## **<mark>BHFS</mark>**

<mark>BHFS is a nationally representative survey of r</mark> egistered health facilities; it includes public facilities, NGO static clinics/hospitals, and private for-profit hospitals. The BHFS 2014 included 1,596 facilities,<sup>17</sup> while the <mark>BHFS 2017 included 1,600 f</mark> acilities.<sup>18</sup> The <mark>BHFS p</mark> rovides information on the availability of basic and essential health care services, and the readiness of health facilities for care provision. It uses standardized questionnaires from the service provision assessment (SPA) component of the Demographic and Health Surveys (DHS) Program. Specifically, it provides information on child health, maternal and newborn care and family planning. For each of these services, BHFS assesses whether necessary elements are present and functioning.

## **DHS**

DHS is a nationally-representative survey of households and ever-married women aged 15-49 years.<sup>12</sup> The DHS 2014 covered 17,300 households and 17,863 women,<sup>17</sup> while the 2017 survey covered 19,457 households and 20,127 women.<sup>12</sup> DHS collects information on health and living conditions of women and children, household assets and wealth status, socio-economic and demographic characteristics, maternal and child health status, nutrition, fertility, family planning, mortality and care seeking for maternal and child health. This study only considered the RMNCH-N care-seeking, perceptions and health outcomes for the most-recent childbirth and child health episode from each DHS survey.

# **2.2 Variables**

Nineteen outcome variables (Table 2) related to service utilization, quality of care and nutrition status were selected from the DHS survey. Demand-side explanatory variables (or potential determinants) selected from the DHS were socio-economic and demographic characteristics and location of service seekers (Table 3). Supply-side explanatory variables chosen from the BFHS and the DHS include – type of provider, quality of care, availability of services (infrastructure, drugs, equipment and skilled staff) and readiness for care provision (Table 4). For the BFHS data, where possible, similar variables were combined and aggregated to create indices (e.g., medical equipment index and drug availability index) to reduce the variance of similar variables based on the categorization or criteria of indexing provided by the BFHS survey (more details can be found in BFHS reports). For utilization of reproductive and maternal care and quality of ANC, the unit of analysis was an individual woman. The unit of analysis for child related indicators was a child under-5. All study variables were selected based on the contextual literature and compatibility for a comparative analysis across time points.<sup>16,19–22</sup>

**Table 2:  Outcome variables**

|**Domain**|**Indicator**|
|---|---|
|Utilization|**Antenatal care (ANC)**<br>•<br>4+ ANC visits<br>•<br>ANC from medically trained provider<br>•<br>ANC in public sector|
||**Delivery**<br>•<br>Skilled birth attendance (i.e., delivery assisted by skilled staff such as doctor, nurse or<br>midwife)<br>•<br>Delivery in public sector|
||**Postnatal care (PNC)**<br>•<br>Availed atleast onePNC (for mother) within 42days|

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