SynthesisReproductive health2013
Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review.
Synthesis in Reproductive health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 223 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of the Safe Childbirth Checklist on Health Worker Childbirth Practices in Luapula Province of Zambia
Addressing Provider Stress and Unconscious Bias to Improve Quality of Maternal Health Care
Caring for Providers to Improve Patient Experience (CPIPE) Study: A Cluster Randomized-controlled Trial to Assess the Impact of the CPIPE Intervention on Person-centered Maternity Care
Who cites it
223 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Gendered experiences of people living with tuberculosis or leprosy: A global systematic review.PLoS neglected tropical diseases · 2026Pooled it
- Community-Based Impact of Community-Based Antenatal Care Models on Prevention and Early Detection of Obstetric Complications: A Systematic Review.Annals of global health · 2026Pooled it
- Utilization of maternal healthcare services in low- and middle-income countries: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Predictors of institutional delivery service utilization in Ethiopia: an umbrella review.BMC pregnancy and childbirth · 2025Pooled it
- Factors affecting utilization of antenatal care in Ethiopia: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Meeting need vs. sharing the market: a systematic review of methods to measure the use of private sector family planning and childbirth services in sub-Saharan Africa.BMC health services research · 2018Pooled it
- Complications associated with adolescent childbearing in Sub-Saharan Africa: A systematic literature review and meta-analysis.PloS one · 2018Pooled it
- Access barriers to obstetric care at health facilities in sub-Saharan Africa-a systematic review.Systematic reviews · 2017Pooled it
- Pooled it
- Spatial variability in factors influencing maternal health service use in Jimma Zone, Ethiopia: a geographically-weighted regression analysis.BMC health services research · 2021Trial
- Effectiveness of upgraded maternity waiting homes and local leader training on improving institutional births: a cluster-randomized controlled trial in Jimma, Ethiopia.BMC public health · 2020Trial
- Effect of a maternal and newborn health system quality improvement project on the use of facilities for childbirth: a cluster-randomised study in rural Tanzania.Tropical medicine & international health : TM & IH · 2019Trial
- Trial
- Determinants of facility based-deliveries among urban slum dwellers of Kampala, Uganda.PloS one · 2019Trial
- The impact of community health worker-led home delivery of antiretroviral therapy on virological suppression: a non-inferiority cluster-randomized health systems trial in Dar es Salaam, Tanzania.BMC health services research · 2017Trial
- Factors Associated With Maternal Health Care Facilities Utilization in the Slum Communities of Kathmandu Valley, Nepal: A Cross-Sectional Study.Health science reports · 2026Article
- Prevalence and risk factors of home delivery among rural women: evidence from 28 African countries.Reproductive health · 2026Article
- Introducing a group antenatal care model at the health post level in Ethiopia: a qualitative pilot study.Pilot and feasibility studies · 2026Article
- Mapping health-related quality of life measurement tools in Africa: a scoping review.Journal of patient-reported outcomes · 2026Article
- Who gets to deliver in a health facility? An investigation of wealth-based inequities in institutional delivery in Ghana.BMJ open · 2026Article
163 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
While the most important factors associated with facility-based delivery (FBD) have been explored within individual countries in Africa, no systematic review has explored the factors associated with FBD across sub-Saharan Africa. A systematic search of the peer-reviewed literature was conducted to identify articles published in English from 1/1995-12/2011 that reported on original research conducted entirely or in part in sub-Saharan Africa and included a primary outcome variable of FBD, delivery location, or skilled birth attendance (SBA). Out of 1,168 citations identified, 65 met inclusion criteria. 62 of 65 were cross-sectional, and 58 of 65 relied upon household survey data. Fewer than two-thirds (43) included multivariate analyses. The factors associated with facility delivery were categorized as maternal, social, antenatal-related, facility-related, and macro-level factors. Maternal factors were the most commonly studied. This may be a result of the overwhelming reliance on household survey data - where maternal sociodemographic factors are likely to be well-represented and non-maternal factors may be less consistently and accurately represented. Multivariate analysis suggests that maternal education, parity / birth order, rural / urban residence, household wealth / socioeconomic status, distance to the nearest facility, and number of antenatal care visits were the factors most consistently associated with FBD. In conclusion, FBD is a complex issue that is influenced by characteristics of the pregnant woman herself, her immediate social circle, the community in which she lives, the facility that is closest to her, and context of the country in which she lives. Research to date has been dominated by analysis of cross-sectional household survey data. More research is needed that explores regional variability, examines longitudinal trends, and studies the impact of interventions to boost rates of facility delivery in sub-Saharan Africa.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.