Determinants of Facility-Based Delivery in Rufiji, Tanzania

Francis Levira, Ifakara Health Institute (IHI)
Josephine Shabani, Ifakara Health Institute (IHI)
Lauren Gaydosh, Princeton University
Astha Ramaiya, Ifakara Health Institute (IHI)

Facility delivery plays an important role in improving maternal health worldwide. Yet currently only half of pregnant women in Tanzania give birth at a facility. In Rufiji, the region under study, facility delivery increased from 65-77% between 2001 and 2010. However, village proportions ranged from 30-95%. In order to reduce infant and maternal mortality, there is a need to understand both the individual and community factors contributing to facility delivery. Drawing from ten years of birth records from the Rufiji Health and Demographic Surveillance System, we investigate community and individual factors influencing place of delivery using multilevel logistic regression. Odds of facility delivery are higher for younger, wealthier, more educated, first time mothers. Residence close to the facility and birth in the dry season are associated with increased odds of facility delivery. Nevertheless, there remains an important influence of unobserved maternal and village level characteristics.