Does Distance and Transportation Cost Matter? Access to Maternity Services by Bangladeshi Rural Women

In Bangladesh, women dying for maternal causes remain high. Women face long distance and significant transportation cost to deliver at hospital. To reduce barriers, government introduced demand-side financing program that gives transportation allowance for antenatal, delivery, complication management and postnatal care. A total of 3300 mothers aged 18-49 years given birth preceding year of survey were interviewed in 2010. The self-reported distance and round trip transportation cost from residence to the health facility was recorded. Only 53% women received ANC, 20% delivery and 10% received PNC. On average women travelled six kilometers for ANC and PNC but eight kilometers for complication care or delivery. Majority women used rickshaw or human powered van to reach health facility. On average women spent taka 100 (US$1.4) for ANC, taka 432 (US$6) for delivery and taka 132 (US$1.83) for PNC. For each additional kilometer, cost increased by taka 9 (US$0.12) for ANC, taka 30 (US$0.44) for delivery and taka 7 (US$0.11) for PNC. Currently a flat rate of taka 100 (US$1.4) for each is given; based on findings, the program should reconsider the transportation allowance.