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Place, Time and Experience: Barriers to Universalization Of Institutional Child Delivery in Rural Mozambique

Resource type
Authors/contributors
Title
Place, Time and Experience: Barriers to Universalization Of Institutional Child Delivery in Rural Mozambique
Abstract
CONTEXT: Although institutional coverage of childbirth is increasing in the developing world, a substantial minority of births in rural Mozambique still occur outside of health facilities. Identifying the remaining barriers to safe professional delivery services can aid in achieving universal coverage. METHODS: Survey data collected in 2009 from 1,373 women in Gaza, Mozambique, were used in combination with spatial, meteorological and health facility data to examine patterns in place of delivery. Geographic information system-based visualization and mapping and exploratory spatial data analysis were used to outline the spatial distribution of home deliveries. Multilevel logistic regression models were constructed to identify associations between individual, spatial and other characteristics and whether women's most recent delivery took place at home. RESULTS: Spatial analysis revealed high- and low-prevalence clusters of home births. In multivariate analyses, women with a higher number of clinics within 10 kilometers of their home had a reduced likelihood of home delivery, but those living closer to urban centers had an increased likelihood. Giving birth during the rainy, high agricultural season was positively associated with home delivery, while household wealth was negatively associated with home birth. No associations were evident for measures of exposure to and experience with health institutions. CONCLUSIONS: The results suggest the need for a comprehensive approach to expansion of professional delivery services. Such an approach should complement measures facilitating physical access to health institutions for residents of harder-to-reach areas with community-based interventions aimed at improving rural women's living conditions and opportunities, while also taking into account seasonal and other variables.
Publication
International perspectives on sexual and reproductive health
Volume
42
Issue
1
Pages
21-31
Date
março 2016
Journal Abbr
Int Perspect Sex Reprod Health
Language
eng
ISSN
1944-0405
Archive
PubMed
Loc. in Archive
28770025
Citation
Agadjanian, V., Yao, J., & Hayford, S. R. (2016). Place, Time and Experience: Barriers to Universalization Of Institutional Child Delivery in Rural Mozambique. International Perspectives on Sexual and Reproductive Health, 42(1), 21–31. PubMed. https://doi.org/10.1363/42e0116
Themes / Temas
Geography / Geografia