Bulletin of the World Health Organization

Bypassing primary care clinics for childbirth: a cross-sectional study in the Pwani region, United Republic of Tanzania

Margaret E Kruk, Sabrina Hermosilla, Elysia Larson & Godfrey M Mbaruku

Volume 92, Number 4, April 2014, 246-253

Table 2. Multivariable associations between bypasser status and characteristics of subjects and local primary care clinics, United Republic of Tanzania, 2012

Characteristic aOR (95% CI) P
Women    
Age (years)    
    20–35 1.0
    < 20 0.83 (0.58–1.20) 0.330
    > 35 1.17 (0.89–1.54) 0.252
First delivery 2.53 (1.93–3.30) < 0.001
Literatea 1.14 (0.85–1.54) 0.387
80th percentile of wealth or above 1.44 (1.02–2.03) 0.036
Watches television 1.19 (0.92–1.54) 0.177
> 5 visits to local health clinic in past year 1.23 (1.00–1.50) 0.045
Perceived overall quality of care at local clinic as fair or poor 1.29 (1.00–1.66) 0.049
Local clinicsb    
Electricity available 0.60 (0.27–1.35) 0.217
Upgraded or renovated in past year 0.39 (0.18–0.84) 0.016
Conducts community outreach 0.75 (0.36–1.56) 0.439
Obstetric signal functions performed, no.c    
    0–1 1.0
    2 0.49 (0.23–1.04) 0.065
    3 0.37 (0.14–0.99) 0.047
    ≥ 4 0.19 (0.08–0.41) < 0.001

aOR, adjusted odds ratio; CI, confidence interval.

a Has completed primary school or was able to read part of a sentence in Swahili.

b The primary health facility for which the subject's house falls in the official catchment area.

c Based on a maximum of 7, specified as follows: parenteral antibiotics, parenteral oxytocics, parenteral anticonvulsants, manual removal of placenta, removal of retained products, assisted vaginal delivery and newborn resuscitation with bag and mask.

Note: A total of 1667 (87.8%) of 1898 women who delivered at a facility had complete information for all variables of interest. The model also includes a fixed effect for district, not shown here, to account for differences in health system and infrastructural characteristics at this administrative level. See Methods for definitions of “bypasser” and “non-bypasser”.