A META-ANALYSIS OF SOCIO-DEMOGRAPHIC FACTORS PREDICTING BIRTH IN HEALTH FACILITY

Abstract

BACKGROUND: The low proportion of health facility delivery in developing countries is one of themain challenges in achieving the Millennium Development Goal of a global reduction of maternaldeaths by 75% by 2015. There are several primary studies which identified socio-demographic and otherpredictors of birth in health facility. However, there are no efforts to synthesis the findings of thesestudies. The objective of this meta-analysis was to determine the strength of the association of birth in thehealth facility with selected sociodemographic factors.METHODS: A meta-analysis of Mantel–Haenszel odds ratios was conducted by including 24 articleswhich were reported between 2000 and 2013 from developing countries. A computer-based search wasdone from MEDLINE, African Journals Online, Google Scholar and HINARI databases. Includedstudies did compare the women’s’ health facility delivery in relation to their selected socio-demographiccharacteristics.RESULTS: The pooled analysis demonstrated association of health facility delivery with living in urbanareas (OR = 9.8), secondary and above educational level of the parents (OR = 5.0), middle to high wealthstatus (OR = 2.3) and first time pregnancy (OR = 2.8). The risk of delivering outside the health facilitywas not significantly associated with maternal age (teenage vs 20 years and above) and marital status.The distance of pregnant women’s residence from the health facility was found to have an inverserelation to the proportion of health facility delivery.CONCLUSION: Although the present meta-analysis identified several variables which were associatedwith an increase in health facility delivery, the most important predictor of birth in the health facilityamenable to intervention is educational status of the parents to be. Therefore, formal and informaleducation to women and family members on the importance of health facility delivery needs to bestrengthened. Improving the wealth status of the population across the world may not be achieved soon,but should be in the long-term strategy to increase the birth rate in the health facility.