Utilization of Antenatal and Delivery Care Services and Its Associations with Early Child Health and Neonatal Outcome: A Cross-Sectional Study in Noakhali Region, Bangladesh

Abstract

Although the World Health Organization has encouraged proper antenatal care and skilled birth attendance in low and middle-income countries, maternal and neonatal deaths still pose a significant public health problem in Bangladesh. This study aimed to explore the impact of ANC utilization, delivery care, and socio-economic factors on neonatal survival and early childhood health in Noakhali, Bangladesh. The study used a quantitative cross-sectional design targeting 400 postpartum women aged 15-49 years who gave birth in the previous year, from May 2024 to May 2025. Face-to-face interviews were conducted using random sampling and a pretested structured questionnaire following STROBE guidelines. SPSS version 23.0 was used to perform chi-square and logistic regression analyses. The results showed that low household income, poor parental education, and husbands' being day laborers were significant factors for the adverse neonatal outcomes of stillbirth, preterm birth, and NICU admission. Poor quality of ANC, pregnancy complications, chronic illness, low gestational age, and insufficient investigations (e.g., blood pressure, urine, blood group, and glucose) during ANC were also significantly associated with poor neonatal outcomes. Logistic regression revealed that increased household income, education of the mother, and education of the partner were independently associated with a lower risk of stillbirth and a higher odds of live birth. The study concludes that socioeconomic inequality and the quality of maternal services affect the health of neonates in Noakhali. Enhancing timely, good-quality ANC and minimizing the barriers among underprivileged women is crucial for achieving neonatal survival.