ArticleBMC health services research2016
What is the role of community capabilities for maternal health? An exploration of community capabilities as determinants to institutional deliveries in Bangladesh, India, and Uganda.
Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Enhancing Service Quality and Empowerment in Government Clinics Through Continuous Quality Improvement of Community Score Cards: A Case Study From the Dominican Republic.Global health, science and practice · 2026Article
- Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh.International journal for equity in health · 2020Article
- Factors influencing institutional delivery and the role of accredited social health activist (ASHA): a secondary analysis of India human development survey 2012.BMC pregnancy and childbirth · 2020Article
- "Midwives do not appreciate pregnant women who come to the maternity with torn and dirty clothing": institutional delivery and postnatal care in Torit County, South Sudan: a mixed method study.BMC pregnancy and childbirth · 2020Article
- Studying social accountability in the context of health system strengthening: innovations and considerations for future work.Health research policy and systems · 2019Article
- Organising Concepts of 'Women's Empowerment' for Measurement: A Typology.Social indicators research · 2019Article
- Unlocking community capabilities across health systems in low- and middle-income countries: lessons learned from research and reflective practice.BMC health services research · 2016Article
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7 authors.
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Abstract
backgroundWhile community capabilities are recognized as important factors in developing resilient health systems and communities, appropriate metrics for these have not yet been developed. Furthermore, the role of community capabilities on access to maternal health services has been underexplored. In this paper, we summarize the development of a community capability score based on the Future Health System (FHS) project's experience in Bangladesh, India, and Uganda, and, examine the role of community capabilities as determinants of institutional delivery in these three contexts.
methodsWe developed a community capability score using a pooled dataset containing cross-sectional household survey data from Bangladesh, India, and Uganda. Our main outcome of interest was whether the woman delivered in an institution. Our predictor variables included the community capability score, as well as a series of previously identified determinants of maternal health. We calculate both population-averaged effects (using GEE logistic regression), as well as sub-national level effects (using a mixed effects model).
resultsOur final sample for analysis included 2775 women, of which 1238 were from Bangladesh, 1199 from India, and 338 from Uganda. We found that individual-level determinants of institutional deliveries, such as maternal education, parity, and ante-natal care access were significant in our analysis and had a strong impact on a woman's odds of delivering in an institution. We also found that, in addition to individual-level determinants, greater community capability was significantly associated with higher odds of institutional delivery. For every additional capability, the odds of institutional delivery would increase by up to almost 6 %.
conclusionIndividual-level characteristics are strong determinants of whether a woman delivered in an institution. However, we found that community capability also plays an important role, and should be taken into account when designing programs and interventions to support institutional deliveries. Consideration of individual factors and the capabilities of the communities in which people live would contribute to the vision of supporting people-centered approaches to health.
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