Table 3. Association of distance, facility type and quality of care at closest facility with facility delivery.
| Deliveries n (%) | Facility deliveries, n (%)2 | Crude OR (95% CI), p-value3, n = 11,274 | Adjusted4 OR (95% CI), p-value3, n = 11,129 | |
|---|---|---|---|---|
| Distance to closest delivery facility (of any level) | ||||
| <1 km | 3890 (34.5) | 3060 (78.7) | 1.0 | 1.0 |
| 1–5 km | 2876 (25.5) | 1736 (60.4) | 0.32 (0.23–0.45), <0.001 | 0.32 (0.23–0.44), <0.001 |
| 5–10 km | 2786 (24.7) | 1248 (44.8) | 0.20 (0.14–0.28), <0.001 | 0.27 (0.20–0.38), <0.001 |
| >10 km | 1722 (15.3) | 479 (27.8) | 0.10 (0.07–0.15), <0.001 | 0.16 (0.11–0.24), <0.001 |
| Distance to closest delivery facility (of any level; distance as a continuous variable) | ||||
| Sqrt-distance1 | 0.47 (0.42–0.53), <0.001 | 0.56 (0.50–0.63), <0.001 | ||
| Distance to closest delivery facility + type of closest facility | ||||
| Sqrt-distance1 | 0.47 (0.42–0.53), <0.001 | 0.56 (0.50–0.63), <0.001 | ||
| Hospital | 1657 (14.7) | 933 (56.3) | 1.26 (0.95–1.67), 0.11 | 1.18 (0.90–1.57), 0.24 |
| Health center | 7650 (67.9) | 4389 (57.4) | 1.0 | 1.0 |
| Clinic | 687 (6.1) | 475 (69.1) | 1.26 (0.77–2.06), 0.35 | 1.61 (0.99–2.60), 0.05 |
| Maternity home | 1280 (11.4) | 726 (56.7) | 1.42 (1.01–2.00), 0.04 | 1.49 (1.06–2.08), 0.02 |
| Distance to closest delivery facility + EmOC quality of closest facility | ||||
| Sqrt-distance1 | 0.46 (0.42–0.52), <0.001 | 0.56 (0.50–0.62), <0.001 | ||
| CEmOC | 648 (5.8) | 379 (58.5) | 1.32 (0.89–1.97), 0.17 | 1.19 (0.79–1.78), 0.41 |
| BEmOC | 1.52 (9.3) | 550 (52.3) | 0.98 (0.65–1.48), 0.94 | 0.91 (0.60–1.38), 0.67 |
| Intermediate | 2785 (24.7) | 1592 (57.2) | 1.0 | 1.0 |
| Low | 5876 (52.1) | 3682 (62.7) | 0.95 (0.72–1.24), 0.70 | 0.94 (0.71–1.25), 0.71 |
| Substandard | 913 (8.1) | 320 (35.1) | 0.43 (0.27–0.68), <0.001 | 0.57 (0.35–0.92), 0.02 |
| Distance to closest delivery facility + EmNC quality of closest facility | ||||
| Sqrt-distance1 | 0.47 (0.42–0.52), <0.001 | 0.56 (0.50–0.62), <0.001 | ||
| CEmNC | 0 | 0 | ||
| BEmNC | 298 (2.6) | 204 (68.5) | 0.71 (0.39–1.31), 0.28 | 0.65 (0.35–1.21), 0.18 |
| Intermediate | 3967 (35.2) | 2329 (58.7) | 1.0 | 1.0 |
| Low | 5464 (48.5) | 3214 (58.8) | 0.86 (0.68–1.08), 0.20 | 1.01 (0.80–1.28), 0.94 |
| Substandard | 1545 (13.7) | 776 (50.2) | 0.67 (0.46–0.97), 0.03 | 0.86 (0.59–1.25), 0.42 |
| Distance to closest delivery facility + routine delivery care quality of closest facility | ||||
| Sqrt-distance1 | 0.46 (0.41–0.51), <0.001 | 0.55 (0.50–0.62), <0.001 | ||
| Highest | 1087 (9.6) | 667 (61.4) | 1.13 (0.72–1.76), 0.60 | 0.93 (0.59–1.48), 0.76 |
| High | 3760 (33.4) | 2007 (53.4) | 0.73 (0.54–0.98), 0.03 | 0.67 (0.50–0.90), 0.01 |
| Intermediate | 2482 (22.0) | 1697 (68.4) | 1.0 | 1.0 |
| Low | 3584 (31.8) | 1951 (54.4) | 0.70 (0.52–0.95), 0.02 | 0.79 (0.58–1.08), 0.14 |
| Substandard | 361 (3.2) | 201 (55.7) | 0.31 (0.16–0.59), <0.001 | 0.45 (0.23–0.87), 0.02 |
Middle categories (health center, intermediate quality) were chosen as reference group to increase power.
1Straight-line distance was square root transformed, e.g., 4 km–> √4 = 2; 9 km–> √9 = 3. ORs for facility delivery reflect the change per one unit of the transformed variable, i.e. from 1 km to 4 km to 9 km, etc.
2Chi square tests for % facility delivery across categories, all variables: p < 0.001.
3Wald test p-values for each level of categorical variables.
4Covariates in adjusted models include: age, parity, previous stillbirth, multiple birth, marital status, wealth quintile, education, occupation, religion, ethnicity, health insurance and Newhints intervention zone.