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Effect of maternal age on facility-based delivery: analysis of first-order births in 34 countries of sub-Saharan Africa using demographic and health survey data

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dc.contributor.author Dunlop, Catherine L
dc.contributor.author Benova, Lenka
dc.contributor.author Campbell, Oona
dc.date.accessioned 2020-04-27T12:35:00Z
dc.date.available 2020-04-27T12:35:00Z
dc.date.issued 2018-02-01
dc.identifier.citation Dunlop CL, Benova L, Campbell O. Effect of maternal age on facility-based delivery: analysis of first-order births in 34 countries of sub-Saharan Africa using demographic and health survey data. BMJ Open 2018 en_US
dc.identifier.uri doi:10.1136/ bmjopen-2017-020231
dc.identifier.uri http://awdflibrary.org:8080/xmlui/handle/123456789/992
dc.description.abstract Objectives Increasing access to skilled birth attendance, usually via childbirth in health facilities, is a key intervention to reduce maternal and perinatal mortality and morbidity. Yet, in some countries of sub-Saharan Africa, the uptake is <50%. Age and parity are determinants of facility-based delivery, but are strongly correlated in high fertility settings. This analysis assessed the independent effect of age on facility-based delivery by restricting to first-order births. It was hypothesised that older first-time mothers in this setting might have lower uptake of facilitybased deliveries than women in the most common age groups for first birth. Setting The most recent Demographic and Health Surveys from 34 sub-Saharan African countries were used to assess women’s delivery locations. Participants 72 772 women having their first birth in the 5 years preceding the surveys were included in the analysis. Primary and secondary outcome measures Proportions and 95%CIs of facility-based deliveries were estimated overall and by country. Multivariable logistic regression was used to calculate the odds of facility-based delivery for different maternal age groups (15–19, 20–24 and ≥25 years) for a pooled sample of all countries. Results 59.9% of women had a facility-based delivery for their first birth (95%CI 58.6 to 61.2), ranging from 19.4% in Chad to 96.6% in Rwanda. Compared with women aged 15–19 years, the adjusted odds of having a facility-based delivery for those aged 20–24 was 1.4 (95% CI 1.3 to 1.5, p<0.001) and for those aged ≥25, 1.9 (95% CI 1.6 to 2.2, p<0.001). Conclusions Older age at first birth was independently associated with significantly higher odds of facility-based delivery. This went against the hypothesis. Further mixedmethod research is needed to explore how increased age improves uptake of facility-based delivery. Promoting facility-based delivery, while ensuring quality of care, should be prioritised to improve birth outcomes in subSaharan Africa. en_US
dc.language.iso en en_US
dc.publisher BMJ Open en_US
dc.subject Maternal age en_US
dc.subject facility based delivery en_US
dc.subject sub-Saharan Africa en_US
dc.title Effect of maternal age on facility-based delivery: analysis of first-order births in 34 countries of sub-Saharan Africa using demographic and health survey data en_US
dc.type Article en_US


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