Document Type : Original Article
Author
Department of Public Administration, Bangladesh University of Professionals, Dhaka, Bangladesh
Abstract
Background: In Bangladesh, the use of reproductive health (RH) services is influenced by a range of cultural, gender-related, and structural factors. Women may experience stigma, restricted decision-making power, and concerns about privacy when seeking care. Men’s participation is also limited in many cases by prevailing social expectations about gender roles. Adolescents, especially girls, often face additional difficulties, including stigma, inadequate information, and concerns about confidentiality. Addressing these barriers requires reproductive health interventions that are inclusive and responsive to the different needs and experiences of women, men, and adolescents. This study explored men’s and women’s experiences of reproductive health service utilization across urban, peri-urban, and rural/char settings in Bangladesh.
Methods: A qualitative descriptive study using a multiple-case design was conducted across urban, peri-urban, and rural/char settings in Bangladesh, and data were collected between June and July 2025. Data were gathered through in-depth interviews, focus group discussions, key informant interviews, and observations of health facilities involving women, men, adolescents, and healthcare providers. Participants were purposively recruited based on their recent experience with reproductive health services or their involvement in providing or facilitating such services. In total, 81 unique participants took part in the interviews and discussions, representing the different participant groups. Semi-structured interview guides covered experiences of seeking care, decision-making, privacy and confidentiality, interactions with healthcare providers, and the use of digital health services. The data were analyzed using reflexive thematic analysis based on the approach developed by Braun and Clarke. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
Results: Participants’ views and experiences of reproductive health services differed according to their gender, age, and place of residence. Women described how decisions about seeking care were often shaped by household power relations. Adolescents, particularly girls, expressed concerns about social stigma and the possibility that their personal information might not remain confidential. Participants also reported practical difficulties, such as long distances to health facilities, transportation expenses, inconvenient clinic hours, and shortages of essential reproductive health commodities. Experiences with respectful and confidential providers encouraged service use, whereas judgmental or dismissive behavior could discourage people from seeking care. Participants living in urban areas described greater access to digital health services and more consistent follow-up. In contrast, those living in rural and char areas experienced greater difficulties in accessing services. Although men’s participation in reproductive health decisions was generally limited, participants noted that greater male involvement could support joint decision-making and encourage timely care-seeking.
Conclusion: Improving the use of reproductive health (RH) services in Bangladesh calls for action at several levels, including adolescent- and male-friendly services, respectful and confidential care, digital and community-based approaches, dependable supply systems, and greater support for women’s decision-making. These measures can help reduce inequalities in access to care and support the protection of reproductive rights. The findings can contribute to the development of context-specific RH policies and help guide the provision of health services that are more inclusive, accessible, and responsive to the needs of different groups in Bangladesh.
Keywords
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