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Correlates of home and hospital delivery in Pakistan
Zainab Parveen1, Maqsood Sadiq2, Faisal Abbas3
1Department of Management Sciences, COMSATS Institute of Information Technology (CIIT), Islamabad, Pakistan.
Insights
Socio-economic factors significantly influence delivery location in Pakistan. Institutional delivery rates are rising but remain lower for women in lower wealth quintiles, exacerbated by illiteracy.
Area of Science:
- Public Health
- Demography
- Health Economics
Background:
- Home-based deliveries were historically more common than institutional deliveries in Pakistan.
- Significant disparities exist in healthcare access and utilization across socio-economic groups.
Purpose of the Study:
- To investigate the socio-economic determinants influencing home-based versus institutional delivery practices in Pakistan.
- To analyze trends in delivery location over time and identify associated factors.
Main Methods:
- Utilized data from three Pakistan Demographic and Health Surveys (PDHS) conducted in 1990-91, 2006-07, and 2012-13.
- Employed descriptive analysis and logistic regression to determine the odds of hospital delivery.
- Analyzed data based on socio-economic indicators and wealth quintiles.
Main Results:
- Home-based delivery prevalence decreased from 85.3% in 1990-91 to 51.6% in 2012-13.
- Institutional delivery rates increased from 13.3% in 1990-91 to 48.2% in 2012-13.
- Significant socio-economic and wealth-based disparities persisted in institutional delivery rates.
Conclusions:
- Socio-economic disparities and high illiteracy rates in lower wealth quintiles are key determinants of lower institutional delivery rates.
- Addressing these disparities is crucial for improving maternal health outcomes in Pakistan.
- Policy interventions should focus on enhancing access to healthcare for vulnerable populations.
Objective:
To identify the socio-economic determinants of home-based and institutional delivery in Pakistan.
Methods:
This study has used Pakistan Demographic and Health Survey (PDHS) data collected by the National Institute of Population Studies (NIPS), Islamabad, Pakistan, and Macro International Inc. (now ICF International) Calverton, Maryland, United States. It used three episodes of Pakistan Demographic and Health Survey Data from 1990-91, 2006-07 and 2012-13. Data was analysed using descriptive analysis and odds of delivering at hospital were calculated using logistic regression analysis.
Results:
Home-based delivery was over 4 times higher in 1990-91 compared with institutional delivery 5,465(85.3%) vs. 852(13.3%), and around 2 times higher in 2006-07 5,900(64.7%) vs. 3,128(34.3%). However, in 2012-13, the share of women delivering at home or health facility was roughly the same, i.e. 6,180(51.6%) at home and 5,773(48.2%) at health facility.
Conclusions:
There were wide gaps in the rates of institutional delivery among different subgroups, and they were accentuated by the socio-economic and financial disparities, and high illiteracy rates in the lowest wealth quintiles.
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