This document presents preliminary results from a baseline household survey assessing utilization and expenditures for maternal and newborn care. A two-stage sampling strategy was used to randomly select 1,813 women who had completed a pregnancy in the past 12 months across 4 districts. Descriptive results show high ANC utilization but lower rates for 4+ visits and early first visits. 9% of deliveries were non-facility based. Bivariate analysis found these deliveries were associated with increased age, household size, number of children, distance to facility, lower socioeconomic status, illiteracy, and residing in Balaka district. Next steps will use regression to model determinants of non-facility delivery and out-of-pocket expenditures.

1. Preliminary Results from the
Baseline Household Survey
Jacob Mazalale

2. Outline
•
•
•
•
•
Background
Methods
Preliminary Results
Next Steps
Discussion

3. Background
As was presented before
Objective
Assess status quo on utilisation and
expenditure for maternal and newborn
care at the community/household level
We present results from the household
baseline survey

4. Methods
• Sampling Strategy
– Unit of analysis
• a woman who has completed a pregnancy in
the previous twelve months
– A two-staged sampling strategy
• Randomly selected 2 enumeration areas (EAs)
in catchment area of each H/F
– 2*33 = 66 EAs
• Randomly select 26 women from each
enumeration area.
– 28*66 = 1,716 women

5. Methods
• Close-ended questionnaire
• Collected data on
•
•
•
•
•
Demographics
Socio-economic status
Distance to facility
Utilisation of MCH services
Out of pocket expenditure

6. Methods
• Data from both intervention and
control facilities.
• Data collected by trained enumerators
• 2 enumerators assigned to each EA.
• Using EA maps
– EA was split into six parts which were
shared between the enumerators.

7. Results
• Descriptives (n=1,813)
Variable
Total (n, %)
Sample Size
(n,%)
Age
Balaka (%) Dedza (%) Mchinji (%) Ntcheu (%)
Marital Status
Education
453 (25)
453 (25)
455 (25)
452 (25)
mean(sd)
25.6 (6)
25 (6)
26 (7)
26 (6)
26 (6)
Christians
1,574 (87)
332 (73)
385 (85)
420 (92)
437 (97)
239 (13)
121 (27)
68 (15)
35 (8)
15 (3)
1,579 (87)
384 (85)
396 (87)
405 (89)
394 (87)
Unmarried
234 (13)
69 (15)
57 (13)
50 (11)
58 (13)
No Formal
Religion
1,813
805 (44)
137 (30)
240 (53)
215 (47)
213 (47)
Primary
770 (42)
244 (54)
169 (37)
170 (37)
187 (41)
Secondary &
above
238 (13)
72 (16)
44 (10)
70 (16)
52 (12)
Non Christians
Married

8. Results
• Descriptives (n=1,813)
Variable
Household
members
Total
mean (sd)
Rural
Household
Setting (n, %)
Urban
Biological
mean (sd)
Children
Distance to
Official/Closest mean (sd)
H/F (in kms)
Balaka
Dedza
Mchinji
Ntcheu
4.9 (2)
5.0 (2)
4.9 (2)
5.1 (2)
4.7 (2)
1,626 (90) 397 (88) 402 (89) 405 (89) 422 (93)
187 (10)
56 (12)
51 (11)
50 (11)
30 (7)
2.7 (2)
2.8 (2)
2.6 (2)
2.8 (2)
2.5 (2)
5.7 (3)
5.1 (3)
5.2 (4)
6.2 (3)
6.4 (3)

9. Results
• Utilisation of MNHC Services (n=1, 813)
Variable
Total (n, %)
Balaka (%) Dedza (%) Mchinji (%) Ntcheu (%)
ANC Utilisation- went Yes
to ANC at least once
No
1,798 (99)
99.8
98.5
99.1
99.3
15 (1)
0.2
1.6
0.9
0.7
ANC Utilisation- went Yes
to ANC at least 4
times
No
799 (44)
47
43
44
42
1,014 (56)
53
57
56
58
270 (15)
17
16
11
15
1,543 (85)
83
84
89
85
ANC Utilisation- made Yes
first ANC Visit in 1st
trimester
No

10. Results
Who are the women that are not utilizing delivery care
Total (n, %)
Non Facility
Based Delivery
Balaka (%)
No
1,654 (91)
397 (88)
416 (92)
428 (94)
413 (91)
Yes
159 (9)
56 (12)
37 (8)
27 (6)
39 (9)
Dedza (%) Mchinji (%)
Ntcheu (%)

11. Results
Total (n, %)
PNC Utilisation –
attended PNC at least
once within 48 hrs of
delivery
Had Family Planning
Counseling During PNC
Currently Using Modern
Family Planning
Methods
Balaka (%) Dedza (%) Mchinji (%)
Ntcheu (%)
Yes
1,518 (84)
93
77
80
86
No
295 (16)
7
23
20
14
Yes
1,417 (78)
84
71
75
81
No
396 (22)
16
29
25
19
Yes
1,032 (57)
54
53
53
64
No
781 (43)
46
47
47
36.

12. Results
• Bivariate Analysis for Non Institutional Delivery
Variable
Facility Based
Delivery
Non Facility
Based Delivery
P- value for Chi2
or t- statistics
Age in years
25.4 (0.15)
28.13 (0.57)
<0.001
Household size
4.88 (0.04)
5.42 (0.14)
0.0002
2.6 (0.05)
3.7 (0.17)
<0.001
5.68 (0.08)
6.26 (0.25)
0.0324
321 (88.43)
322 (88.71)
337 (93.09)
334 (92.01)
340 (93.92)
42 (11.57)
41 (11.29)
25 (6.91)
29 (7.99)
22 (6.08)
0.021
# of children
Distance to facility
Social Economic Status
1st Quintile
2nd Quintile
3rd Quintile
4th Quintile
5th Quintile
Literacy
Illiterate
Literate
597 (36.)
1057 (64)
76 (48)
83 (52)
0.004
District
BLK
DZ
MC
NU
397 (24)
416 (25)
428 (26)
413 (25)
56 (35)
37 (23)
27 (14)
39 (25)
0.007

13. Next Steps
• Regression model on determinants of
non facility based deliveries
• Modeling determinants of out of
pocket

14. • Thank you!!!