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Determinants of Institutional Delivery Among Women of Childbearing Age in Rural Haiti

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Abstract

Institutional delivery is an important factor associated with reduced maternal mortality rate (MMR). MMR in Haiti is high (350 per 100,000) and institutional delivery is low—just over 25 % of women delivered at a health facility in 2010. There also exists substantial rural–urban disparity in delivery with more hospital deliveries in urban than in rural areas. We aimed to study the prevalence and determinants of institutional delivery in a sample of women of childbearing age in rural Haiti. The study took place in Fond des Blancs and Villa, as part of a baseline assessment undertaken prior to implementation of a maternal, child health, nutrition, and water and sanitation program. From October to November 2011, women 15–49 years old (N = 575) were selected using a cross-sectional two-stage sampling strategy. We used descriptive and multivariate logistic regression analyses to assess the prevalence of and factors associated with institutional delivery. The prevalence of institutional delivery was 45.4 %; a rate higher than the national average of 25 %. In adjusted analyses, correlates of institutional delivery were younger maternal age (25 years and younger) (OR 1.82; CI 1.15, 2.90; P = 0.0112), antenatal care receipt (OR 3.70; CI 1.84, 7.43; P = 0.0003) and those who were poor according to our poverty index score classification (OR 2.04; CI 1.13, 3.69; P = 0.0187). This study shows that increased hospital delivery is likely explained by accessibility to antenatal care. Programs that improve access to antenatal care, with concurrent efforts to address structural inequalities that drive socio-economic deprivation, are likely critical to increasing institutional delivery.

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Acknowledgments

This study was funded by a grant to St. Boniface Haiti Foundation from UNICEF Haiti. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of St. Boniface Haiti Foundation and UNICEF. The authors would like to thank Dr. Linda Cottler and the Writing Circle class at the Department of Epidemiology, University of Florida for constructive comments on earlier drafts of the manuscript.

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Authors and Affiliations

  1. Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA

    Marie Nancy Séraphin, Maria R. Khan & Catherine W. Striley

  2. UNICEF Country Office, 125 Rue Faubert, Petionville, Port-au-Prince, Haiti

    Ismael Ngnie-Teta, Mohamed Ag Ayoya, Aissa Mamadoultaibou, Jean Ernst Saint-Fleur & Leslie Koo

  3. St. Boniface Haiti Foundation, 12 Rue E. Guello, Fond Des Blancs, Haiti

    Ellen Boldon & Miliane Clermont

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  1. Marie Nancy Séraphin
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  2. Ismael Ngnie-Teta
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  3. Mohamed Ag Ayoya
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  4. Maria R. Khan
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  5. Catherine W. Striley
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  6. Ellen Boldon
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  7. Aissa Mamadoultaibou
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  8. Jean Ernst Saint-Fleur
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  9. Leslie Koo
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  10. Miliane Clermont
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Correspondence to Marie Nancy Séraphin.

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Séraphin, M.N., Ngnie-Teta, I., Ayoya, M.A. et al. Determinants of Institutional Delivery Among Women of Childbearing Age in Rural Haiti. Matern Child Health J 19, 1400–1407 (2015). https://doi.org/10.1007/s10995-014-1646-1

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  • DOI: https://doi.org/10.1007/s10995-014-1646-1

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