Evidence map›Paper›PMID 27316970›Full record

ArticleReproductive health2016

Inequalities in the coverage of place of delivery and skilled birth attendance: analyses of cross-sectional surveys in 80 low and middle-income countries.

Gary Joseph, Inácio Crochemore Mohnsam da Silva, Fernando C Wehrmeister, Aluísio J D Barros, Cesar G Victora

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In one paragraph

Article in Reproductive health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 4 pooled it
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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

45 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  4. Postpartum depression in India: a systematic review and meta-analysis.Bulletin of the World Health Organization · 2017
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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

5 authors.

Gary JosephInternational Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3o andar, Pelotas, RS, 96020-220, Brazil. gjoseph@equidade.org.ORCID http://orcid.org/0000-0002-9300-2069
Inácio Crochemore Mohnsam da SilvaInternational Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3o andar, Pelotas, RS, 96020-220, Brazil.
Fernando C WehrmeisterInternational Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3o andar, Pelotas, RS, 96020-220, Brazil.
Aluísio J D BarrosInternational Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3o andar, Pelotas, RS, 96020-220, Brazil.
Cesar G VictoraInternational Center for Equity in Health, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3o andar, Pelotas, RS, 96020-220, Brazil.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundHaving a health worker with midwifery skills present at delivery is one of the key interventions to reduce maternal and newborn mortality. We sought to estimate the frequencies of (a) skilled birth attendant coverage, (b) institutional delivery, and (c) the combination of place of delivery and type of attendant, in LMICs.

methodsNational surveys (DHS and MICS) performed in 80 LMICs since 2005 were analyzed to estimate these four categories of delivery care. Results were stratified by wealth quintile based on asset indices, and by urban/rural residence. The combination of place of delivery and type of attendant were also calculated for seven world regions.

resultsThe proportion of institutional SBA deliveries was above 90 % in 25 of the 80 countries, and below 40 % in 11 countries. A strong positive correlation between SBA and institutional delivery coverage (rho: 0.97, p <0,001) was observed. Eight countries had over 10 % of home SBA deliveries, and two countries had over 10 % of institutional non-SBA deliveries. Except for South Asia, all regions had over 80 % of urban deliveries in the institutional SBA category, but in rural areas, only two regions (CEE & CIS, Middle East & North Africa) presented average coverage above 80 %. In all regions, institutional SBA deliveries were over 80 % in the richest quintile. Home SBA deliveries were more common in rural than in urban areas, and in the poorest quintiles in all regions. Facility non-SBA deliveries also tended to be more common in rural areas and among the poorest.

conclusionFour different categories of delivery assistance were identified worldwide. Pro-urban and pro-rich inequalities were observed for coverage of institutional SBA deliveries.

Indexed as

Delivery, ObstetricDeveloping CountriesFemaleHealthcare DisparitiesHealth FacilitiesHealth Services AccessibilityHome ChildbirthHumansIncomeMidwiferyPovertyPregnancySocioeconomic FactorsBirth attendanceDelivery assistanceDeveloping countriesGlobal healthLow and middle-income countriesMaternal health servicesSkilled birth attendanceSkilled delivery

Identifiers

PMID27316970
PMCPMC4912761

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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.