Table 5.
Factors affecting maternal and neonatal service usage, ordered by service type and outcome
| Author (year), country | Outcomes | Determinants | Odds ratio or percentage |
|---|---|---|---|
| Skilled birth attendance | |||
| Choulagai et al. (2013) [16], Nepal | SBA usage | Education | |
| Informally educated Educated intermediate and above |
OR 1.18 (CI0.92–1.51), p < 0.05 OR 4.41 (CI2.89–6.72), p < 0.05 |
||
| Wealth quintile | |||
| Q2 (poorer) Q5 (wealthiest) |
OR 1.08 (CI 0.81–1.43), p < 0.05 OR 1.90 (CI 1.42–2.56), p < 0.05 |
||
| Knowledge | |||
| Knowledge of at least one danger sign | OR 1.31 (CI 1.08–1.58), p < 0.05 | ||
| Distance | |||
| Staying ≤ 30 min from facility | OR 1.31 (CI 1.08–1.58), p < 0.05 | ||
| ANC use | |||
| ≥ 4 ANC visits | OR 2.39 (CI 1.97–2.89), p < 0.05 | ||
| Mayhew et al. (2008) [20], Nepal | SBA usage | Wealth quintile | |
| Q2 (poorer) Q5 (wealthiest) |
OR 1.6 (CI 1.2–2.3), p < 0.01 OR 6.3 (CI 4.4–8.9), p < 0.01 |
||
| Distance | |||
| Walking distance to clinic (31–60 min) Walking distance to clinic (>90 min) |
OR 0.7 (CI 0.6–0.8), p < 0.01 OR 0.4 (CI 0.3–0.6), p < 0.01 |
||
| Education | |||
| Formally educated | OR 3.8 (CI 3.2–4.5), P < 0.05 | ||
| Earlier been to this health facility | OR 1.7 (CI 1.3–2.1), p < 0.05 | ||
| At least some basic EmONC equipment in facility | OR 1.0 (CI 0.7–1.3), p < 0.05 | ||
| ≥ 1 Community health worker in catchment area | OR 0.7 (CI 0.6–0.95), p < 0.05 | ||
| ≥ 1 female TBA in catchment area | OR 1.3 (CI 1.0–1.7), p < 0.05 | ||
| ≥ 1 female doctor or midwife at health facility | OR 1.4 (CI 1.1–1.8), p < 0.05 | ||
| User fees collected in facility | OR 0.8 (CI 0.6–0.96), p < 0.05 | ||
| Antenatal care provided in facility | OR 1.1 (CI 0.8–1.5), p < 0.05 | ||
| Siziya et al. (2009) [29], Iraq | TBA usage | Wealth quintile | |
| Q2 (poorer) Q4 (wealthier) |
OR 2.90 (CI 2.49–3.39), p < 0.05 OR 0.79 (CI 0.65–0.96), p < 0.05 |
||
| Age | |||
| Women aged 25–34 years | AOR 1.22 (CI 1.08–1.39), p < 0.05 | ||
| Education | |||
| Formally educated | OR 1.08 (CI 0.96–1.22), p < 0.05 | ||
| Children | |||
| Having 1–2 children | AOR 0.72 (CI 0.59–0.87), p < 0.05 | ||
| Facility-based delivery | |||
| Dhakal et al. (2011) [18], Nepal | FBD | Age | |
| 25+ years 20–24 years |
OR1.38 (CI 0.34–5.55), p < 0.001 OR 2.67 (CI 0.70–10.19), p < 0.001 |
||
| Occupation | |||
| Housewife Working women |
OR 4.77 (CI 2.16–10.54), p < 0.001 OR 5.80 (CI 0.91–36.84), p < 0.001 |
||
| Education | |||
| Educated up to primary level Educated to secondary and above |
OR 2.29 (CI 0.82–6.37), p < 0.001 OR 16.59 (CI 6.27–43.80), p < 0.001 |
||
| ANC use | |||
| ≥ 1 ANC visit | OR 20.0 (CI 2.64–151.51), p < 0.001 | ||
| Giacaman et al. (2006) [33], Palestine | FBD | Client satisfaction | |
| Avoiding public facilities due to dissatisfaction | OR 2.77 (CI 1.89–4.05), p < 0.001 | ||
| Financial reasons | |||
| Insurance or low cost for opting facility | OR 5.83 (CI 3.96–8.59), p < 0.001 | ||
| Karkee et al. (2013) [19], Nepal | FBD | Education | |
| Educated up to primary level Educated to higher-secondary or above |
AOR 3.57 (CI 1.60–7.94), p < 0.001 AOR 12.39 (CI 5.09–30.2), p < 0.001 |
||
| ANC use | |||
| ≥ 4 ANC visits | AOR 2.15 (CI 1.25–3.69), p < 0.005 | ||
| Distance | |||
| ≤ 30 min 31–60 min |
OR 11.61 (CI 5.77–24.0), p < 0.001 AOR 1.72 (CI 0.93–3.19), p < 0.001 |
||
| Sharma et al. (2014) [21], Nepal | FBD | Education | |
| Formally educated | OR 2.8 (CI 1.58–4.97), p < 0.001 | ||
| Distance | |||
| < 60 min to facility | OR 3.12 (CI 1.61–0.04), p < 0.001 | ||
| ANC use | |||
| Had antenatal visits | OR 5.82 (CI 2.95–11.5), p < 0.001 | ||
| Shrestha et al. (2012) [22], Nepal | FBD | Distance | |
| Residing in remote area | OR 2.81 (CI1.08–7.30), p < 0.05 | ||
| Community | |||
| Newer community | OR 2.56 (CI 1.19–5.55), p < 0.05 | ||
| Education | |||
| Formally educated | OR 2.66 (CI 1.18–6.01), p < 0.05 | ||
| ANC use | |||
| No ANC visits | OR 5.53 (CI 2.12–14.4), p < 0.05 | ||
| Emergency obstetric care | |||
| Hirose et al. (2011) [24], Afghanistan | Delay in seeking EmONC | ANC use | |
| Lack of ANC | AOR 4.6 (CI 1.7–12.2), p < 0.05 | ||
| Socio-cultural factors | |||
| Usage of traditional healer Weak relationship with her birth family No plan to use health facility for delivery |
AOR 3.2 (CI 1.2–8.5), p < 0.05 AOR 2.0 (CI 0.9–4.4), p < 0.05 AOR 2.0 ( CI 0.9–4.2), P < 0.05 |
||
| System factors | |||
| Absence of a midwife | AOR 2.2 (CI 1.1–4.5), p < 0.05 | ||
| Khorrami et al. (2008) [25], Afghanistan | Timely EmONC usage | Distance to facility | |
| < 100 miles ≥ 100 miles |
N = 249 (85.3%) N = 43 (14.7%) |
||
| Mode of travel | |||
| Automobile Bus |
N = 192 (65.8%) N = 97 (33.2%) |
||
| Cost as a limitation | |||
| Yes No |
N = 38 (30.7%) N = 86 (69.4%) |
||
| Safety felt about care at this hospital | |||
| Moderately safe Mildly safe |
N = 100 (34.4%) N = 177 (60.8%) |
||
NB: CI is 95% confidence interval. AOR is adjusted odds ratio