Maternal and child health services: evaluating mothers' perceptions and participation

Urban mothers' perceptions and their actual practices in respect of antenatal care, postnatal care, childbirth and breast-feeding were reviewed through a predesigned questionnaire provided to all mothers (n = 114) staying for a day in the Clinical Research Centre of the International Centre for Diarrhoeal Disease Research, Bangladesh. Only 8% of mothers surveyed were pregnant and 71% had access to a maternal and child health clinic near their homes. Although 61% of the mothers replied that antenatal care is needed, 45% of all mothers actually used the service. Similarly, 79% of them felt that postnatal care is needed, yet only 26% attended the clinics. Only 6% of all mothers had their previous children delivered at a hospital or clinic. The majority (91%) were delivered at home, traditional birth attendants assisting in childbirth in most cases (74%). In spite of mass campaigning against the use of pre-lacteal foods (like honey and sugar water), these were given to 90% of the newborns. Underutilization of maternal and child health clinics was mostly due to the clinics only being open during the busy hours of family work and because of the misbehaviour of the staff. Changing clinic opening times, supervising staff properly and educating mothers will help to overcome their taboos and to motivate them to use 'institutional services'.