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The role of health systems and policies in promoting safe delivery in low-and middle-income countries: A multilevel analysis

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  • Kruk, M.E.
  • Prescott, M.R.

Abstract

We aimed to measure the contribution of national factors, particularly health system characteristics, to the individual likelihood of professionally attended delivery ("safe delivery") for women in low-and middle-income countries. Using Demographic and Health Survey data for 165 774 women in 31 countries, we estimated multilevel logistic regression models to measure the contribution of national economic and health system characteristics to likelihood of attended delivery. More health workers, higher national income, urbanization, and lower income inequality were associated with higher odds of attended delivery. Macrosocial factors increase utilization of attended delivery and may be more efficient in reducing maternal mortality than are interventions aimed at individual women.

Suggested Citation

  • Kruk, M.E. & Prescott, M.R., 2012. "The role of health systems and policies in promoting safe delivery in low-and middle-income countries: A multilevel analysis," American Journal of Public Health, American Public Health Association, vol. 102(4), pages 645-650.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300462_5
    DOI: 10.2105/AJPH.2011.300462
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    Cited by:

    1. Sandra G. Sosa-Rubí & Sergio Bautista-Arredondo & Carlos Chivardi-Moreno & David Contreras-Loya & Gina Hera-Fuentes & Marjorie Opuni, 2021. "Efficiency, quality, and management practices in health facilities providing outpatient HIV services in Kenya, Nigeria, Rwanda, South Africa and Zambia," Health Care Management Science, Springer, vol. 24(1), pages 41-54, March.
    2. Tulsi Ram Bhandari & V Raman Kutty & P Sankara Sarma & Ganesh Dangal, 2017. "Safe delivery care practices in western Nepal: Does women’s autonomy influence the utilization of skilled care at birth?," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-10, August.
    3. Masters, Samuel H. & Burstein, Roy & Amofah, George & Abaogye, Patrick & Kumar, Santosh & Hanlon, Michael, 2013. "Travel time to maternity care and its effect on utilization in rural Ghana: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 93(C), pages 147-154.
    4. Margaret E. Kruk & Adanna Chukwuma & Godfrey Mbaruku & Hannah H. Leslie, 2017. "Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania," WIDER Working Paper Series wp-2017-139, World Institute for Development Economic Research (UNU-WIDER).

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