Delays in Accessing Facility-Based Maternal Healthcare Services for Female Rice Mill Workers in Khulna

Introduction: Although the Government of Bangladesh is working to meet the targets

of Sustainable Development Goal 3 to ensure health and well-being for all, some

segments of the population such as female rice mill workers do not have equal

healthcare access. It is evident to examine women’s delays in accessing maternal

healthcare MHC services, however, delays of the women working in rice mills in

accessing MHC services is not identified. Therefore, the study aims to explore the

delays in accessing facility-based MHC services for female rice mill workers.

Methods: An exploratory qualitative approach was utilized to conduct this study. This

study employed In-Depth Interview (IDI) method with the female rice mill workers

and Key Informant Interview (KII) method with healthcare providers to collect data.

Participants for this study were purposefully selected. The topic guides for IDIs and

KIIs based on the Three Delays Model were developed. Data collection took place

between September and October in 2025, and they were analyzed using thematic

approach underpinned by Three Delays Model.

Findings: The findings were summarized in four themes: (i) understanding delays in

seeking MHC services, (ii) delays in deciding to seeking care, (iii) delay in reaching

the facility and (iv) delay in receiving adequate care. Delays in receiving MHC

services for rice mill workers were identified when the number of visits they received

was less than the required number. Delays in deciding to seek care includes a lack of

knowledge, economic insecurity, traditional gender norms, and workplace-related

restrictions. The distance and transport cost as well as lack of emergency preparedness

in the area also hindered the prompt arrival at facilities. Delays in receiving adequate

care include long waiting time, discriminatory services, and poor quality of services.

Conclusion: Several reasons for delays in receiving facility-based maternal

healthcare (MHC) services were identified. Findings from the study identify several

strategies, including arranging awareness programs with female workers to increase

knowledge of the available services, introducing emergency care services, ensuring

timely, equal and quality access to care, to increase timely MHC of female rice mill

workers.

• Supervision