Introduction
Methods
Data
Year | Number of women | Region | |
---|---|---|---|
Angola
| 2007 | 1,758 | Southern Africa |
Bangladesh
| 2011 | 14,895 | Southern Asia |
Benin
| 2006 | 13,251 | Western Africa |
Burkina Faso
| 2010 | 13,099 | Western Africa |
Burundi
| 2011 | 5,893 | Eastern Africa |
Cambodia
| 2010 | 11,345 | Southeast Asia |
Cameroon
| 2011 | 10,669 | Middle Africa |
Chad
| 2004 | 4,259 | Middle Africa |
Congo
| 2005 | 4,722 | Middle Africa |
Cote D'Ivoire
| 2005 | 1,920 | Western Africa |
DRC
| 2007 | 6,870 | Middle Africa |
Egypt
| 2005 | 14,971 | Northern Africa |
Ethiopia
| 2011 | 10,674 | Eastern Africa |
Gabon
| 2012 | 6,105 | Middle Africa |
Ghana
| 2008 | 3,136 | Western Africa |
Guinea
| 2005 | 5,853 | Western Africa |
India
| 2006 | 65,794 | Southern Asia |
Indonesia
| 2007 | 6,852 | Southeast Asia |
Kenya
| 2008 | 5,810 | Eastern Africa |
Lesotho
| 2009 | 4,880 | Southern Africa |
Liberia
| 2007 | 5,397 | Western Africa |
Madagascar
| 2008 | 12,333 | Eastern Africa |
Malawi
| 2010 | 17,656 | Eastern Africa |
Maldives
| 2009 | 5,760 | Southern Asia |
Mali
| 2006 | 11,123 | Western Africa |
Morocco
| 2004 | 7,135 | Northern Africa |
Mozambique
| 2011 | 10,270 | Eastern Africa |
Namibia
| 2006 | 6,152 | Southern Africa |
Nepal
| 2011 | 8,239 | Southern Asia |
Niger
| 2006 | 6,997 | Western Africa |
Nigeria
| 2008 | 22,997 | Western Africa |
Pakistan
| 2007 | 8,177 | Southern Asia |
Philippines
| 2008 | 7,951 | Southeast Asia |
Rwanda
| 2011 | 8,382 | Eastern Africa |
Sao Tome
| 2008 | 1,943 | Middle Africa |
Senegal
| 2010 | 10,449 | Western Africa |
Sierra Leone
| 2008 | 5,676 | Western Africa |
Swaziland
| 2007 | 3,175 | Southern Africa |
Tanzania
| 2010 | 7,101 | Eastern Africa |
Timor-Leste
| 2010 | 7,813 | Southeast Asia |
Uganda
| 2011 | 6,291 | Eastern Africa |
Zambia
| 2007 | 5,180 | Southern Africa |
Zimbabwe
| 2010 | 6,521 | Eastern Africa |
TOTAL
| 405,474 |
Methods
Factors Listed in Moyer and Mustafa, 2012 | Included in this analysis? |
---|---|
Maternal Factors
| |
Maternal Age | Yes |
Maternal Education | Yes, years of education |
Religion | No |
Ethnicity | No |
Region/province of residence | Yes, clustered by stratum |
Urban/rural | Yes |
Wealth/SES | Yes, wealth index |
Maternal Employment | Yes, employed/not |
Health insurance coverage | No, only collected in sub-set of countries |
Parity/birth order | Yes, parity |
Martial Status | Yes |
Polygamous union | No, only applicable to a subset of countries |
Empowerment/autonomy | Yes, score of acceptability of wife beating |
Attitude towards importance of facility delivery/perceived need | No, not available |
Attitude towards skills of doctor vs. TBA | No, not available |
Embarrassment/fear of being shamed | No, not available |
Discussion with male partner on place of delivery | No, not available |
Knowledge of pregnancy risk factors | No, high levels of missing data |
Completion of birth plan | No, not available |
Concept of abnormal vs. normal pregnancy | No, not available |
Having means of transport to facility/vouchers | No, not available |
Quality of previous delivery | No, not available |
Location of previous delivery | No, because not all women had a previous delivery |
Pregnancy wantedness | Yes, desired pregnancy/not |
Birth complications | No, not available |
Use of herbal drugs | No, not available |
Desire to appear modern | No, not available |
Fear of episiotomy | No, not available |
Precipitate Labor | No, not available |
Use of maternity waiting homes | No, not available |
Social Factors
| |
Non-male household head | Yes |
Husband’s occupation | Yes |
Husband/partner education | Yes |
Small family norm (community level) | No, not available |
Stigma/gossip/on lookers | No, not available |
Living in socially disadvantaged neighborhood | No, not available |
Permission from husband, TBA, mother, mother-in-law | No, not available |
Social influence of others | Yes, stratum level acceptability of wife beating score |
Village level: % of village who agree facility delivery is important | No, high levels of missing data |
Village level: % of village who rated local facility as “excellent” | No, not available |
Village level: % of village who attended 4+ ANC | Yes |
Village level: % of village who agreed doctors and nurses have good skills | No, not available |
Village level: % of village who agree TBAs have good skills | No, not available |
Community perception of access to nearest facility | No, not available |
Traditional views on delivery and motherhood | No, not available |
Antenatal care (ANC) factors
| |
Attended ANC | Yes, any ANC |
Timing of firs ANC visit (early) | No, not available |
Number of ANC | Yes, 4+ ANC |
Saw doctor at ANC | Yes |
Quality of ANC | No, not available |
Advised to deliver in a facility during ANC | No, not available |
Results
Country-level descriptive analyses: place of delivery and provider type by region
Inequalities: urban rural and wealth quintile differences in place of delivery by region
Multivariate models: drivers of facility deliveries: individual, household, and community level factors
Descriptive characteristics
Variable | Mean/Percent | Which countries missing entirely | Missing, N (%) |
---|---|---|---|
Deliver in a facility
| 53.5% | 125, 462 (30.9%) | |
Deliver with a provider
| 54.9% | 125, 410 (30.9%) | |
Woman’s age
| 31.4 | 0 | |
Woman’s education
| 4.5 years | 277 (0.07%) | |
Total number of children ever born
| 3.7 | 0 | |
Married
| 80.3% | Angola | 1,761 (0.4%) |
Woman employed
| 58.6% | Angola, Bangladesh | 22,181 (5.5%) |
Wanted last pregnancy at that time
| 73.3% | Angola | 128,499 (31.7%) |
Urban
| 34.1% | 0 | |
Wealth Index (quintiles)
| 3.1 | 0 | |
Non-male household head
| 19.3% | 0 | |
Husband’s age
| 38.7 | Angola, Cote D’Ivoire, | 53,819 (13.3%) |
Husband’s education
| 5.7 years | Angola, Cote D’Ivoire, Maldives | 33,245 (8.2%) |
Husband employed
| 94.9% | Angola, Cote D’Ivoire, Bangladesh | 33,245 (8.2%) |
Any ANC
| 83.1% | Angola | 133,117 (32.8%) |
More than 4 ANC
| 49.4% | Angola | 133,117 (32.8%) |
Saw doctor at ANC
| 21.6% | 126,321 (31.2%) | |
Mean score of wife beating acceptability
| 1.4 | Angola, Chad, Congo, Cote D’Ivoire, Pakistan | 21,684 (5.4%) |
Stratum level % of women with 4+ ANC
| 36.9% | 0 | |
Mean score of wife beating acceptability per stratum
| 1.4 | Angola, Chad, Congo, Cote D’Ivoire, Pakistan | 21,684 (5.4%) |
Multivariate model outcomes
Odds of delivering in a health facility | (1): Full | (2): Demo-graphics | (3): House-hold | (4): Community |
---|---|---|---|---|
Woman’s Age
| 1.026*** | 1.043*** | ||
Woman’s Years Education
| 1.041*** | 1.102*** | ||
Total Children Ever Born
| 0.866*** | 0.848*** | ||
Married
| 0.761*** | 0.724*** | ||
Woman Being Employed
| 1.008 | 0.906** | ||
Wanted Last Pregnancy Then
| 0.864*** | 0.820*** | ||
Year of Most Recent Birth
| 1.092*** | 1.075*** | ||
Four plus ANC
| 1.491*** | 1.927*** | ||
Any ANC
| 4.854*** | 6.164*** | ||
Saw Doctor at ANC
| 1.136** | 1.111 | ||
Acceptability of Wife Beating Score
| 0.974*** | 0.961*** | ||
Urban
| 1.638*** | 1.941*** | ||
Wealth Index
| 1.385*** | 1.487*** | ||
Non Male Head
| 1.109*** | 1.318*** | ||
Husband’s Age
| 1.008*** | 0.997 | ||
Husband’s Years Education
| 1.005 | 1.069*** | ||
Husband Being Employed
| 0.698*** | 0.614*** | ||
Percent of stratum with 4 plus ANC
| 8.716*** | 153.7*** | ||
Mean Stratum level Acceptability of Wife Beating Score
| 0.997 | 0.764*** | ||
Country
| 0.967*** | 0.970*** | 0.976*** | 0.979*** |
Constant
| 0*** | 0*** | 0.586** | 0.495*** |
Observations
| 213,255 | 245,891 | 232,620 | 264,240 |
Delivery with provider
Odds of delivering with a health provider | (1): Full | (2): Demo-graphics | (3): House-hold | (4): Community |
---|---|---|---|---|
Woman’s Age
| 1.039*** | 1.050*** | ||
Woman’s Years Education
| 1.051*** | 1.118*** | ||
Total Children Ever Born
| 0.848*** | 0.830*** | ||
Married
| 0.757*** | 0.744*** | ||
Woman Being Employed
| 0.985 | 0.898*** | ||
Wanted Last Pregnancy Then
| 0.881*** | 0.830*** | ||
Year of Most Recent Birth
| 1.073*** | 1.062*** | ||
Four plus ANC
| 1.514*** | 1.921*** | ||
Any ANC
| 3.860*** | 5.032*** | ||
Saw Doctor at ANC
| 1.433*** | 1.413*** | ||
Acceptability of Wife Beating Score
| 0.977*** | 0.942*** | ||
Urban
| 1.576*** | 1.832*** | ||
Wealth Index
| 1.371*** | 1.497*** | ||
Non Male Head
| 1.092*** | 1.314*** | ||
Husband’s Age
| 1.003* | 0.994*** | ||
Husband’s Years Education
| 1.016*** | 1.083*** | ||
Husband Being Employed
| 0.769*** | 0.728** | ||
Percent of stratum with 4 plus ANC
| 7.093*** | 136.8*** | ||
Mean Stratum level Acceptability of Wife Beating Score
| 0.912** | 0.708*** | ||
Country
| 0.968*** | 0.971*** | 0.979*** | 0.979*** |
Constant
| 0*** | 0*** | 0.538** | 0.635*** |
Observations
| 213,204 | 245,839 | 232,567 | 264,189 |
Drivers by region: Africa and Asia
Africa
Odds of delivering in a health facility | (1): Full | (2): Demo-graphics | (3): House-hold | (4): Community |
---|---|---|---|---|
Woman’s Age
| 1.038*** | 1.042*** | ||
Woman’s Years Education
| 1.061*** | 1.128*** | ||
Total Children Ever Born
| 0.856*** | 0.839*** | ||
Married
| 0.872** | 0.876*** | ||
Woman Being Employed
| 0.876*** | 0.822*** | ||
Wanted Last Pregnancy Then
| 0.839*** | 0.797*** | ||
Year of Most Recent Birth
| 1.034* | 1.018 | ||
Four plus ANC
| 1.328*** | 1.611*** | ||
Any ANC
| 6.665*** | 8.398*** | ||
Saw Doctor at ANC
| 0.837*** | 0.879** | ||
Acceptability of Wife Beating Score
| 0.975*** | 0.940*** | ||
Urban
| 1.812*** | 2.147*** | ||
Wealth Index
| 1.289*** | 1.398*** | ||
Non Male Head
| 0.996 | 1.226*** | ||
Husband’s Age
| 0.998 | 0.990*** | ||
Husband’s Years Education
| 1.013** | 1.090*** | ||
Husband Being Employed
| 0.796*** | 0.708*** | ||
Percent of stratum with 4 plus ANC
| 6.823*** | 97.26*** | ||
Mean Stratum level Acceptability of Wife Beating Score
| 0.924* | 0.730*** | ||
Country
| 0.971*** | 0.972*** | 0.976*** | 0.982*** |
Constant
| 0** | 0 | 0.881 | 0.652 |
Observations
| 154,174 | 181,630 | 166,970 | 191,237 |
Asia
Odds of delivering in a health facility | (1): Full | (2): Demo-graphics | (3): House-hold | (4): Community |
---|---|---|---|---|
Woman’s Age
| 1.041*** | 1.072*** | ||
Woman’s Years Education
| 1.049*** | 1.107*** | ||
Total Children Ever Born
| 0.789*** | 0.760*** | ||
Married
| 1.110 | 1.017 | ||
Woman Being Employed
| 0.966 | 0.759*** | ||
Wanted Last Pregnancy Then
| 0.991 | 0.950 | ||
Year of Most Recent Birth
| 1.210*** | 1.210*** | ||
Four plus ANC
| 2.393*** | 3.402*** | ||
Any ANC
| 1.552*** | 1.772*** | ||
Saw Doctor at ANC
| 2.663*** | 2.942*** | ||
Acceptability of Wife Beating Score
| 0.994 | 0.972 | ||
Urban
| 1.591*** | 1.911*** | ||
Wealth Index
| 1.495*** | 1.776*** | ||
Non Male Head
| 1.206*** | 1.377*** | ||
Husband’s Age
| 1.009** | 0.989*** | ||
Husband’s Years Education
| 1.005 | 1.069*** | ||
Husband Being Employed
| 1.060 | 1.005 | ||
Percent of stratum with 4 plus ANC
| 3.470*** | 376.0*** | ||
Mean Stratum level Acceptability of Wife Beating Score
| 1.009 | 0.784*** | ||
Country
| 0.940*** | 0.941*** | 0.974*** | 0.952*** |
Constant
| 0*** | 0*** | 0.160*** | 0.477*** |
Observations
| 59,081 | 64,261 | 65,650 | 73,003 |
Modeling correlates of specific places of delivery and types of provider
Model 4: Odds of delivery at a hospital | Model 5: Odds of delivery at a private facility vs other | Model 6: Odds of delivery at a public facility vs other | Model 7: Odds of delivery with a doctor vs other | |
---|---|---|---|---|
Woman’s Age
| 1.020*** | 0.991** | 1.017*** | 1.037*** |
Woman’s Years Education
| 1.052*** | 1.060*** | 0.986*** | 1.064*** |
Total Children Ever Born
| 0.915*** | 1.036** | 0.902*** | 0.854*** |
Married
| 0.659*** | 1.559*** | 0.711*** | 1.125* |
Woman Being Employed
| 0.860*** | 0.874*** | 1.090** | 0.699*** |
Wanted Last Pregnancy Then
| 0.829*** | 1.004 | 0.855*** | 0.951* |
Year of Most Recent Birth
| 0.951*** | 0.897*** | 1.107*** | 0.879*** |
Four plus ANC
| 1.494*** | 1.182*** | 1.238*** | 1.573*** |
Any ANC
| 1.681*** | 0.425*** | 6.411*** | 0.479*** |
Saw Doctor at ANC
| 2.612*** | 2.277*** | 0.637*** | 10.35*** |
Acceptability of Wife Beating Score
| 0.994 | 0.989 | 0.990 | 1.008 |
Urban
| 1.914*** | 0.799** | 1.408*** | 1.051 |
Wealth Index
| 1.191*** | 1.114*** | 1.253*** | 1.154*** |
Non Male Head
| 1.188*** | 0.891*** | 1.135*** | 0.951* |
Husband’s Age
| 1.000 | 0.990** | 1.006*** | 0.986*** |
Husband’s Years Education
| 1.031*** | 1.058*** | 0.980*** | 1.027*** |
Husband Being Employed
| 0.625** | 0.667 | 0.869 | 0.899 |
Percent of stratum with 4 plus ANC
| 1.553* | 2.606** | 3.113*** | 1.340 |
Mean Stratum level Acceptability of Wife Beating Score
| 0.878*** | 0.790*** | 1.034 | 0.793*** |
Country
| 0.986** | 0.970*** | 0.986** | 0.978*** |
Constant
| 8.8e + 42*** | 3.3e + 94*** | 0*** | 1.1e + 111*** |
Observations
| 213,255 | 114,334 | 213,255 | 213,204 |