Correlates of preferences for home or hospital confinement in Pakistan: evidence from a national survey

Abstract

BackgroundDespite the pregnancy complications related to home births, homes remain yet major place of delivery in Pakistan and 65 percent of totals births take place at home. This work analyses the determinants of place of delivery in Pakistan.MethodsMultivariate Logistic regression is used for analysis. Data are extracted from Pakistan Demographic and Health Survey (2006–07). Based on information on last birth preceding 5 years of survey, we construct dichotomous dependent variable i.e. whether women deliver at home (Coded=1) or at health facility (coded=2).ResultsBivariate analysis shows that 72% (p≤0.000) women from rural area and 81% women residing in Baluchistan delivered babies at home. Furthermore 75% women with no formal education, 81% (p≤0.000) women working in agricultural sector, 75% (p≤0.000) of Women who have 5 and more children and almost 77% (p≤0.000) who do not discussed pregnancy related issues with their husbands are found delivering babies at home. Multivariate analysis documents that mothers having lower levels of education, economic status and empowerment, belonging to rural area, residing in provinces other than Punjab, working in agriculture sector and mothers who are young are more likely to give births at home.ConclusionA trend for home births, among Pakistani women, can be traced in lower levels of education, lower autonomy, poverty driven working in agriculture sector, higher costs of using health facilities and regional backwardness.

Determinants of home delivery in Nepal – A disaggregated analysis of marginalised and non-marginalised women from the 2016 Nepal Demographic and Health Survey

“…Factors like cultural and religious beliefs might have been stronger in rural areas among marginalised groups. This finding is consistent with other studies [31,33].…”

“…We could not find any previous studies comparing factors associated with home delivery disaggregated by ethnicity in Nepal. However, several studies demonstrated statistically significant associations of home delivery with mothers age at birth [31], educational level of the mother [32][33][34], wealth status [31,33], province [33], place of residence [31,33], travel time to nearest health facility [32,34,35], and completion of four ANC visits as per national protocol [31,32,34,36].…”

Predictors of decision making about childbirth setting in the southeast of Iran: home or hospital

“…The results of the present study, in line with Javed et al (2013), showed that if women consult with others, and especially about their advice regarding childbirth setting, the likelihood of hospital births will increase. In fact, this shows the social influence of group attachment on personal preferences and individual decisions (Lindstrom and Muñoz-Franco 2006).…”

“…In accordance with Javed et al (2013) in Pakistan, mothers of Baluch ethnicity are more likely to deliver at home owing to strong cultural norms. Furthermore, when such cultural norms are accompanied by past positive experiences, the likelihood of homebirth will increase.…”

“…Jomeen (2010) noted that women are considered to be consumers of maternity services and commodification of giving birth, which is extended to the childbirth setting. Actually, this expectation and image is a part of today's life and ritual of giving birth, and women may feel short-changed if they do not Along with previous studies (Javed et al 2013;Moyer et al 2013), the present study showed that insurance coverage can increase the odds of hospital birth, yet it cannot necessarily guarantee hospital birth (Abed Saeedi et al 2013;Ghazi Tabatabaie et al 2012). Two pivotal issues exist.…”