TY - JOUR
T1 - Levels, trends, and inequalities in using institutional delivery services in low- And middle-income countries
T2 - A stratified analysis by facility type
AU - Mehedi Hasan, Md
AU - Soares Magalhaes, Ricardo J.
AU - Fatima, Yaqoot
AU - Ahmed, Saifuddin
AU - Mamun, Abdullah A.
N1 - Funding Information:
Acknowledgments: We thank the Demographic and Health Survey program for providing access to the data sets. We gratefully acknowledge the commitment of the Australian Government and the University of Queensland, Brisbane, QLD, Australia, to their research efforts. To undertake the PhD degree, MMH is supported by the “Research Training Program” scholarship funded by the Commonwealth Government of Australia and the University of Queensland, Brisbane, QLD, Australia.
Publisher Copyright:
© Hasan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-20-00533
PY - 2021/4
Y1 - 2021/4
N2 - Introduction: To ensure equitable and accessible services and improved utilization of institutional delivery it is important to identify what progress has been achieved, whether there are vulnerable and disadvantaged groups that need specific attention and what are the key factors affecting the utilization of institutional delivery services. In this study, we examined levels, trends, and inequalities in the utilization of institutional delivery services in low- and middle-income countries. Methods: We used nationally representative cross-sectional data from Demographic and Health Surveys (DHS) conducted during 1990-2018. Bayesian linear regression analysis was performed. Results: Among 74 countries, the utilization of institutional delivery services ranged from 23.7% in Chad to 100% in Ukraine and Armenia (with >90% in 19 countries and <50% in 13 countries) during the latest DHS rounds. Trend analysis in 63 countries with at least 2 surveys showed that the utilization of institutional delivery services increased in 60 countries during 1990-2018, with the highest increase being in Cambodia (18.3%). During this period, the utilization of institutional delivery services increased in 90.3% of countries among the richest, 95.2% of countries in urban, and 84.1% of countries among secondaryþ educated women. The utilization of institutional delivery services was higher among wealthiest, urban, and secondaryþ educated women compared to their counterparts. Greater utilization of private facilities for delivery was observed in women from the highest income group and urban communities, whereas highest utilization of public facilities was observed for women from the lowest income group and rural communities. Conclusions: The utilization of institutional delivery services varied substantially between and within countries over time. Significant disparities in service utilization identified in this study highlight the need for tailored support for women from disadvantaged and vulnerable groups.
AB - Introduction: To ensure equitable and accessible services and improved utilization of institutional delivery it is important to identify what progress has been achieved, whether there are vulnerable and disadvantaged groups that need specific attention and what are the key factors affecting the utilization of institutional delivery services. In this study, we examined levels, trends, and inequalities in the utilization of institutional delivery services in low- and middle-income countries. Methods: We used nationally representative cross-sectional data from Demographic and Health Surveys (DHS) conducted during 1990-2018. Bayesian linear regression analysis was performed. Results: Among 74 countries, the utilization of institutional delivery services ranged from 23.7% in Chad to 100% in Ukraine and Armenia (with >90% in 19 countries and <50% in 13 countries) during the latest DHS rounds. Trend analysis in 63 countries with at least 2 surveys showed that the utilization of institutional delivery services increased in 60 countries during 1990-2018, with the highest increase being in Cambodia (18.3%). During this period, the utilization of institutional delivery services increased in 90.3% of countries among the richest, 95.2% of countries in urban, and 84.1% of countries among secondaryþ educated women. The utilization of institutional delivery services was higher among wealthiest, urban, and secondaryþ educated women compared to their counterparts. Greater utilization of private facilities for delivery was observed in women from the highest income group and urban communities, whereas highest utilization of public facilities was observed for women from the lowest income group and rural communities. Conclusions: The utilization of institutional delivery services varied substantially between and within countries over time. Significant disparities in service utilization identified in this study highlight the need for tailored support for women from disadvantaged and vulnerable groups.
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U2 - 10.9745/GHSP-D-20-00533
DO - 10.9745/GHSP-D-20-00533
M3 - Article
C2 - 33795363
AN - SCOPUS:85103485341
SN - 2169-575X
VL - 9
SP - 78
EP - 88
JO - Global Health Science and Practice
JF - Global Health Science and Practice
IS - 1
ER -