Eliciting women's preferences for place of child birth at a peri-urban setting in Nairobi, Kenya: A discrete choice experiment.
PLoS One
; 15(12): e0242149, 2020.
Article
en En
| MEDLINE
| ID: mdl-33301447
ABSTRACT
OBJECTIVE:
Maternal and newborn mortality rates are high in peri-urban areas in cities in Kenya, yet little is known about what drives women's decisions on where to deliver. This study aimed at understanding women's preferences on place of childbirth and how sociodemographic factors shape these preferences.METHODS:
This study used a Discrete Choice Experiment (DCE) to quantify the relative importance of attributes on women's choice of place of childbirth within a peri-urban setting in Nairobi, Kenya. Participants were women aged 18-49 years, who had delivered at six health facilities. The DCE consisted of six attributes cleanliness, availability of medical equipment and drug supplies, attitude of healthcare worker, cost of delivery services, the quality of clinical services, distance and an opt-out alternative. Each woman received eight questions. A conditional logit model established the relative strength of preferences. A mixed logit model was used to assess how women's preferences for selected attributes changed based on their sociodemographic characteristics.RESULTS:
411 women participated in the Discrete Choice Experiment, a response rate of 97.6% and completed 20,080 choice tasks. Health facility cleanliness was found to have the strongest association with choice of health facility (ß = 1.488 p<0.001) followed respectively by medical equipment and supplies availability (ß = 1.435 p<0.001). The opt-out alternative (ß = 1.424 p<0.001) came third. The attitude of the health care workers (ß = 1.347, p<0.001), quality of clinical services (ß = 0.385, p<0.001), distance (ß = 0.339, p<0.001) and cost (ß = 0.0002 p<0.001) were ranked 4th to 7th respectively. Women who were younger and were the main income earners having a stronger preference for clean health facilities. Older married women had stronger preference for availability of medical equipment and kind healthcare workers.CONCLUSIONS:
Women preferred both technical and process indicators of quality of care. DCE's can lead to the development of person-centered strategies that take into account the preferences of women to improve maternal and newborn health outcomes.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Conducta de Elección
/
Servicios Urbanos de Salud
/
Comportamiento del Consumidor
/
Parto
/
Mujeres Embarazadas
Tipo de estudio:
Prognostic_studies
Aspecto:
Equity_inequality
/
Patient_preference
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Kenia