Household decision-making about delivery in health facilities: evidence from Tanzania

J Health Popul Nutr. 2009 Oct;27(5):696-703. doi: 10.3329/jhpn.v27i5.3781.

Abstract

This study investigated how partners' perceptions of the healthcare system influence decisions about delivery-location in low-resource settings. A multistage population-representative sample was used in Kasulu district, Tanzania, to identify women who had given birth in the last five years and their partners. Of 826 couples in analysis, 506 (61.3%) of the women delivered in the home. In multivariate analysis, factors associated with delivery in a health facility were agreement of partners on the importance of delivering in a health facility and agreement that skills of doctors are better than those of traditional birth attendants. When partners disagreed, the opinion of the woman was more influential in determining delivery-location. Agreement of partners regarding perceptions about the healthcare system appeared to be an important driver of decisions about delivery-location. These findings suggest that both partners should be included in the decision-making process regarding delivery to raise rates of delivery at facility.

MeSH terms

  • Adult
  • Attitude to Health*
  • Delivery, Obstetric / statistics & numerical data*
  • Dissent and Disputes*
  • Female
  • Health Facilities / statistics & numerical data*
  • Humans
  • Interpersonal Relations*
  • Interviews as Topic
  • Male
  • Middle Aged
  • Midwifery
  • Physicians
  • Pregnancy
  • Professional Competence
  • Sex Factors
  • Spouses*
  • Tanzania
  • Young Adult