The Effect of Space, Time and Night-Time Light Intensity on Antenatal Care Coverage in Bangladesh
Year: 2025
Type: article
Abstract: This paper presents a small area estimation approach to assess trends in antenatal care (ANC) coverage among reproductive-age women in Bangladesh at various disaggregated levels. A multinomial multilevel time-series model is developed using district (admin-2) level ANC coverage data, categorizing women into three groups: (i) those with no ANC visits (ANC0), (ii) those with 1-3 visits (ANC123), and (iii) those with four or more visits (ANC4 +). The model accounts for the distinct behavioral profiles of each group in relation to factors influencing maternal health coverage, using remote-sensed night-time light intensity data to provide improved estimates. Our proposed small area model-based estimators incorporate significant social, economic, and geographical disparities, allowing us to identify regions exhibiting progress, stagnation, or decline. The model-based estimates demonstrate improved precision over direct estimates and provide valuable insights for designing targeted interventions to maximize impact. Additionally, a 1 spatio-temporal extension of the multinomial multilevel logistic model has yielded further refined estimates, helping to uncover disparities in the trends of maternal health care access. In Bangladesh, as in many developing countries, the health system operates under a decentralized structure, making district-level statistics crucial for localized planning and decision-making to ensure health equity.
Source: Spatial Demography
Institutions: Australian National University, Khulna University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,190
Funder: Australian National University
OpenAlex ID: W4413521322