Who gives birth in private facilities in Asia? A look at six countries

Amanda M. Pomeroy, Marge Koblinsky, Soumya Alva

Research output: Contribution to journalArticle

Abstract

Over the past two decades, multilateral organizations have encouraged increased engagement with private healthcare providers in developing countries. As these efforts progress, there are concerns regarding how private delivery care may effect maternal health outcomes. Currently available data do not allow for an in-depth study of the direct effect of increasing private sector use on maternal health across countries. As a first step, however, we use demographic and health surveys (DHS) data to (1) examine trends in growth of delivery care provided by private facilities and (2) describe who is using the private sector within the healthcare system. As Asia has shown strong increases in institutional coverage of delivery care in the last decade, we will examine trends in six Asian countries. We hypothesize that if the private sector competes for clients based on perceived quality, their clientele will be wealthier, more educated and live in an area where there are enough health facilities to allow for competition. We test this hypothesis by examining factors of socio-demographic, economic and physical access and actual/perceived need related to a mother's choice to deliver in a health facility and then, among women delivering in a facility, their use of a private provider. Results show a significant trend towards greater use of private sector delivery care over the last decade. Wealth and education are related to private sector delivery care in about half of our countries, but are not as universally related to use as we would expect. A previous private facility birth predicted repeat private facility use across nearly all countries. In two countries (Cambodia and India), primiparity also predicted private facility use. More in-depth work is needed to truly understand the behaviour of the private sector in these countries; these results warn against making generalizations about private sector delivery care.

Original languageEnglish (US)
JournalHealth Policy and Planning
Volume29
Issue numberSUPPL. 1
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Private Sector
Parturition
Health Facilities
Demography
Cambodia
Parity
Private Facilities
Health Personnel
Developing Countries
India
Economics
Mothers
Organizations
Delivery of Health Care
Education
Growth

Keywords

  • Asia
  • delivery care
  • Maternal health
  • private sector

ASJC Scopus subject areas

  • Health Policy

Cite this

Who gives birth in private facilities in Asia? A look at six countries. / Pomeroy, Amanda M.; Koblinsky, Marge; Alva, Soumya.

In: Health Policy and Planning, Vol. 29, No. SUPPL. 1, 2014.

Research output: Contribution to journalArticle

Pomeroy, Amanda M. ; Koblinsky, Marge ; Alva, Soumya. / Who gives birth in private facilities in Asia? A look at six countries. In: Health Policy and Planning. 2014 ; Vol. 29, No. SUPPL. 1.
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