Source of Antenatal Care Influences Facility Delivery in Rural Tanzania: A Population-Based Study |
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Authors: | Peter C Rockers Mark L Wilson Godfrey Mbaruku Margaret E Kruk |
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Institution: | (1) Department of Epidemiology, School of Public Health, University of Michigan, 109 Observatory Road, Ann Arbor, MI 48109, USA;(2) Ifakara Health Research and Development Centre, Mikocheni, P.O. Box 78373, Dar-es-salaam, Tanzania;(3) Department of Health Management and Policy, School of Public Health, University of Michigan, 109 Observatory Road, Ann Arbor, MI 48109, USA;(4) Averting Maternal Death and Disability Program, Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, Room B-320, New York, NY 10032, USA |
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Abstract: | Objective While antenatal care does not directly contribute to reducing maternal mortality, it may play an indirect role by encouraging
women to deliver with a skilled birth attendant or in a health facility. We investigated whether the frequency of visits and
select characteristics of antenatal care were associated with facility delivery. Methods We selected a population-representative sample of households in a rural district of western Tanzania. Women who had given
birth within five years were asked about their most recent delivery and antenatal care. Results Of 1,204 women interviewed, 1,195 (99.3%) made at least one antenatal care visit, while only 438 (36.4%) delivered in a health
facility. In adjusted analysis, women were significantly more likely to deliver in a health facility if they attended antenatal
care at a government health center (OR 3.17, 95% CI: 1.60–6.30) or a mission facility (OR 2.87, 95% CI: 1.36–6.07), rather
than a government dispensary. Women were significantly less likely to deliver in a health facility if their nearest health
facility was outside their village (OR 0.38, 95% CI: 0.22–0.66). Conclusion Though facility utilization for antenatal care is frequent, most women who accessed antenatal care did not deliver in a health
facility. Women who obtained antenatal care at higher level government facilities or mission facilities, which offered better
quality of care, were more likely to deliver in any facility. Improving the quality of antenatal care may improve the health
of mothers through encouraging women to return to facilities for delivery. |
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