SynthesisPloS one2018
The impact of geographic access on institutional delivery care use in low and middle-income countries: Systematic review and meta-analysis.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Utilization of maternal healthcare services in low- and middle-income countries: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Worldwide Wellness of Mothers and Babies (WWOMB): program overview and lessons learned from Ethiopia.Archives of public health = Archives belges de sante publique · 2024Pooled it
- Pooled it
- Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis.International journal of public health · 2019Pooled it
- Quality of Life, Symptom Burden, and Associated Factors Among Patients With Lung Cancer in Sub-Saharan Africa: Cross-Sectional Study.JMIR cancer · 2026Article
- Why Do Parents Take Their Children to Informal Healthcare Providers? Insights from Bangladesh.The American journal of tropical medicine and hygiene · 2026Article
- Factors influencing decision-making for facility-based childbirth in rural Nepal: a qualitative study.BMJ public health · 2026Article
- Spatio-temporal patterns of health service delivery and access to maternal, child, and outpatient healthcare in Volta region, Ghana: a repeated cross-sectional ecological study using health facility data.Global health action · 2025Article
- Access and satisfaction with healthcare services among chronic disease patients during the Sudan armed conflict: a cross-sectional study.Conflict and health · 2025Article
- Past, current status, and future trends of the rural healthcare network in the Republic of Kazakhstan.Scientific reports · 2025Article
- Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study.BMJ open · 2025Article
- Spatial profiling of geographical accessibility to maternal healthcare and coverage of maternal health service utilisation in Nepal: a geospatial analysis based on demographic and health survey.BMJ global health · 2025Article
- Qualitative application of the diffusion of innovation theory to maternity waiting homes in rural Zambia.Implementation science communications · 2025Article
- Paediatric anaemia in rural Kenya and the role of travel time to emergency care services.Frontiers in epidemiology · 2025Article
- Patient journey and timeliness of care for patients with breast cancer in Africa: a scoping review protocol.BMJ open · 2024Article
- Determinants of hemoglobin level and time to default from Highly Active Antiretroviral Therapy (HAART) for adult clients living with HIV under treatment; a retrospective cohort study design.Scientific reports · 2024Article
- Maternal delay for institutional delivery and associated factors among postnatal mothers at Southeastern Ethiopia: a cross sectional study.BMC pregnancy and childbirth · 2024Article
- Inequity in the face of success: understanding geographic and wealth-based equity in success of facility-based delivery for under-5 mortality reduction in six countries.BMC pediatrics · 2024Article
- Predicting place of delivery choice among childbearing women in East Africa: a comparative analysis of advanced machine learning techniques.Frontiers in public health · 2024Article
- Time to antenatal care booking and its predictors among pregnant women in East Africa: a Weibull gamma shared frailty model using a recent demographic and health survey.Frontiers in global women's health · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeographic access to obstetric care facilities has a significant influence on women's uptake of institutional delivery care. However, this effect was not consistent across studies. Some studies reported that geographic access to obstetric care facilities had no influence on the use of facility delivery. Therefore, this systematic review and meta-analysis synthesized and pooled the influence of geographic access on institutional delivery service uptake in low and middle-income countries.
methodsMultiple combinations of search terms were used to search articles from six databases and a hand search of reference lists performed. We included observational studies conducted in low and middle-income countries which reported the influence of geographic access on delivery care use. The pooled effects of geographic access on institutional delivery care use were calculated using a random-effects model with a 95% confidence interval.
findingsIn this study a total of 31 studies were included. Among these studies, 15 met criteria for inclusion in the meta-analyses, while the remaining 16 were summarized using qualitative synthesis. Studies included in the analysis where women had to walk 60 minutes or less to access a health facility delivery were significantly heterogeneous. Having access to obstetric care facilities within five kilometres was significantly associated with institutional deliveries (pooled OR = 2.27; 95% CI = 1.82, 2.82). Similarly, a travelling time of 60 minutes or less was significantly associated with higher odds of health facility delivery (pooled OR = 3.30; 95% CI = 1.97, 5.53). Every one-hour and one-kilometre increase in travel time and distance, respectively, was negatively associated with institutional delivery care use.
interpretationGeographic access measured in either physical distance and/or travel time was significantly associated with women's use of facility delivery. The greater the distance and/or travel time to obstetric care facilities, the greater the barrier and the lesser the service uptake.
Indexed as
Identifiers
What OpenQuestion holds
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.