Aspects of a community's sociocultural and economic environment appear to influence a woman's use of modern contraceptive methods.

Studies of maternal health seeking behaviour have focused on individual and household level factors. This analysis examines community level influences on the decision to deliver a child in a health facility across six African countries.Demographic and Health Survey data are linked with contextual data, and multilevel models are fitted to identify the determinants of childbirth in a health facility in the six countries. There are strong community level influences on a woman's decision to deliver her child in a health facility. Several pathways of influence between the community and individual were identified. Community economic development, the climate of female autonomy, service provision and fertility preferences all exert an influence on a woman's decision to seek care during labour, although significant community variation remains unexplained.

No abstract

Need and supply factors influence service use as expressed as acceptance onto RRT. Pressure to expand RRT services needs to be aimed at areas with large minority ethnic populations and those living far from existing units.