ArticlePloS one2021
Urban-rural disparities in institutional delivery among women in East Africa: A decomposition analysis.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Who gets to deliver in a health facility? An investigation of wealth-based inequities in institutional delivery in Ghana.BMJ open · 2026Article
- Comparison of urban-rural inequality in quality antenatal care among women in Bangladesh and Pakistan: a multivariable decomposition analysis.Reproductive health · 2026Article
- Urban-rural disparities in receipt of treatment for obstetric complications in Ethiopia: A multivariate decomposition analysis.PloS one · 2026Article
- Socioeconomic inequalities in institutional delivery in Ethiopia: a decomposition analysis of EDHS data (2011-2019).BMC health services research · 2025Article
- Inequality in Utilization of Maternal Healthcare Services in Low‑ and Middle‑Income Countries: A Scoping Review of the Literature.Maternal and child health journal · 2025Article
- Residence-based disparities of composite index of anthropometric failures in East African under five children; multivariate decomposition analysis.BMC public health · 2025Article
- Institutional delivery and its determinants among reproductive-age women in Mozambique: A geographic weighted regression.PLOS global public health · 2025Article
- Article
- Expression of Concern: Urban-rural disparities in institutional delivery among women in East Africa: A decomposition analysis.PloS one · 2025Article
- Article
- Impacts of COVID-19 on reproductive health service provision, access, and utilization in Ethiopia: Results from a qualitative study with service users, providers, and stakeholders.PLOS global public health · 2023Article
- Article
- Prevalence and determinants of home delivery in urban and rural Philippines: Evidence from the 2017 National Demographic and Health Survey.Women's health (London, England)Article
Corrections and comments
- Expression of concern
Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThough institutional delivery plays a significant role in maternal and child health, there is substantial evidence that the majority of rural women have lower health facility delivery than urban women. So, identifying the drivers of these disparities will help policy-makers and programmers with the reduction of maternal and child death.
methodsThe study used the data on a nationwide representative sample from the most recent rounds of the Demographic and Health Survey (DHS) of four East African countries. A Blinder-Oaxaca decomposition analysis and its extensions was conducted to see the urban-rural differences in institutional delivery into two components: one that is explained by residence difference in the level of the determinants (covariate effects), and the other components was explained by differences in the effect of the covariates on the outcome (coefficient effects).
resultsThe findings showed that institutional delivery rates were 21.00% in Ethiopia, 62.61% in Kenya, 65.29% in Tanzania and 74.64% in Uganda. The urban-rural difference in institutional delivery was higher in the case of Ethiopia (61%), Kenya (32%) and Tanzania (30.3%), while the gap was relatively lower in the case of Uganda (19.2%). Findings of the Blinder-Oaxaca decomposition and its extension showed that the covariate effect was dominant in all study countries. The results were robust to the different decomposition weighting schemes. The frequency of antenatal care, wealth and parity inequality between urban and rural households explains most of the institutional delivery gap.
conclusionsThe urban-rural institutional delivery disparities were high in study countries. By identifying the underlying factors behind the urban-rural institutional birth disparities, the findings of this study help in designing effective intervention measures targeted at reducing residential inequalities and improving population health outcomes. Future interventions to encourage institutional deliveries to rural women of these countries should therefore emphasize increasing rural women's income, access to health care facilities to increase the frequency of antenatal care utilization.
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