(2016) find that women who moved to the city are less likely to use maternal and child health services. Adams, Nababan, and Hanifi (2015) find that mothers who have community health workers as part of their social networks are more likely to use maternal and child health services in selected slum settlements under the Manoshi program in Dhaka city.

Distance may not be an important determinant of household demand for RMNCH services, as suggested by responses from users and nonusers of such services (Gazi et al. 2015). Using 2006 BUHS data, Heller (2013) finds that distance of an area to the nearest primary health facility and the density of primary health facilities in an area do not appear to be associated with the use of antenatal or postnatal care services, whether or not the author accounts for the potential endogeneity of where the household resides.

_Quality_ : The quality of care may influence whether households use maternal and child health services, and which provider type they choose. Rigorous, representative evidence is lacking for urban Bangladesh on provider quality of care (measured either directly or indirectly), and on its determinants.<sup>19</sup> Among the available evidence, Gazi et al. (2015) find that the main reported reasons for user satisfaction with BUPHCP- and BSSFP-supported NGO primary health facilities in Sylhet city were staff professionalism and courtesy, and low-cost or free services. Banu and Nasreen (2011) find that the performance of Manoshi delivery facilities in some slum settlements in Dhaka varied markedly across facilities; that the retention and effort of community health workers were key factors associated with facility performance; and that facility hygiene, free services, staff courtesy, and lack of space at home were key factors associated with use.<sup>20</sup> Examining the causes of neonatal and maternal deaths in selected slum settlements in Dhaka under the Manoshi program, Khatun et al. (2012) find performance issues existed with

> 19 Audit-study evidence by Das et al. (2012) and Das et al. (2016) for rural and urban India suggests that the quality of care was low in both public and private primary health facilities, as measured by such indicators as completion of checklists for essential and recommended care, correct diagnosis, and correct treatment. At the same time, indicators such as medical equipment, doctor qualifications, and patient caseloads were either not associated, or only weakly associated, with quality of care. While private doctors tended to be unqualified, they were likely to exert greater effort, and did not perform any worse on diagnosis and treatment than qualified public doctors. Qualified public doctors exerted greater effort and were more likely to provide correct treatment in their private practices than in their public practices. We suspect that these issues are similarly prevalent in Bangladesh.

> 20 Intermediate indicators of worker retention and job effort were found to be associated with financial rewards, and, to a lesser degree, social recognition and positive community feedback, among a sample of NGO female volunteer community health workers in Dhaka city (Alam, Tasneem, and Oliveras 2012a, 2012b).

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