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Factors influencing the decision-making regarding place of delivery among mothers in three provinces, Lao PDR  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Introduction  (1)
[object Object],[object Object],[object Object],[object Object],Literature review  (2)
[object Object],[object Object],[object Object],Research Aim and Objectives  (3)
[object Object],[object Object],Study site  Selected  (4)  V i e n t i a n e H u a p h a n h S a v a n n a k h e t X a y a b u r y L u a n g p r a b a n P h o n g s a l y K h a m m u a n e A t t a p e u B o k e o C h a m p a s a c k X i e n g k h u a ng B o l i k h a m x a y O u d o m x a y S a r a v a n e S e k o n g L u a n g n a m t h a X a y s o m b o o n V i e n t i ane C a p i t a l
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Methodology ,[object Object],(5)  ,[object Object],[object Object]
Borlikhamxay (6 Districts) Khammuane (9Districts) Savannakhet (15Districts) (1)District (63 Villages) (1)District (54 Villages) (1)District (20 Villages) 10 villages 10 villages 10 villages 303 mothers with <1 year child Systematic Random sampling  Simple Random Sampling Population and housing census, 2005 (6)  Community survey: Multistage probability sampling  Simple Random Sampling
Results  Distance far from health facility
Table 1: Socio-demographics and place of delivery  *8,767 kip is equal to US$ 1  (8)  (n=311) % Age  (year) Mean (SD) 13-24 25-48 25.7 (6.1) 150 161 48.2 52.8 Ethnicity  Lowland Lao (Lao Lum) Midland Lao (Lao Thung) Highland Lao (Lao Sung) 232 79 0 74.6 25.4 0.0 Household income (Kip)*/ month Mean (SD) >300,001  <300,000  1.7 (0.5) 214 97 68.8 31.2 Education of mothers  Illiterate  Educated  68 243 21.9 78.1 Education of fathers  Illiterate  Educated  50 261 16.1  83.9 Occupation of fathers  Farmer  Government official  Daily wage worker  177 50 84 56.9 16.1 27.0 Number of children  Mean (SD) ≤ 2 >2 2.6 (1.9) 190 121 61.1  38.9 Time from house go to health facility ( in minutes) by using personal transportation  Mean (SD) ≤ 45 >45  44.2 (45.9) 189 113 63.7 36.6 Place of delivery  Hospital  Home  159 152 51.1 48.9
Table 2: History of reproductive health and antenatal care  (9)  (n=311) % Parity  Mean (SD) ≤ 2 >2 193 118 2.6 (2.0) 62.1 37.9 Gravida Mean (SD) ≤ 2 >2 179 132 2.8 (2.1) 57.6 42.4 Abortion  Mean (SD) Never had abortion  Had abortion  259 52 0.2 (0.5) 83.3 16.7 Attend antenatal clinic during the last child Yes  No 207 104  66.6 33.4 Times and attended ANC during pregnancy  (207) Mean (SD) ≤  4 > 4 128 79 4.3 (1.9) 61.8 38.2 Antenatal card or booklet Yes  No  148 59 71.4 28.6
a 8,767 kip is equal to US$1 Table 3: Factors influencing place of delivery (10)  Place of delivery  No (%) n=311 Hospital  Home  OR (95% CI) P-value  Ethnicity  Midland Lao  Lowland Lao  79 (25.4) 232 (74.6) 22 (27.8) 137 (59.1) 57 (72.2) 95 (40.9) 1 3.7 (2.1-6.5) 0.000*** Household income (Kip) a  /month <300,000 >300,001 97 (31.2) 214 (68.8) 35 (36.1) 124 (57.9) 62 (63.9) 90 (42.1) 1 2.4 (1.5-4.0) 0.000*** Education of mothers  No education  Education  68 (21.9) 243 (78.1) 15 (22.1) 144 (59.3) 53 (77.9) 99 (40.7) 1 5.1 (2.7-9.6) 0.000*** Education of fathers  No education  Education  50 (16.1) 261 (83.9) 12 (24.0) 147 (56.3) 38 (76.0) 114 (43.7) 1 4.1 (2.0-8.2) 0.000*** Occupation of fathers  Farmer  Government official  Daily wage worker  177 (56.9) 50 (16.1) 84 (27.0) 66 (37.3) 33 (66.0) 60 (71.4) 111 (62.7) 17 (34.0) 24 (28.6) 1 4.2 (2.4-7.4) 1.4 (0.6-2.7) 1 0.000*** 0.001***
Table 4: Factors influencing place of delivery  (11)  Place of delivery  No (%) n=311  Hospital  Home  OR (95%CI) p-value  Gravida (times) > 2 ≤  2 132 (42.4) 179 (57.6) 52 (39.4) 107 (59.8) 80 (60.6) 72 (40.2) 1 2.3 (1.4-3.6) 0.000*** Number of children >2 ≤  2 121 (38.9) 190(61.1) 47 (29.6) 112 (70.4) 74 (48.7) 78 (51.3) 1 2.3 (1.4-3.6) 0.001*** Time from house go to the facility (in minute) >45 ≤ 45 113 (36.3) 198 (63.7) 36 (31.9) 123 (62.1) 77 (68.1) 75 (37.9) 1 3.5 (2.2-5.7) 0.001*** Attend ANC during the last child  No  Yes   104 (33.4) 207(66.6) 22 (21.2) 137 (66.2) 82 (78.8) 70 (33.8) 1 7.3 (4.2-12.7) 0.000*** Times and attend ANC during pregnancy  (n=207) ≤  4 > 4 128 (41.2) 79 (25.4) 78 (60.9) 59 (74.7) 50 (39.1) 20 (25.3) 1 1.9 (1.0-3.5) 0.043* Process an antenatal card or booklet  No  Yes   59 (28.5) 148 (71.4) 30 (50.8) 107 (72.3) 29 (49.2) 41 (27.7) 1 2.5 (1.4-4.7) 0.003**
OR= Odd ratio; AOR= Adjusted odds ratio by Binary Logistic Regression (12)  Table 5: Regression analysis: Factors influencing place of delivery  Place of delivery  No (%) n=311  Hospital  Home  AOR (95% CI) P-value  Ethnicity  Midland Lao  Lowland Lao  79 (25.4) 232 (74.6) 22 (27.8) 137 (59.1) 57 (72.2) 95 (40.9) 1 1.3 (0.4-3.7) 0.632 Household income (Kip/month) <300,000 >300,001 97 (31.2) 214 (68.8) 35 (36.1) 124 (57.9) 62 (63.9) 90 (42.1) 1 1.0 (0.4-2.3) 0.952 Education of mothers  No education  Education  68 (21.9) 243 (78.1) 15 (22.1) 144 (59.3) 53 (77.9) 99 (40.7) 1 0.5 (0.1-1.8) 0.315 Education of fathers  No education  Education  50 (16.1) 261 (83.9) 12 (24.0) 147 (56.3) 38 (76.0) 114 (43.7) 1  0.9 (0.2-3.8) 0.883 Occupation of fathers  Farmer  Government official  Daily wage worker  177 (56.9) 50 (16.1) 84 (27.0) 66 (37.3) 33 (66.0) 60 (71.4) 111 (62.7) 17 (34.0) 24 (28.6) 1 8.3 (2.9-23.5) 5.2 (1.7-16.2) 0.000*** 0.004** Gravida (times) >2 ≤ 2 132 (42.4) 179 (57.6) 52 (39.4) 107 (59.8) 80 (60.6) 72 (40.2) 1 0.5 (0.3-1.1) 0.092 Times and attended ANC  (n=207) ≤ 4 >4  128 (41.2) 79 (25.4) 78 (60.9) 59 (74.7) 50 (39.1) 20 (25.3) 1 2.3 (1.1-4.8) 0.026* Process an antenatal  Card or booklet  No  Yes  59 (28.5) 148 (71.4) 107 (72.3) 30 (50.8) 41 (27.7) 29 (49.2) 1 0.5 (0.2-1.1) 0.118 Time from home go to the facility (in minute)  > 45  ≤ 45 113 (36.3) 198 (63.7) 36 (31.9) 123 (62.1) 77 (68.1) 75 (37.9) 1 2.3 (1.0-5.1) 0.042*
Discussion
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(14)  Discussions
[object Object],[object Object],(15)  Limitations
[object Object],[object Object],[object Object],[object Object],[object Object],(16)  Conclusions
Thank you

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14. douangphachanh xaysomphou

  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Borlikhamxay (6 Districts) Khammuane (9Districts) Savannakhet (15Districts) (1)District (63 Villages) (1)District (54 Villages) (1)District (20 Villages) 10 villages 10 villages 10 villages 303 mothers with <1 year child Systematic Random sampling Simple Random Sampling Population and housing census, 2005 (6) Community survey: Multistage probability sampling Simple Random Sampling
  • 8. Results Distance far from health facility
  • 9. Table 1: Socio-demographics and place of delivery *8,767 kip is equal to US$ 1 (8) (n=311) % Age (year) Mean (SD) 13-24 25-48 25.7 (6.1) 150 161 48.2 52.8 Ethnicity Lowland Lao (Lao Lum) Midland Lao (Lao Thung) Highland Lao (Lao Sung) 232 79 0 74.6 25.4 0.0 Household income (Kip)*/ month Mean (SD) >300,001 <300,000 1.7 (0.5) 214 97 68.8 31.2 Education of mothers Illiterate Educated 68 243 21.9 78.1 Education of fathers Illiterate Educated 50 261 16.1 83.9 Occupation of fathers Farmer Government official Daily wage worker 177 50 84 56.9 16.1 27.0 Number of children Mean (SD) ≤ 2 >2 2.6 (1.9) 190 121 61.1 38.9 Time from house go to health facility ( in minutes) by using personal transportation Mean (SD) ≤ 45 >45 44.2 (45.9) 189 113 63.7 36.6 Place of delivery Hospital Home 159 152 51.1 48.9
  • 10. Table 2: History of reproductive health and antenatal care (9) (n=311) % Parity Mean (SD) ≤ 2 >2 193 118 2.6 (2.0) 62.1 37.9 Gravida Mean (SD) ≤ 2 >2 179 132 2.8 (2.1) 57.6 42.4 Abortion Mean (SD) Never had abortion Had abortion 259 52 0.2 (0.5) 83.3 16.7 Attend antenatal clinic during the last child Yes No 207 104 66.6 33.4 Times and attended ANC during pregnancy (207) Mean (SD) ≤ 4 > 4 128 79 4.3 (1.9) 61.8 38.2 Antenatal card or booklet Yes No 148 59 71.4 28.6
  • 11. a 8,767 kip is equal to US$1 Table 3: Factors influencing place of delivery (10) Place of delivery No (%) n=311 Hospital Home OR (95% CI) P-value Ethnicity Midland Lao Lowland Lao 79 (25.4) 232 (74.6) 22 (27.8) 137 (59.1) 57 (72.2) 95 (40.9) 1 3.7 (2.1-6.5) 0.000*** Household income (Kip) a /month <300,000 >300,001 97 (31.2) 214 (68.8) 35 (36.1) 124 (57.9) 62 (63.9) 90 (42.1) 1 2.4 (1.5-4.0) 0.000*** Education of mothers No education Education 68 (21.9) 243 (78.1) 15 (22.1) 144 (59.3) 53 (77.9) 99 (40.7) 1 5.1 (2.7-9.6) 0.000*** Education of fathers No education Education 50 (16.1) 261 (83.9) 12 (24.0) 147 (56.3) 38 (76.0) 114 (43.7) 1 4.1 (2.0-8.2) 0.000*** Occupation of fathers Farmer Government official Daily wage worker 177 (56.9) 50 (16.1) 84 (27.0) 66 (37.3) 33 (66.0) 60 (71.4) 111 (62.7) 17 (34.0) 24 (28.6) 1 4.2 (2.4-7.4) 1.4 (0.6-2.7) 1 0.000*** 0.001***
  • 12. Table 4: Factors influencing place of delivery (11) Place of delivery No (%) n=311 Hospital Home OR (95%CI) p-value Gravida (times) > 2 ≤ 2 132 (42.4) 179 (57.6) 52 (39.4) 107 (59.8) 80 (60.6) 72 (40.2) 1 2.3 (1.4-3.6) 0.000*** Number of children >2 ≤ 2 121 (38.9) 190(61.1) 47 (29.6) 112 (70.4) 74 (48.7) 78 (51.3) 1 2.3 (1.4-3.6) 0.001*** Time from house go to the facility (in minute) >45 ≤ 45 113 (36.3) 198 (63.7) 36 (31.9) 123 (62.1) 77 (68.1) 75 (37.9) 1 3.5 (2.2-5.7) 0.001*** Attend ANC during the last child No Yes 104 (33.4) 207(66.6) 22 (21.2) 137 (66.2) 82 (78.8) 70 (33.8) 1 7.3 (4.2-12.7) 0.000*** Times and attend ANC during pregnancy (n=207) ≤ 4 > 4 128 (41.2) 79 (25.4) 78 (60.9) 59 (74.7) 50 (39.1) 20 (25.3) 1 1.9 (1.0-3.5) 0.043* Process an antenatal card or booklet No Yes 59 (28.5) 148 (71.4) 30 (50.8) 107 (72.3) 29 (49.2) 41 (27.7) 1 2.5 (1.4-4.7) 0.003**
  • 13. OR= Odd ratio; AOR= Adjusted odds ratio by Binary Logistic Regression (12) Table 5: Regression analysis: Factors influencing place of delivery Place of delivery No (%) n=311 Hospital Home AOR (95% CI) P-value Ethnicity Midland Lao Lowland Lao 79 (25.4) 232 (74.6) 22 (27.8) 137 (59.1) 57 (72.2) 95 (40.9) 1 1.3 (0.4-3.7) 0.632 Household income (Kip/month) <300,000 >300,001 97 (31.2) 214 (68.8) 35 (36.1) 124 (57.9) 62 (63.9) 90 (42.1) 1 1.0 (0.4-2.3) 0.952 Education of mothers No education Education 68 (21.9) 243 (78.1) 15 (22.1) 144 (59.3) 53 (77.9) 99 (40.7) 1 0.5 (0.1-1.8) 0.315 Education of fathers No education Education 50 (16.1) 261 (83.9) 12 (24.0) 147 (56.3) 38 (76.0) 114 (43.7) 1 0.9 (0.2-3.8) 0.883 Occupation of fathers Farmer Government official Daily wage worker 177 (56.9) 50 (16.1) 84 (27.0) 66 (37.3) 33 (66.0) 60 (71.4) 111 (62.7) 17 (34.0) 24 (28.6) 1 8.3 (2.9-23.5) 5.2 (1.7-16.2) 0.000*** 0.004** Gravida (times) >2 ≤ 2 132 (42.4) 179 (57.6) 52 (39.4) 107 (59.8) 80 (60.6) 72 (40.2) 1 0.5 (0.3-1.1) 0.092 Times and attended ANC (n=207) ≤ 4 >4 128 (41.2) 79 (25.4) 78 (60.9) 59 (74.7) 50 (39.1) 20 (25.3) 1 2.3 (1.1-4.8) 0.026* Process an antenatal Card or booklet No Yes 59 (28.5) 148 (71.4) 107 (72.3) 30 (50.8) 41 (27.7) 29 (49.2) 1 0.5 (0.2-1.1) 0.118 Time from home go to the facility (in minute) > 45 ≤ 45 113 (36.3) 198 (63.7) 36 (31.9) 123 (62.1) 77 (68.1) 75 (37.9) 1 2.3 (1.0-5.1) 0.042*
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