What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries
Abstract
Prenatal and delivery care are critical both for maternal and newborn health. Using the Demographic and Health Surveys (DHS) data for thirty-two low-income countries across Asia, sub-Saharan Africa and Latin America, and employing a two-level random-intercept model, this paper empirically assesses the influence of prenatal attendance and a wide array of observed individual-, household- and community-level characteristics on a woman's decision to give birth at a health facility or at home. The results show that prenatal attendance does appreciably influence the use of facility delivery in all three geographical regions, with women having four visits being 7.3 times more likely than those with no prenatal care to deliver at a health facility. These variations are more pronounced for Sub-Saharan Africa. The influence of the number of prenatal visits, maternal age and education, parity level, and economic status of the birthing women on the place of delivery is found to vary across the three geographical regions. The results also indicate that obstetrics care is geographically and economically more accessible to urban and rural women from the non-poor households than those from the poor households. The strong influence of number of visits, household wealth, education and regional poverty on the site of delivery setting suggests that policies aimed at increasing the use of obstetric care programs should be linked with the objectives of social development programs such as poverty reduction, enhancing the status of women, and increasing primary and secondary school enrollment rate among girls.
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Findings are in line with previous studies reporting correlations between facility delivery and distance to the nearest health facility.
“Findings are in line with previous studies reporting correlations between facility delivery and the distance to the nearest health facility [43, 45–47].”
From Impact of smartphone-assisted prenatal home visits on women’s use of facility delivery: Results from a cluster-randomized trial in rural Tanzania (2018) · cites this paper as [43]
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Dennis, M. L., Benova, L., Goodman, C., Barasa, E., Abuya, T., & Campbell, O. M. R. (2020) · Figshare · doi:10.6084/m9.figshare.11986026
HARTWIG, L. M., Namukose, V., Kiriya, J., Onyancha, C., Shibanuma, A., & Jimba, M. (2022) · Figshare · doi:10.6084/m9.figshare.20521581
Dennis, M. L., Benova, L., Goodman, C., Barasa, E., Abuya, T., & Campbell, O. M. R. (2020) · Figshare · doi:10.6084/m9.figshare.11986038
Dennis, M. L., Benova, L., Goodman, C., Barasa, E., Abuya, T., & Campbell, O. M. R. (2020) · Figshare · doi:10.6084/m9.figshare.11986056
Dennis, M. L., Benova, L., Goodman, C., Barasa, E., Abuya, T., & Campbell, O. M. R. (2020) · Figshare · doi:10.6084/m9.figshare.11986029
Belay, D. G., Norman, R., Dunne, J., Alemu, M. B., Haile, T. G., & Tessema, G. A. (2024) · Journal of Global Health Economics and Policy · doi:10.7189/001c.126465
Filimberti, I. N., & Nauman, J. (2025) · SAP Primary Care · doi:10.62486/pc202525
- Authors
- Guliani, H., Sepehri, A., & Serieux, J.
- Affiliations
- University of Regina (CA)
- University of Manitoba (CA)
- Corresponding author
- Guliani, Harminder
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 74
- Issue
- 12
- Pages
- 1882-1890
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2157364140
- Cited by
- 70
- References
- 47
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 9 · 2019: 7 · 2018: 2 · 2017: 6 · 2016: 4 · 2015: 6 · 2014: 9 · 2013: 6
- FWCI
- 5.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- institutional delivery, prenatal care, antenatal care visits, birthplace, home birth, access to obstetric care, maternal health, low-income countries, household wealth, maternal education, parity, regional poverty, sub-Saharan Africa, Asia, Latin America
- MeSH terms
- Adolescent, Adult, Asia, Developing Countries, Female, Home Childbirth, Humans, Latin America, Maternal-Child Health Centers, Middle Aged, Pregnancy, Prenatal Care, Socioeconomic Factors, Africa South of the Sahara, Health Care Surveys, Delivery, Obstetric, Young Adult
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