Effect of maternal education on choice of location for delivery among Indian women |
Authors: |
RAKESH AGGARWAL, AMARDEEP THIND |
Source: |
National Medical Journal of India, 2011;24:328–34 |
Topic(s): |
Delivery care Women's health
|
Country: |
Asia
India
|
Published: |
OCT 2011 |
Abstract: |
Background. Delivery in a healthcare facility is associated
with better outcomes for both mother and child. However, in
India, a large proportion of deliveries take place outside health
facilities. We studied the effect of maternal education on the
choice of location for delivery in the Indian population.
Methods. Data from the National Family Health Survey 3
(NFHS-3) were used. The survey included women who were
selected using a multi-stage (2-stage for urban areas and 3-
stage for rural areas), stratified (based on demographic or
social factors) sampling technique; the primary sampling units
selected were proportional to population size, and the
subsequent steps used simple random sampling. Effect of
maternal education on the choice of place for delivery (home,
public or private facility) was investigated through a multinomial
logistic regression model. The model adjusted for several
factors at individual, household and community level, the
survey design effect and included sampling weights.
Results. Of the 124 385 women aged 15–49 years
included in the NFHS-3 dataset, 36 850 (29.6%) had had
one or more childbirth during the past 5 years. A little more
than half of all the deliveries were at home, and approximately
a quarter each of the remaining deliveries were at public and
private facilities, respectively. Maternal education was strongly
and independently associated with the choice of location of
delivery. For the choice sets of public facility versus home
delivery and private facility versus home delivery, a clear
dose–response relationship was apparent—higher maternal
education was associated with a higher probability of delivery
at a public or private health facility compared to home.
Conclusion. Level of maternal education was a significant
independent predictor of choice of location for childbirth
among Indian women. Compared to cash incentives to increase
facility-based delivery, improving maternal education may be
a better way to achieve long term and sustained increase in
facility deliveries in India. |
Web: |
http://www.nmji.in/archives/Volume-24/Issue-6/Original-Article-I.pdf |
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