Factors behind Institutional Delivery Preference in the Republic of Benin: An Analysis of 2011-2012 Benin Demographic and Health Survey (BDHS) data
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Abstract
Background: Ending preventable maternal and newborn morbidity and mortality remains a core component of the Sustainable Development Goals (SDG) which is a continuation of the Millennium Development Goals (MDG). It has been documented that most women in developing countries give birth at home without the intervention of skilled attendants despite the prevailing multitude risks associated with childbirth for both mother and the unborn child. The study was aimed at identifying the most significant factors influencing selection of health facility based delivery among reproductive age mothers.
Data and methods: Data was obtained from Benin Demographic and Health Survey (BDHS) of 2011-2012 using percent distribution, binomial logistic regression and multinomial regression. Out of 16,599 interviewed only 9,111 were eligible for the present study.
Results: Most (76.0%) of the respondents gave birth at public health centers, 11% in private health centers and the rest outside health institutions. Out of 17 variables examined, 13 were found (using Akaike Information Criterion in a stepwise algorithm) to be the most important factors for institutional delivery. Among them, Antenatal Care (ANC) frequency, mother’s education, and household wealth index had most impact on institutional deliveries with positive and linear relationships. Most of the educated women (secondary or above) were more likely to give birth in a private health facility (Private Health OR=5.2, 95% CI 2.47-10.88; Public Health OR=3.7, 95% CI 1.82-7.6). Similar results were found among the richest women (Private Health OR=8.6, 95% CI 3.5-21.3; Public Health OR=4.4, 95% CI 1.90-10.4). Female education and economic status were the most important factors for institutional delivery preference.
Conclusion: Encouraging regular ANC visits (at least the four recommended visits), and girls’ education up to secondary school will help getting women to deliver in a well-equipped health facility. There is also a need to investigate thoroughly through qualitative researches reasons behind their preference of health facility for reproductive health services, including institutional delivery.
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• Abebe, F., Berhane, Y., & Girma B. (2012). Factors associated with home delivery in Bahirdar, Ethiopia: A case control study. BMC Research Notes, 5(653), 6.
• Amano, A., Gebeyehu, A., & Birhanu, Z. (2012). Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study. BMC Pregnancy and Childbirth, 12(105), 6.
• Anastasi, E., Borchert, M., Campbell, O.M.R., Sondorp, E., Kaducu, F., Hill, O., … Lange, I.L. (2015). Losing women along the path to safe motherhood: why is there such a gap between women’s use of antenatal care and skilled birth attendance? A mixed methods study in northern Uganda. BMC Pregnancy and Childbirth, 15(287). doi:10.1186/s12884-015-0695-9.
• Barros, F.C., Bhutta, Z.A., Batra, M., Hansen, T.N., Cesar, G.V., Craig, E.R., & GAPPS Review Group. (2010). Global report on preterm birth and stillbirth (3 of 7): evidence for eff ectiveness of interventions. BMC Pregnancy and Childbirth, 10 (Suppl 1), 13.
• Bhutta, Z.A., Cabral, S., Chan, C., & Keenan, W.J. (2012). Reducing maternal, newborn, and infant mortality globally: An integrated action agenda. International Journal of Gynecology and Obstetrics, 119(2012), 13-17.
• Borchert, M., Goufodji, S., Alihonou, E., Delvaux, T., Saizonou, J., Kanhonou, L., & Filippi, V. (2012). Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin. BMC Pregnancy and Childbirth, 12(109), 16. doi:10.1186/1471-2393-12-109.
• Boshara, R., Emmons, W.R., & Noeth, B.J. (2015). The demographics of wealth: How Age, education and race separate thrivers from strugglers in today’s economy. Essay No. 2: Education and Wealth.
• Byrne, A., Caulfield, T., Onyo, P., Nyagero, J., Morgan, A., Nduba, J., & Kermode, M. (2016). Community and provider perceptions of traditional and skilled birth attendants providing maternal health care for pastoralist communities in Kenya: a qualitative study. BMC Pregnancy and Childbirth, 10(43), 12. doi:10.1186/s12884-016-0828-9.
• Chiswick, B.R., & Mirtcheva, D.M. (2010). Religion and child health. IZA Discussion Papers (No. 5215).
• Dansou, J., Adekunle, A.O., & Arowojolu, A.O. (2017). Factors associated with the compliance of recommended first postnatal care services utilization among reproductive age women in Benin Republic: an analysis of 2011/2012 BDHS data. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6(4), 1161-1169. doi:10.18203/2320-1770.ijrcog20171378.
• Das, P., Mausumi, B., Tikadar, T., Biswas, G.C., Mridha, P., & Pal, R. (2010). Client satisfaction on maternal and child health services in rural Bengal. Indian J Community Med, 35(4), 478-481.
• De Allegri, M., Tiendrebéogo, J., Müller, O., Yé, M., Jahn, A., & Ridde, V. (2015). Understanding home delivery in a context of user fee reduction: a cross-sectional mixed methods study in rural Burkina Faso. BMC Pregnancy and Childbirth, 15(330), 13p. doi:DOI 10.1186/s12884-015-0764-0.
• de Graft-Johnson, J., Kerber, K., Tinker, A., Otchere, S., Narayanan, I., Shoo, R., Oluwole, D., & Lawn, J. (2006). The maternal, newborn, and child health: Continuum of care Opportunities for Africa's newborns: Practical data, policy and programmatic support for newborn care in Africa (pp. 23-36).
• De-Banguirys, S.L., Dansou, J., & Beninguisse, G. (2015, November 30 – December 04). Analyse des facteurs de non recours en première Consultation Prénatale lors des premières grossesses des adolescentes/jeunes à Yaoundé. Paper presented at the 7th African Population Conference, Pretoria, South Africa, 18p.
• Eker Harv T. (2005). Secrets of the millionnaire mind: mastering the inner game of wealth. Library of Congress Cataloging-in-Publication, Adobe Acrobat eBook Reader February 2005, ISBN 0-06-083194-4. 223p.
• Faye, A., Niane, M., & Ba, I. (2011). Home birth in women who have given birth at least once in a health facility: contributory factors in a developing country. Acta Obstet Gynecol Scand, 90(11).
• Feinstein, L., Sabates, R., Anderson, T.M., Sorhaindo, A., & Hammond, C. (2006). What are the effects of education on health? Measuring the effects of education on health and civic engagement: proceedings of the Copenhagen symposium (pp. 171-354): OECD.
• Ganle, J.K., Obeng, B., Segbefia, Alexander, Y., Mwinyuri, V., & Yeboah, J.Y. (2015). How intra-familial decision-making affects women’s access to, and use of maternal healthcare services in Ghana: a qualitative study. BMC Pregnancy and Childbirth, 15(173). doi:10.1186/s12884-015-0590-4.
• Higgins, C., Lavin, T., & Metcalfe, O. (2008). Health impacts of education, a review. Ireland:
• INSAE, & ICF. (2013). Rapport de l'Enquête Démographique et de Santé du Bénin 2011-2012. 575p.
• Kashitala, J., Nyambe, N., Mwalo, S., Musamba, J., Chishinga, N., Kasonde, P., … Welsh, M. (2015). Is male involvement in ANC and PMTCT associated with increased facility-based obstetric delivery in pregnant women? African Journal of Reproductive Health, 19(2), 117-224.
• Kesterton, A.J., Cleland, J., Sloggett, A., & Ronsmans, C. (2010). Institutional delivery in rural India: the relative importance of accessibility and economic status. BMC Pregnancy Childbirth, 10(30).
• Kitui, J., Lewis, J., & Davey, G. (2013). Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009. BMC Pregnancy and Childbirth, 13(40).
• Lerberg, P.M., Sundby, J., Jammeh, A., & Fretheim, A. (2014). Barriers to skilled birth attendance: A survey among mothers in rural Gambia. African Journal of Reproductive Health, 18(1), 35-43.
• Lincetto, O., Mothebesoane-Anoh, S., Gomez, P., & Munjanja, S. (2006). Antenatal care Opportunites for Africa's newborns: Pratical data, policy and programmatic support for newborn care in Africa (pp. 51-62): Partnership for Maternal, Newborn & Child Health (PMNCH).
• Lule, G.S., & Mtitimila, G.S. (1993). Intention to deliver and delivery outcome. Malawi Med J, 9(15).
• Mazalale, J., Kambala, C., Brenner, S., Jobiba C., Lohmann J., Mathanga, D.P., … De Allegri M. (2015). Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi. Tropical Medicine and International Health, 20(5), 617-625.
• Moyer, C.A., Dako-Gyeke, P., & Adanu, R.M. (2013). Facility-based delivery and maternal and early neonatal mortality in sub-Saharan Africa: A regional review of the literature. African Journal of Reproductive Health, 17(3), 30-41.
• Nganawara, D. (2016). Famille et scolarisation des enfants en âge obligatoire scolaire au Cameroun : Une analyse à partir du recensement de 2005. Retrieved from Québec:
• NPDHS. (2015). The importance of health and social well-being for the economy and other policy areas. Health is wealth and wealth is health, 10(8).
• OCS/MGEP, & DGAE/MEF. (2012). Impacts de la gratuite des soins de sante des enfants de 0 a 5 ans et des femmes enceintes sur la pauvrete, le social et les OMD. Cotonou, 105p.
• Ono, M., Matsuyama, A., Karama, M., & Honda, S. (2013). Association between social support and place of delivery: a cross-sectional study in Kericho, Western Kenya. BMC Pregnancy and Childbirth, 13(214), 9.
• Pervin, J., Mora, A., Rahman, M., Razzaque, A., Sibley, L., Streatfield, P.K., … Rahman, A. (2012). Association of antenatal care with facility delivery and perinatal survival – a population-based study in Bangladesh. BMC Pregnancy and Childbirth, 12(111), 12.
• Requejo, Jennifer, H., & Bhutta, Z.A. (2015). The post-2015 agenda: staying the course in maternal and child survival. Arch Dis Child, 100(Suppl 1), s76-s81. doi:10.1136/archdischild-2013-305737.
• Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A., Daniels, J., … Alkema, L. (2014). Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health, 2, e323–e333. doi:http://dx.doi.org/10.1016/ S2214-109X(14)70227-X.
• Shehu, C.E., Ibrahim, M.T.O., Oche, M.O., et al. (2016). Determinants of place of delivery: A comparison between an urban and a rural community in Nigeria. Journal of Public Health and Epidemiology, 8(6). doi:10.5897/JPHE2016.0817
• SIDA. (2002). Health is Wealth: Policy for Health and Development (91-586-8787-4).
• Tann, C.J., Kizza, M., Morison, L., Mabey, D., Muwanga, M., Grosskurth, H., & Elliott, A.M. (2007). Use of antenatal services and delivery care in Entebbe, Uganda: a community survey. BMC Pregnancy & Childbirth, 7(23).
• Tura, G., Fantahun, M., & Worku, A. (2013). The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis. BMC Pregnancy and Childbirth, 13(18).
• United Nations Development Programme. (2014). Sustaining Human Progress: Reducing Vulnerabilities and Building Resilience. Retrieved from UN Plaza, New York, NY 10017, USA:
• United Nations Children's Fund. (2009). The state of the world's children: 2009, maternal and new born. New York, USA.
• United Nations Children's fund. (2015). Levels & trends in Child mortality: Report 2015, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. United Nations Children’s Fund.
• World Health Organization. (2009). Stratégie de Coopération: Un appercu, Bénin. Santé et developpement, Benin.
• World Health Organization, United Nations International Children's Emergency Fund,
United Nations Fund for Population Activities, et al. (2015). Trends in maternal mortality: 1990 to 2015. World Health Organisation, Geneva, ISBN 978 92 4 156514 1.