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Who gives birth in private facilities in Asia? A look at six countries

Bibliographic Data

ID11490758
AuthorsA M Pomeroy (United States Agency for International Development), Marge Koblinsky (United States Agency for International Development), Soumya Alva (0000-0001-9404-1898, United States Agency for International Development)
Year2014
Volume29
Issuesuppl 1
Pagesi38-i47
Publication date2014-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czt103
PMID25012797
PMCIDPMC4095919
OpenAlexW2137606402
LanguageEN
Citations received3
References cited35

Over the past two decades, multilateral organizations have encouraged increased engagement with private healthcare providers in developing countries. As these efforts progress, there are concerns regarding how private delivery care may effect maternal health outcomes. Currently available data do not allow for an in-depth study of the direct effect of increasing private sector use on maternal health across countries. As a first step, however, we use demographic and health surveys (DHS) data to (1) examine trends in growth of delivery care provided by private facilities and (2) describe who is using the private sector within the healthcare system. As Asia has shown strong increases in institutional coverage of delivery care in the last decade, we will examine trends in six Asian countries. We hypothesize that if the private sector competes for clients based on perceived quality, their clientele will be wealthier, more educated and live in an area where there are enough health facilities to allow for competition. We test this hypothesis by examining factors of socio-demographic, economic and physical access and actual/perceived need related to a mother's choice to deliver in a health facility and then, among women delivering in a facility, their use of a private provider. Results show a significant trend towards greater use of private sector delivery care over the last decade. Wealth and education are related to private sector delivery care in about half of our countries, but are not as universally related to use as we would expect. A previous private facility birth predicted repeat private facility use across nearly all countries. In two countries (Cambodia and India), primiparity also predicted private facility use. More in-depth work is needed to truly understand the behaviour of the private sector in these countries; these results warn against making generalizations about private sector delivery care.

Birth attendant · Business · Competition (biology) · Developing country · Economic growth · Economics · Environmental health · Health care · Health facility · Health services · Maternal health · Population · Private sector · Quality (philosophy) · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine

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Unique citing works3
Citations per year0,38
Citation span2018 - 2025 (8)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 3

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