Evidence map›Paper›PMID 25656750›Full record

ArticleTropical medicine & international health : TM & IH2015

Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi.

Jacob Mazalale, Christabel Kambala, Stephan Brenner, Jobiba Chinkhumba, Julia Lohmann, Don P Mathanga, Bjarne Robberstad, Adamson S Muula, Manuela De Allegri

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Article in Tropical medicine & international health : TM & IH, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jacob MazalaleInstitute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
Christabel KambalaInstitute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
Stephan BrennerInstitute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
Jobiba ChinkhumbaSchool of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Julia LohmannInstitute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
Don P MathangaSchool of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Bjarne RobberstadCentre for International Health, University of Bergen, Bergen, Norway.
Adamson S MuulaSchool of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Manuela De AllegriInstitute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify factors associated with delivery outside a health facility in rural Malawi.

methodA cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility.

resultsOf the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086-3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28-0.95) and fourth-quartile OR = 0.48; 95% CI (0.29-0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23-0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96-2.14)] and multigravidae [OR = 1.14; 95% CI (0.98-1.73)] were more likely to deliver outside a health facility at 10% level of significance.

conclusionAbout 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users.

Indexed as

accouchement dans un établissementaccoucheuses qualifiéesÁfrica subsaharianaAfrique subsahariennecuidados maternos: parto intrahospitalariofacility-based deliveryMalawimaternal carepartera cualificadasanté maternelleskilled birth attendancesub-Saharan Africa

Identifiers

PMID25656750
PMCPMC4433497

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.