Contextual influences on the use of health facilities for childbirth in Africa

Stephenson, Rob, Clements, Steve, Baschieri, Angela, Hennink, Monique and Madise, Nyovani (2004) Contextual influences on the use of health facilities for childbirth in Africa. Southampton, UK, Southampton Statistical Sciences Research Institute, 35pp. (S3RI Applications and Policy Working Papers, A04/18).


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Studies of maternal health seeking behaviour have focused on individual and household level factors. This analysis examines community level influences on the decision to deliver a child in a health facility across six African countries. Demographic and Health Survey data are linked with contextual data, and multilevel models are fitted to identify the determinants of childbirth in a health facility in the six countries. There are 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. 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 labour, although significant community variation remains unexplained.

Item Type: Monograph (Working Paper)
Subjects: H Social Sciences > HA Statistics
Divisions : University Structure - Pre August 2011 > Southampton Statistical Sciences Research Institute
ePrint ID: 12493
Accepted Date and Publication Date:
22 November 2004Made publicly available
Date Deposited: 22 Nov 2004
Last Modified: 31 Mar 2016 11:24

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