TY - JOUR
T1 - Determinants of Skilled Delivery Assistance in a Rural Population
T2 - Findings from an HDSS Site of Rural West Bengal, India
AU - Ghosh, Saswata
AU - Siddiqui, Md Zakaria
AU - Barik, Anamitra
AU - Bhaumik, Sunil
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Objective: This study examines the determinants of utilisation of skilled birth attendants (SBAs) amongst 2886 rural women in the state of West Bengal, India, using data from a survey of 2012–2013 conducted by the Birbhum Health and Demographic Surveillance System. Method: Multilevel logit regression models were estimated and qualitative investigations conducted to understand the determinants of utilisation of SBAs in rural West Bengal. Results: Among women who delivered their last child during the 3 years preceding the survey, 69.1 % of deliveries were assisted by SBAs, while 30.9 % were home deliveries without any SBA assistance. Multivariate analysis revealed that apart from socio-demographic and economic factors (such as household affluence, women’s education, birth order, uptake of comprehensive ANC check-ups, advice regarding danger signs of pregnancy and household’s socio-religious affiliation), supply side factors, such as availability of skilled birth attendants in the village and all-weather roads, have significant effect on seeking skilled assistance. Our findings also show that unobserved factors at village level independently influence uptake of SBA-assisted delivery. Conclusions for Practice: The present findings emphasise that both demand and supply side intervention strategies are essential prerequisites to enhance skilled birth attendance. Ample communication is observed at the individual level, but improving community level outreach and advocacy activities could generate further demand. SBAs can be better integrated by accommodating the socio-religious needs of local communities, such as providing female doctors and doctors with similar socio-religious backgrounds.
AB - Objective: This study examines the determinants of utilisation of skilled birth attendants (SBAs) amongst 2886 rural women in the state of West Bengal, India, using data from a survey of 2012–2013 conducted by the Birbhum Health and Demographic Surveillance System. Method: Multilevel logit regression models were estimated and qualitative investigations conducted to understand the determinants of utilisation of SBAs in rural West Bengal. Results: Among women who delivered their last child during the 3 years preceding the survey, 69.1 % of deliveries were assisted by SBAs, while 30.9 % were home deliveries without any SBA assistance. Multivariate analysis revealed that apart from socio-demographic and economic factors (such as household affluence, women’s education, birth order, uptake of comprehensive ANC check-ups, advice regarding danger signs of pregnancy and household’s socio-religious affiliation), supply side factors, such as availability of skilled birth attendants in the village and all-weather roads, have significant effect on seeking skilled assistance. Our findings also show that unobserved factors at village level independently influence uptake of SBA-assisted delivery. Conclusions for Practice: The present findings emphasise that both demand and supply side intervention strategies are essential prerequisites to enhance skilled birth attendance. Ample communication is observed at the individual level, but improving community level outreach and advocacy activities could generate further demand. SBAs can be better integrated by accommodating the socio-religious needs of local communities, such as providing female doctors and doctors with similar socio-religious backgrounds.
KW - Birbhum HDSS
KW - Multilevel modelling
KW - Skilled birth attendant
KW - Supply side factors
KW - Unobserved heterogeneity
UR - http://www.scopus.com/inward/record.url?scp=84943362286&partnerID=8YFLogxK
U2 - 10.1007/s10995-015-1768-0
DO - 10.1007/s10995-015-1768-0
M3 - Article
SN - 1092-7875
VL - 19
SP - 2470
EP - 2479
JO - Maternal and Child Health Journal
JF - Maternal and Child Health Journal
IS - 11
ER -