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Institutional births, Contextual influences on the use of health facilities for childbirth in Africa.
Authors: Stephenson, R., A. Baschieri, S. Clements, M. Hennink, N. Madise
Source: American Journal of Public Health, Vol 96, Num 1, Page: 84-93
Topic(s): Institutional births
Country: Africa
  Multiple African Countries
Published: FEB 2006
Abstract: 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.