PT  - JOURNAL ARTICLE
AU  - A S M Shahabuddin
AU  - Thérèse Delvaux
AU  - Bettina Utz
AU  - Azucena Bardají
AU  - Vincent De Brouwere
TI  - Determinants and trends in health facility-based deliveries and caesarean sections among married adolescent girls in Bangladesh
AID  - 10.1136/bmjopen-2016-012424
DP  - 2016 Sep 01
TA  - BMJ Open
PG  - e012424
VI  - 6
IP  - 9
4099  - http://bmjopen.bmj.com/content/6/9/e012424.short
4100  - http://bmjopen.bmj.com/content/6/9/e012424.full
SO  - BMJ Open2016 Sep 01; 6
AB  - Objective To identify the determinants and measure the trends in health facility-based deliveries and caesarean sections among married adolescent girls in Bangladesh.Methods In order to measure the trends in health facility-based deliveries and caesarean sections, Bangladesh Demographic Health Survey (BDHS) data sets were analysed (BDHS; 1993–1994, 1996–1997, 1999–2000, 2004, 2007, 2011). The BDHS 2011 data sets were analysed to identify the determinants of health facility-based deliveries and caesarean sections. A total of 2813 adolescent girls (aged 10–19 years) were included for analysis. Bivariate and multivariate analyses were performed.Results Health facility-based deliveries have continuously increased among adolescents in Bangladesh over the past two decades from 3% in 1993–1994 to 24.5% in 2011. Rates of population-based and facility-based caesarean sections have increased linearly among all age groups of women including adolescents. Although the country's overall (population-based) caesarean section rate among adolescents was within acceptable range (11.6%), a rate of nearly 50% health facility level caesarean sections among adolescent girls is alarming. Among adolescent girls, use of antenatal care (ANC) appeared to be the most important predictor of health facility-based delivery (OR: 4.04; 95% CI 2.73 to 5.99), whereas the wealth index appeared as the most important predictor of caesarean sections (OR: 5.7; 95% CI 2.74 to 12.1).Conclusions Maternal health-related interventions should be more targeted towards adolescent girls in order to encourage them to access ANC and promote health facility-based delivery. Rising trends of caesarean sections require further investigation on indication and provider–client-related determinants of these interventions among adolescent girls in Bangladesh.