Display options
Cite
Mazalale J, Kambala C, Brenner S, et al. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi. Trop Med Int Health. 2015;20(5):617-626doi: 10.1111/tmi.12473.
Mazalale, J., Kambala, C., Brenner, S., Chinkhumba, J., Lohmann, J., Mathanga, D. P., Robberstad, B., Muula, A. S., & De Allegri, M. (2015). Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi. Tropical medicine & international health : TM & IH, 20(5), 617-626. https://doi.org/10.1111/tmi.12473
Mazalale, Jacob, et al. "Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi." Tropical medicine & international health : TM & IH vol. 20,5 (2015): 617-626. doi: https://doi.org/10.1111/tmi.12473
Mazalale J, Kambala C, Brenner S, Chinkhumba J, Lohmann J, Mathanga DP, Robberstad B, Muula AS, De Allegri M. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi. Trop Med Int Health. 2015 May;20(5):617-626. doi: 10.1111/tmi.12473. Epub 2015 Mar 02. PMID: 25656750; PMCID: PMC4433497.
Copy Download .nbib Format: NLM
Share it on

Trop Med Int Health. 2015 May;20(5):617-626. doi: 10.1111/tmi.12473. Epub 2015 Mar 02.

Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi.

Tropical medicine & international health : TM & IH

Jacob Mazalale, Christabel Kambala, Stephan Brenner, Jobiba Chinkhumba, Julia Lohmann, Don P Mathanga, Bjarne Robberstad, Adamson S Muula, Manuela De Allegri

Affiliations

  1. Institute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
  2. School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
  3. Centre for International Health, University of Bergen, Bergen, Norway.

PMID: 25656750 PMCID: PMC4433497 DOI: 10.1111/tmi.12473

Abstract

OBJECTIVE: To identify factors associated with delivery outside a health facility in rural Malawi.

METHOD: A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility.

RESULTS: Of the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086-3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28-0.95) and fourth-quartile OR = 0.48; 95% CI (0.29-0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23-0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96-2.14)] and multigravidae [OR = 1.14; 95% CI (0.98-1.73)] were more likely to deliver outside a health facility at 10% level of significance.

CONCLUSION: About 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users.

© 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Keywords: Afrique subsaharienne; Malawi; accouchement dans un établissement; accoucheuses qualifiées; cuidados maternos: parto intrahospitalario; facility-based delivery; maternal care; partera cualificada; santé maternelle; skilled birth attendance; sub-Saharan Africa; África subsahariana

References

  1. Health Serv Res. 1974 Fall;9(3):208-20 - PubMed
  2. Lancet. 2011 Apr 23;377(9775):1421-8 - PubMed
  3. Int J Health Plann Manage. 2003 Jan-Mar;18(1):3-22 - PubMed
  4. Trop Med Int Health. 2007 Jul;12(7):862-72 - PubMed
  5. Lancet. 2006 Oct 7;368(9543):1284-99 - PubMed
  6. BMC Health Serv Res. 2014 Apr 22;14:180 - PubMed
  7. BMC Pregnancy Childbirth. 2011 May 14;11:34 - PubMed
  8. Med Care. 2008 Jul;46(7):647-53 - PubMed
  9. BMC Pregnancy Childbirth. 2009 Aug 11;9:34 - PubMed
  10. Trop Med Int Health. 2008 Jul;13 Suppl 1:44-52 - PubMed
  11. Br J Oral Maxillofac Surg. 2008 Jan;46(1):38-41 - PubMed
  12. J Health Soc Behav. 1995 Mar;36(1):1-10 - PubMed
  13. J Health Popul Nutr. 2003 Dec;21(4):374-82 - PubMed
  14. Health Serv Res. 1983 Spring;18(1):49-74 - PubMed
  15. Glob Public Health. 2013;8(9):1014-26 - PubMed
  16. Afr Health Sci. 2009 Dec;9(4):234-41 - PubMed
  17. Prim Care Diabetes. 2015 Jun;9(3):211-8 - PubMed
  18. J Health Popul Nutr. 2003 Mar;21(1):40-7 - PubMed
  19. BMC Res Notes. 2012 Nov 24;5:653 - PubMed
  20. J Obstet Gynaecol Can. 2013 Feb;35(2):125-30 - PubMed
  21. BMC Pregnancy Childbirth. 2007 Oct 11;7:23 - PubMed
  22. BMC Health Serv Res. 2014 May 22;14:234 - PubMed
  23. J Public Health Policy. 2012 Nov;33(4):439-53 - PubMed
  24. BMC Public Health. 2013 Apr 20;13:371 - PubMed
  25. Reprod Health. 2011 Dec 02;8:36 - PubMed
  26. Int J Epidemiol. 2004 Dec;33(6):1337-44 - PubMed
  27. JNMA J Nepal Med Assoc. 2009 Jan-Mar;48(173):28-34 - PubMed
  28. Int J Health Geogr. 2014 Jun 26;13:25 - PubMed
  29. Lancet. 2005 Mar 5-11;365(9462):891-900 - PubMed
  30. BMC Pregnancy Childbirth. 2011 Jan 10;11:1 - PubMed
  31. Health Policy Plan. 2006 Nov;21(6):459-68 - PubMed
  32. Health Econ Policy Law. 2009 Apr;4(Pt 2):179-93 - PubMed
  33. Matern Child Health J. 2008 Jul;12(4):509-18 - PubMed
  34. Health Policy. 2010 Oct;97(2-3):209-16 - PubMed
  35. East Afr Med J. 1996 Feb;73(2):91-4 - PubMed
  36. BMC Pregnancy Childbirth. 2007 Dec 06;7:29 - PubMed
  37. Int J Gynaecol Obstet. 2005 Feb;88(2):181-93 - PubMed
  38. Reprod Health. 2013 Aug 20;10:40 - PubMed
  39. Reprod Health. 2014 Mar 14;11:22 - PubMed
  40. Trop Med Int Health. 2007 Aug;12(8):972-81 - PubMed
  41. Health Policy. 2011 Mar;99(3):210-8 - PubMed
  42. Malawi Med J. 2011 Dec;23(4):104-8 - PubMed
  43. Demography. 2001 Feb;38(1):115-32 - PubMed
  44. BMC Health Serv Res. 2010 Jan 06;10:6 - PubMed
  45. Bull World Health Organ. 2009 Jan;87(1):30-8 - PubMed
  46. Am J Public Health. 2010 Oct;100(10):1845-52 - PubMed

Publication Types