S. Khady Ndao-Brumblay|Godfrey Mbaruku|Margaret E Kruk
Parity and institutional delivery in rural Tanzania: a multilevel analysis and policy implications
University of Michigan–Ann Arbor|Ifakara Health Institute|Columbia University
objectiveswe assess extent use healthcare facilities childbirth varies parity conditional socioeconomic psychological health characteristicswe also assess differences determinants institutionalized delivery firsttime mothers multiparous explore villagelevel variations observed relationships methodssurvey data threestage crosssectional cluster sample 1205 women rural district tanzania analysed using randomintercept multilevel models resultsuse health facilities delivery low 39 odds institutionalized delivery three times higher among nulliparous women 0 children prior current delivery compared women one four children 30 lower among women five children compared one four childrenin parity group analyses women least education women three antenatal care visits higher odds institutionalized delivery among nulliparousbelief importance institutionalized delivery increased odds delivering facility among multiparous women health insurance women five childrenwe found significant variation institutionalized delivery among multiparous women based village residence one four five children variations observed among nulliparous womenconclusion parity pivotal determinant use health facilities delivery significance varies village residence hence interventions targeting women according parity may increase use facilities delivery rural tanzaniafuture research focus villagelevel characteristics influence institutionalized delivery multiparous