Women's preferences for obstetric care in rural Ethiopia

A population-based discrete choice experiment in a region with low rates of facility delivery

Dados Bibliográficos

ID11178239
AutoresMargaret E Kruk (0000-0002-9549-8432, University of Michigan, autor correspondente), Magdalena M Paczkowski (University of Michigan), Ayalew Tegegn (Jimma University), Fasil Tessema (Jimma University), Craig Hadley (0000-0001-8120-6665, Emory University), Mekonen Asefa (Jimma University), Sandro Galea (0000-0002-7534-0945, University of Michigan)
Ano2010
Volume64
Fascículo11
Páginas984-988
Data de publicação2010-11-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoJournal of Epidemiology and Community Health (JOURNAL)
Identificadores do periódicoISSN: 0143-005X • E-ISSN: 1470-2738
EditoraBMJ (PUBLISHER • GB)
DOI10.1136/jech.2009.087973
PMID19822558
OpenAlexW2130633309
IdiomaEN
Citações recebidas13
Referências citadas25

BACKGROUND: Delivery attended by skilled professionals is essential to reducing maternal mortality. Although the facility delivery rate in Ethiopia's rural areas is extremely low, little is known about which health system characteristics most influence women's preferences for delivery services. In this study, women's preferences for attributes of health facilities for delivery in rural Ethiopia were investigated. METHODS: A population-based discrete choice experiment (DCE) was fielded in Gilgel Gibe, in southwest Ethiopia, among women with a delivery in the past 5 years. Women were asked to select a hypothetical health facility for future delivery from two facilities on a picture card. A hierarchical Bayesian procedure was used to estimate utilities associated with facility attributes: distance, type of provider, provider attitude, drugs and medical equipment, transport and cost. RESULTS: 1006 women completed 8045 DCE choice tasks. Among them, 93.8% had delivered their last child at home. The attributes with the greatest influence on the overall utility of a health facility for delivery were availability of drugs and equipment (mean β=3.9, p<0.01), seeing a doctor versus a health extension worker (mean β=2.1, p<0.01) and a receptive provider attitude (mean β=1.4, p<0.01). CONCLUSION: Women in rural southwest Ethiopia who have limited personal experience with facility delivery nonetheless value health facility attributes that indicate high technical quality: availability of drugs and equipment and physician providers. Well-designed policy experiments that measure the contribution of quality improvements to facility delivery rates in Ethiopia and other countries with low health service utilisation and high maternal mortality may inform national efforts to reduce maternal mortality

Business · Developing country · Economic growth · Environmental health · Health care · Health facility · Health services · Population · Quality (philosophy) · Rural area · Service (business) · Service delivery framework · Economic and Environmental Valuation · Global Maternal and Child Health · Marketing · Maternal and Perinatal Health Interventions · Medicine