Manuela De Allegri|Justin Tiendrebéogo|Olaf Müller|Maurice Yé|Albrecht Jahn|Valéry Ridde
Understanding home delivery in a context of user fee reduction: a cross-sectional mixed methods study in rural Burkina Faso
Heidelberg University|University Hospital Heidelberg|Centre de Recherche en Santé de Nouna|Heidelberg University|University Hospital Heidelberg|Centre de Recherche en Santé de Nouna|Heidelberg University|University Hospital Heidelberg|Université de Montréal
several african countries recently reducedremoved user fees maternal care producing considerable increases utilization delivery services still across settings conspicuous number women continue deliver home study explores reasons home delivery rural burkina faso successful user fee reduction policy place since 2007 study took place nouna health district adopted triangulation mixed methods design combining quantitative qualitative data collection analysis methods quantitative component relied use data 2011 round panel household survey conducted 1130 households collected data utilization delivery services women experienced delivery previous twelve months investigated factors associated home delivery using multivariate logistic regression qualitative component relied series openended interviews 55 purposely selected households 13 village leaders analyzed data using mixture inductive deductive coding 420 women reported delivery 47 11 delivered home random effect multivariate logistic regression revealed clear albeit significant trend women lower socioeconomic status living outside area deliver home distance health facility found positively significantly associated home delivery qualitative findings indicated women households valued facilitybased delivery home delivery suggesting cultural factors shape decision deliver qualitative findings confirmed geographical access defined relation condition roads high transaction costs associated travel costsharing fees still applied point use represent two major barriers access facilitybased delivery findings suggest current policy burkina faso similar policies region expanded remove fees point use completely incorporate benefitssolutions support transport women labor health facility due time