TY - JOUR
T1 - Access to institutional delivery care and reasons for home delivery in three districts of Tanzania
AU - Exavery, Amon
AU - Kanté, Almamy Malick
AU - Njozi, Mustafa
AU - Tani, Kassimu
AU - Doctor, Henry V.
AU - Hingora, Ahmed
AU - Phillips, James F.
N1 - Funding Information:
Connect Project is funded by the Doris Duke Charitable Foundation (USA) and Comic Relief (UK). An earlier version of this paper was presented at the XXVII IUSSP Conference in Busan, Korea, 26 31 August 2013. Comments received are acknowledged. We are also very thankful to the study participants, study community leaderships, district councils, field interviewers and the entire team of staff working on the Connect Project at the Ifakara Health Institute [Tanzania] and Columbia University (USA). The views expressed in this paper are those of the authors and do not reflect the views of their organizations or institutions.
PY - 2014/6/16
Y1 - 2014/6/16
N2 - Introduction. Globally, health facility delivery is encouraged as a single most important strategy in preventing maternal and neonatal morbidity and mortality. However, access to facility-based delivery care remains low in many less developed countries. This study assesses facilitators and barriers to institutional delivery in three districts of Tanzania. Methods. Data come from a cross-sectional survey of random households on health behaviours and service utilization patterns among women and children aged less than 5 years. The survey was conducted in 2011 in Rufiji, Kilombero, and Ulanga districts of Tanzania, using a closed-ended questionnaire. This analysis focuses on 915 women of reproductive age who had given birth in the two years prior to the survey. Chi-square test was used to test for associations in the bivariate analysis and multivariate logistic regression was used to examine factors that influence institutional delivery. Results: Overall, 74.5% of the 915 women delivered at health facilities in the two years prior to the survey. Multivariate analysis showed that the better the quality of antenatal care (ANC) the higher the odds of institutional delivery. Similarly, better socioeconomic status was associated with an increase in the odds of institutional delivery. Women of Sukuma ethnic background were less likely to deliver at health facilities than others. Presence of couple discussion on family planning matters was associated with higher odds of institutional delivery. Conclusion: Institutional delivery in Rufiji, Kilombero, and Ulanga district of Tanzania is relatively high and significantly dependent on the quality of ANC, better socioeconomic status as well as between-partner communication about family planning. Therefore, improving the quality of ANC, socioeconomic empowerment as well as promoting and supporting inter-spousal discussion on family planning matters is likely to enhance institutional delivery. Programs should also target women from the Sukuma ethnic group towards universal access to institutional delivery care in the study area.
AB - Introduction. Globally, health facility delivery is encouraged as a single most important strategy in preventing maternal and neonatal morbidity and mortality. However, access to facility-based delivery care remains low in many less developed countries. This study assesses facilitators and barriers to institutional delivery in three districts of Tanzania. Methods. Data come from a cross-sectional survey of random households on health behaviours and service utilization patterns among women and children aged less than 5 years. The survey was conducted in 2011 in Rufiji, Kilombero, and Ulanga districts of Tanzania, using a closed-ended questionnaire. This analysis focuses on 915 women of reproductive age who had given birth in the two years prior to the survey. Chi-square test was used to test for associations in the bivariate analysis and multivariate logistic regression was used to examine factors that influence institutional delivery. Results: Overall, 74.5% of the 915 women delivered at health facilities in the two years prior to the survey. Multivariate analysis showed that the better the quality of antenatal care (ANC) the higher the odds of institutional delivery. Similarly, better socioeconomic status was associated with an increase in the odds of institutional delivery. Women of Sukuma ethnic background were less likely to deliver at health facilities than others. Presence of couple discussion on family planning matters was associated with higher odds of institutional delivery. Conclusion: Institutional delivery in Rufiji, Kilombero, and Ulanga district of Tanzania is relatively high and significantly dependent on the quality of ANC, better socioeconomic status as well as between-partner communication about family planning. Therefore, improving the quality of ANC, socioeconomic empowerment as well as promoting and supporting inter-spousal discussion on family planning matters is likely to enhance institutional delivery. Programs should also target women from the Sukuma ethnic group towards universal access to institutional delivery care in the study area.
KW - Access
KW - Delivery care
KW - Institutional delivery
KW - Kilombero
KW - Rufiji
KW - Tanzania
KW - Ulanga
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U2 - 10.1186/1475-9276-13-48
DO - 10.1186/1475-9276-13-48
M3 - Article
C2 - 24934657
AN - SCOPUS:84903607153
SN - 1475-9276
VL - 13
JO - International journal for equity in health
JF - International journal for equity in health
IS - 1
M1 - 48
ER -