ArticlePloS one2020
Eliciting women's preferences for place of child birth at a peri-urban setting in Nairobi, Kenya: A discrete choice experiment.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Preferences of women for maternal healthcare services in low-income and middle-income countries: a systematic review of discrete choice experiments.BMJ global health · 2025Pooled it
- The Evolving Landscape of Discrete Choice Experiments in Health Economics: A Systematic Review.PharmacoEconomics · 2025Pooled it
- Stated Preference Research in Reproductive and Maternal Healthcare Services in Sub-Saharan Africa: A Systematic Review.The patient · 2022Pooled it
- Preferences of Women for Maternal Health Services in Sidama Region, Ethiopia: Discrete Choice Experiment.Applied health economics and health policy · 2026Article
- Examining national health insurance fund members' preferences and trade-offs for the attributes of contracted outpatient facilities in Kenya: A discrete choice experiment.PLOS global public health · 2025Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMaternal and newborn mortality rates are high in peri-urban areas in cities in Kenya, yet little is known about what drives women's decisions on where to deliver. This study aimed at understanding women's preferences on place of childbirth and how sociodemographic factors shape these preferences.
methodsThis study used a Discrete Choice Experiment (DCE) to quantify the relative importance of attributes on women's choice of place of childbirth within a peri-urban setting in Nairobi, Kenya. Participants were women aged 18-49 years, who had delivered at six health facilities. The DCE consisted of six attributes: cleanliness, availability of medical equipment and drug supplies, attitude of healthcare worker, cost of delivery services, the quality of clinical services, distance and an opt-out alternative. Each woman received eight questions. A conditional logit model established the relative strength of preferences. A mixed logit model was used to assess how women's preferences for selected attributes changed based on their sociodemographic characteristics.
results411 women participated in the Discrete Choice Experiment, a response rate of 97.6% and completed 20,080 choice tasks. Health facility cleanliness was found to have the strongest association with choice of health facility (β = 1.488 p<0.001) followed respectively by medical equipment and supplies availability (β = 1.435 p<0.001). The opt-out alternative (β = 1.424 p<0.001) came third. The attitude of the health care workers (β = 1.347, p<0.001), quality of clinical services (β = 0.385, p<0.001), distance (β = 0.339, p<0.001) and cost (β = 0.0002 p<0.001) were ranked 4th to 7th respectively. Women who were younger and were the main income earners having a stronger preference for clean health facilities. Older married women had stronger preference for availability of medical equipment and kind healthcare workers.
conclusionsWomen preferred both technical and process indicators of quality of care. DCE's can lead to the development of person-centered strategies that take into account the preferences of women to improve maternal and newborn health outcomes.
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