The proportion of births attended by an untrained attendant, including traditional this site midwives, was highest in Bangladesh (76.9 percent) and lowest in India (46.9 percent). There was no discernible difference in births attended by untrained personnel between South Asia and Sub-Saharan Africa. In South Asia, most of the deliveries by trained attendants were conducted by doctors, but nurses were the main birth attendants in the three Sub-Saharan African countries (Figure 2).Figure 2Percentage distribution of the type of birth attendant by country.3.3. Determinants of the Use of Health Facilities and Services for DeliveryLogistic regressions were used to examine the determinants of the use of health facilities for childbirth in the multivariate context (Table 2).
In all the six countries under study, place of residence, educational level of women and their husbands, wealth index, women’s exposure to media, maternal age, and birth parity had significant effects on the use of a health facility for delivery. In Tanzania and India, rural women were only half as likely as urban women to deliver in a health facility, but the urban-rural effect was much smaller in Nigeria, where rural women were 24 percent less likely than urban women to give birth in a health facility.Table 2Logistic regression on ��using health facility for delivery in the past 5 years�� by selected variables.Utilization of health facilities for delivery also varied widely by region within each country, probably due to the uneven distribution of hospitals, health centers, and clinics, with concentration in the more developed regions.
More detailed tabulations of DHS data show that women from the more developed regions were much more likely than those from the less developed region to deliver in a health facility. In all countries, rural women were much less likely than urban women to use a health facility for delivery (11.6 percent versus 26.5 percent in Bangladesh, 18.2 percent versus 99.3 percent in India, 21.2 percent versus 44.6 percent in Pakistan, 21.2 percent versus 88.6 percent in Kenya, 8.3 percent versus 70.7 percent in Nigeria, and 22.9 percent versus 72.1 percent in Tanzania).In all the six countries, women who had never been to school were least likely to have institutional delivery, while those with at least secondary education were most likely to do so.
The educational effect on institutional delivery was weakest in Tanzania. In Nigeria and all the three countries in South Asia, the effect of the wife’s education on the use of a health facility for childbirth was much stronger than that of the husband’s education.The odds of using a health facility for delivery were about the same for both working and nonworking women in Tanzania and the three South Asian countries. Cilengitide In these four countries, higher educated women were less likely to work as compared to their lesser educated counterparts.