographic Information (Table 1) 28-29

Major Findings 29

High Maternal Healthcare Service Utilization 29

Poor Mental Health Related to Experiences of Violence 29-31

Low Levels of Perceived Autonomy 31

Inconclusive Relationship Between Exposures and Outcome 31-32

Discussion 32

Summary 32

Strengths and Limitations 33

Conclusion and Recommendations 34

   Manuscript References 35

Public Health Implications 36-37

References 38-40

Tables and Figures 41-47

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