ArticleBMJ global health2022
The impact of institutional delivery on neonatal and maternal health outcomes: evidence from a road upgrade programme in India.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Person-centred maternity care during childbirth: a systematic review in low and middle-income countries.BMC pregnancy and childbirth · 2025Pooled it
- Understanding the perspective of traditional healers on their role within the Malawian healthcare system: a qualitative study in Thyolo District.BMC complementary medicine and therapies · 2026Article
- Impact of a long-term mentorship program for childbirth providers on quality of care: A cluster randomized controlled trial.PLOS global public health · 2026Article
- Machine learning to predict the role of CHWs in shifting birth preferences away from homebirth in India.Scientific reports · 2025Article
- Home birth and its associated factors among mothers aged 15-49 years in Somalia: a nationwide population-based cross-sectional study.BMC women's health · 2025Article
- Improving complex health systems and lived environments for maternal and perinatal well-being in urban sub-Saharan Africa: the UrbanBirth Collective.Journal of global health · 2025Article
- Institutional delivery and its determinants among reproductive-age women in Mozambique: A geographic weighted regression.PLOS global public health · 2025Article
- Determinants of public institutional births in India: An analysis using the National Family Health Survey (NFHS-5) factsheet data.Journal of family medicine and primary care · 2024Article
- Structural capacity and continuum of snakebite care in the primary health care system in India: a cross-sectional assessment.BMC primary care · 2023Article
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2 authors at 1 institution in 1 country.
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Abstract
introductionPersistently high rates of neonatal and maternal mortality have been associated with home births in many low-income and middle-income countries (LMICs). However, causal evidence of the effect of institutional deliveries on neonatal and maternal health outcomes is limited in these settings.
methodsWe investigate the effect of institutional deliveries on neonatal mortality and maternal postpartum complications in rural India using data from the 2015-2016 Indian Demographic and Health Survey and an instrumental variable methodology to overcome selection bias issues inherent in observational studies. Specifically, we exploit plausibly exogenous variation in exposure to a road upgrade programme that quasi-randomly upgraded roads to villages across India.
resultsWe find large effects of the road construction programme on the probability that a woman delivered in a health facility: moving from an unconnected village to a connected village increased the probability of an institutional delivery by 13 percentage points, with the biggest increases in institutional delivery observed in public hospitals and among women with lower levels of education and from poorer households. However, we find no evidence that increased institutional delivery rates improved rates of neonatal mortality or postpartum complications, regardless of whether the delivery occurred in a public or private facility, or if it was with a skilled birth attendant.
conclusionPolicies that encourage institutional delivery do not always translate into increased health outcomes and should thus be complemented with efforts to improve the quality of care to improve neonatal and maternal health outcomes in LMICs.
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