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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis
Health Policy, Volume 97, No. 2-3, Year 2010
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Description
Objectives: Tanzania, a country with high maternal mortality, has many primary health facilities yet has a low rate of facility deliveries. This study estimated the contribution of individual and community factors in explaining variation in the use of health facilities for childbirth in rural Tanzania. Methods: A two-stage cluster population-based survey was conducted in Kasulu District, western Tanzania with women with a recent delivery. Random intercept multilevel logistic regression models were used to assess the association between individual- and village-level factors and likelihood of facility delivery. Results: 1205 women participated in the study. In the fully adjusted two-level model, in addition to several individual factors, positive village perception of doctor and nurse skills (odds ratio (OR) 6.72, 95% confidence interval (CI): 2.47-18.31) and negative perception of traditional birth attendant skills (OR 0.13, 95% CI: 0.04-0.40) were associated with higher odds of facility delivery. Conclusion: This study suggests that community perceptions of the quality of the local health system influence women's decisions to deliver in a clinic. Improving quality of care at first-level clinics and communicating this to communities may assist efforts to increase facility delivery in sub-Saharan Africa. © 2010 Elsevier Ireland Ltd.
Authors & Co-Authors
Kruk, Margaret Elizabeth
United States, New York
Mailman School of Public Health
Rockers, Peter C.
United States, Boston
Harvard T.h. Chan School of Public Health
Mbaruku, Godfrey M.
Tanzania, Ifakara
Ifakara Health Institute
Paczkowski, Magdalena M.
United States, New York
Mailman School of Public Health
Galea, Sandro
United States, New York
Mailman School of Public Health
Statistics
Citations: 122
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1016/j.healthpol.2010.05.002
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Case-Control Study
Study Approach
Quantitative
Study Locations
Tanzania
Participants Gender
Female