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Explaining Disparities in Use of Skilled Birth Attendants in Developing Countries: A Conceptual Framework

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  • Patience A Afulani
  • Cheryl Moyer
Abstract
Despite World Health Organization recommendations that all women deliver with a skilled birth attendant (SBA), research continues to demonstrate large disparities in use of SBAs by socioeconomic status (SES). Yet few quantitative studies empirically examine the factors underlying these disparities, due in part to the fact that current models do not provide clear pathways—with measurable mediators—for how distal factors like SES may affect maternal health-seeking behaviors like delivering with SBAs. We propose the Disparities in Skilled Birth Attendance (DiSBA) framework for examining the determinants of use of SBAs. We posit that three proximal factors directly affect use of SBAs: perceived need, perceived accessibility of maternal health services, and perceived quality of care. Distal factors like SES affect use of SBAs indirectly through these proximal factors, and the effects can be measured. We test the assumptions of the DiSBA framework using data from the Ghana Maternal Health Survey. The analytic techniques we use include logistic regression with mediation analysis to examine the intervening effects. We find that our proxies for perceived access, perceived need, and perceived quality of care account for approximately 23% of the difference between women with no education and those with primary school education, and about 55% of the difference between women in the lowest wealth quintile and those in the middle wealth quintiles. This study suggests that proximal factors are worthy of increased attention in terms of measurement, data collection, analysis, programmatic efforts, and policy interventions, as these factors are potentially more amenable to change than the distal factors. The effects of proximal factors are also likely context specific, thus sufficient understanding in different contexts is essential to developing appropriate interventions.

Suggested Citation

  • Patience A Afulani & Cheryl Moyer, 2016. "Explaining Disparities in Use of Skilled Birth Attendants in Developing Countries: A Conceptual Framework," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-16, April.
    • Handle: RePEc:plo:pone00:0154110
    DOI: 10.1371/journal.pone.0154110
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    References listed on IDEAS

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    1. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    2. Timothy Abuya & Charlotte E Warren & Nora Miller & Rebecca Njuki & Charity Ndwiga & Alice Maranga & Faith Mbehero & Anne Njeru & Ben Bellows, 2015. "Exploring the Prevalence of Disrespect and Abuse during Childbirth in Kenya," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-13, April.
    3. Andersen, Helle Max, 2004. ""Villagers": Differential treatment in a Ghanaian hospital," Social Science & Medicine, Elsevier, vol. 59(10), pages 2003-2012, November.
    4. Stephenson, R. & Baschieri, A. & Clements, S. & Hennink, M. & Madise, N., 2006. "Contextual influences on the use of health facilities for childbirth in Africa," American Journal of Public Health, American Public Health Association, vol. 96(1), pages 84-93.
    5. Ulrich Kohler & Kristian Bernt Karlson & Anders Holm, 2011. "Comparing coefficients of nested nonlinear probability models," Stata Journal, StataCorp LP, vol. 11(3), pages 420-438, September.
    6. Stock, Robert, 1983. "Distance and the utilization of health facilities in rural Nigeria," Social Science & Medicine, Elsevier, vol. 17(9), pages 563-570, January.
    7. Ulrich Kohler, 2011. "Comparing coefficients between nested nonlinear probability models," German Stata Users' Group Meetings 2011 08, Stata Users Group.
    8. Glei, Dana A. & Goldman, Noreen & Rodríguez, Germán, 2003. "Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?," Social Science & Medicine, Elsevier, vol. 57(12), pages 2447-2463, December.
    9. AfDB AfDB, . "Annual Report 2012," Annual Report, African Development Bank, number 461.
    10. WHO & UNICEF & UNFPA & World Bank & United Nations Population Division, 2014. "Trends in Maternal Mortality : 1990 to 2013," World Bank Publications - Books, The World Bank Group, number 18203.
    11. Amooti-Kaguna, B. & Nuwaha, F., 2000. "Factors influencing choice of delivery sites in Rakai district of Uganda," Social Science & Medicine, Elsevier, vol. 50(2), pages 203-213, January.
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