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Am J Public Health. 2006 Jan;96(1):84-93. Epub 2005 Nov 29.

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

Author information

  • 1Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA. rbsteph@sph.emory.edu

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.

PMID:
16317204
[PubMed - indexed for MEDLINE]
PMCID:
PMC1470452
Free PMC Article

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