Factors related to choice of place of birth in a district in Nepal.
OBJECTIVE
In Nepal, both percentage of women giving birth at health facility and proportion of birth assisted by skilled birth attendant is very low. The purpose of this research was to identify predictors for choice of place of birth: either at home, primary health care facility (including birthing centres) or at tertiary health care facilites (hospitals and clinics).


METHODS
A cross-sectional household survey was conducted in seven village development committee of a district lying in plain area of Nepal: Nawalparasi. A structured interview questionnaire was developed and administered face-to-face. Descriptive analysis along with chi-square test and multinomial logistic regression was used to identify the predictors of giving birth at a health care facility.


RESULTS
Women were significantly more likely to give birth at health care facilities compared to home if the distance was less than one hour, belonged to advantaged caste, had radio, television and motorbike/scooter, decision maker for place of birth was husband, reported their frequency of antenatal (ANC) visits at 4 or more and belonged to age group 15-19.


CONCLUSION
The analysis indicates that husbands of women giving birth influence the choice of place of birth. The findings highlight importance of having four or more ANC visits to the health institutions and that it should be located within one-hour walking distance. Inequity in utilisation of childbirth services at health institutions exists as showed by low utilisation of such services by disadvantaged caste.
['Mahato|Preeti K|PK|', 'van Teijlingen|Edwin|E|', 'Simkhada|Padam|P|', 'Sheppard|Zoe A|ZA|', 'Silwal|Ram Chandra|RC|']
D000293:Adolescent D000328:Adult D016550:Birthing Centers D002755:Choice Behavior D003430:Cross-Sectional Studies D003657:Decision Making D036861:Delivery, Obstetric D005260:Female D006268:Health Facilities D006297:Health Services Accessibility D006700:Home Childbirth D006801:Humans D008880:Midwifery D009390:Nepal D036801:Parturition D010342:Patient Acceptance of Health Care D011247:Pregnancy D011295:Prenatal Care D012424:Rural Population D012923:Social Class D012959:Socioeconomic Factors D018454:Spouses D011795:Surveys and Questionnaires D055815:Young Adult
Choice of place of birth Nepal Skilled birth attendance Primary health care facility Tertiary health care facility