Institutional Birth in Uganda: The Interplay of Individual Characteristics, Physical Accessibility, and Social Context

Abstract

A national representative sample of women of reproductive age in Uganda was recruited to examine the individual and contextual influences on women's propensity to seek facility-based childbirth as opposed to childbirth at home. Findings reveal that use of birthing care services is poor in Uganda; roughly 45% of women have given birth in a medical institution. Proximity to a hospital is associated with higher odds of facility-based childbirth. Social constructs of a community also explain structural barriers to institutional births in Uganda; women living in an area where women have higher educational levels as well as those living in a socioeconomically advantaged community were more likely to give birth at a health facility. The results emphasize that efforts to improve the use of maternal health care would require interventions focused on increasing girls’ education. Further, the results support a call for more actions to reduce financial barriers and increase awareness of the importance of maternal health services, particularly among socioeconomically disadvantaged and vulnerable women.