From: Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review
Antenatal care factor | Country in which it was studied | Direction of influence | Cites |
---|---|---|---|
Attended ANC | Kenya | ANC attendance linked to higher likelihood of FBD | [31] |
Timing of first ANC visit (early onset of ANC) | Tanzania; Ghana | Earlier ANC initiation linked to greater likelihood of FBD; Later ANC linked to FBD | |
Number of ANC visits | Burkina Faso; Ghana; Ivory Coast; Kenya; Malawi; Tanzania | Fewer ANC visits linked to lower likelihood of FBD; 3+, 4+ visits linked to higher rates of FBD | |
Saw doctor at ANC | Ghana | Seeing a doctor at ANC linked to greater FBD | |
Quality of ANC | Ghana | Higher perceived quality linked to greater FBD | [54] |
Being advised to deliver in a facility during ANC | Ghana; Kenya; Tanzania | Higher likelihood of FBD | |
FACILITY FACTOR | Â | Â | Â |
Distance to facility | Burkina Faso; Ghana; Kenya; Malawi; Mali; Nigeria; Senegal; Tanzania; Uganda; Zambia | Greater distance, lower likelihood of FBD | |
Cost | Ghana; Nigeria; Uganda | Greater cost associated with lower likelihood of FBD | |
Promptness of care | Nigeria | Perception of promptness of care linked to greater utilization | [48] |
Perceived quality of delivery care | Ghana; Nigeria; Tanzania | Individual perceptions about higher quality of care linked to higher FBD rates. One study showed no relationship between community perceptions of quality and individual FBD | |
Presence of any provider, presence of OB/GYN, 24-hour availability of provider | Nigeria | Higher likelihood of FBD | |
Availability of medicine, equipment, emergency obstetric care | Nigeria; Tanzania; Uganda; Zambia | Increased FBD when medicine, equipment, higher level of emergency obstetric care available | |
Staff attitudes / behavior | Nigeria; Swaziland; Tanzania; Uganda | Negative staff attitudes, abusive treatment at hands of HCPs related to lower FBD | |
Culturally unacceptable | Nigeria; Swaziland | Less likely to deliver in a facility | |
Previous delivery with male provider | Senegal | Less likely to deliver in a facility | [62] |
Electricity, running water, radio communication at facility | Uganda | Presence of infrastructure linked to higher FBD rates | [53] |
MACRO-LEVEL FACTOR | Â | Â | Â |
Government share of health care spending | 42 low-income countries | Greater percentage of government spending, greater likelihood of SBA | [23] |
Female literacy rates (education) | 42 low-income countries | Higher rates of female literacy in a country associated with higher rates of SBA | |
Total health expenditures per capita | 42 low-income countries | Higher total health expenditures per capita associated with higher rates of SBA | |
Gross national income per capita | 21 sub-Saharan African countries | Higher gross national income per capita linked to FBD | [20] |