Contextual Influences on the Use of Health Facilities for Childbirth in Africa

Overview

Journal Am J Public Health

Specialty Public Health

Date 2005 Dec 1

PMID 16317204

Citations 97

Authors

Rob Stephenson

Angela Baschieri

Steve Clements

Monique Hennink

Nyovani Madise

Affiliations

Soon will be listed here.

Abstract

Objectives: Previous studies of maternal health-seeking behavior focused on individual- and household-level factors. We examined community-level influences on the decision to deliver a child in a health facility across 6 African countries.

Methods: Demographic and Health Survey data were linked with contextual data, and multilevel models were fitted to identify the determinants of childbirth in a health facility in the 6 countries.

Results: We found strong community-level influences on a woman's decision to deliver her child in a health facility. Several pathways of influence between the community and individual were identified.

Conclusions: Community economic development, the climate of female autonomy, service provision, and fertility preferences all exert an influence on a woman's decision to seek care during labor, but significant community variation remains unexplained.

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