OBJECTIVES: Tanzania, a country with high maternal mortality, has many primary health facilities yet has a low rate of facility deliveries. This study estimated the contribution of individual and community factors in explaining variation in the use of health facilities for childbirth in rural Tanzania. METHODS: A two-stage cluster population-based survey was conducted in Kasulu District, western Tanzania with women with a recent delivery. Random intercept multilevel logistic regression models were used to assess the association between individual- and village-level factors and likelihood of facility delivery. RESULTS: 1205 women participated in the study. In the fully adjusted two-level model, in addition to several individual factors, positive village perception of doctor and nurse skills (odds ratio (OR) 6.72, 95% confidence interval (CI): 2.47-18.31) and negative perception of traditional birth attendant skills (OR 0.13, 95% CI: 0.04-0.40) were associated with higher odds of facility delivery. CONCLUSION: This study suggests that community perceptions of the quality of the local health system influence women's decisions to deliver in a clinic. Improving quality of care at first-level clinics and communicating this to communities may assist efforts to increase facility delivery in sub-Saharan Africa. Copyright (c)2010 Elsevier Ireland Ltd. All rights reserved.
OBJECTIVES: Tanzania, a country with high maternal mortality, has many primary health facilities yet has a low rate of facility deliveries. This study estimated the contribution of individual and community factors in explaining variation in the use of health facilities for childbirth in rural Tanzania. METHODS: A two-stage cluster population-based survey was conducted in Kasulu District, western Tanzania with women with a recent delivery. Random intercept multilevel logistic regression models were used to assess the association between individual- and village-level factors and likelihood of facility delivery. RESULTS: 1205 women participated in the study. In the fully adjusted two-level model, in addition to several individual factors, positive village perception of doctor and nurse skills (odds ratio (OR) 6.72, 95% confidence interval (CI): 2.47-18.31) and negative perception of traditional birth attendant skills (OR 0.13, 95% CI: 0.04-0.40) were associated with higher odds of facility delivery. CONCLUSION: This study suggests that community perceptions of the quality of the local health system influence women's decisions to deliver in a clinic. Improving quality of care at first-level clinics and communicating this to communities may assist efforts to increase facility delivery in sub-Saharan Africa. Copyright (c)2010 Elsevier Ireland Ltd. All rights reserved.
Authors: Margaret E Kruk; Sabrina Hermosilla; Elysia Larson; Daniel Vail; Qixuan Chen; Festo Mazuguni; Beatrice Byalugaba; Godfrey Mbaruku Journal: Trop Med Int Health Date: 2015-04-30 Impact factor: 2.622
Authors: Yalem Tsegay; Tesfay Gebrehiwot; Isabel Goicolea; Kerstin Edin; Hailemariam Lemma; Miguel San Sebastian Journal: Int J Equity Health Date: 2013-05-14
Authors: Kate Ramsey; Ahmed Hingora; Malick Kante; Elizabeth Jackson; Amon Exavery; Senga Pemba; Fatuma Manzi; Colin Baynes; Stephane Helleringer; James F Phillips Journal: BMC Health Serv Res Date: 2013-05-31 Impact factor: 2.655