title: Household decision-making about delivery in health facilities: evidence from Tanzania.
abstract: This study investigated how partners' perceptions of the healthcare system influence decisions about delivery-location in low-resource settings. A multistage population-representative sample was used in Kasulu district, Tanzania, to identify women who had given birth in the last five years and their partners. Of 826 couples in analysis, 506 (61.3%) of the women delivered in the home. In multivariate analysis, factors associated with delivery in a health facility were agreement of partners on the importance of delivering in a health facility and agreement that skills of doctors are better than those of traditional birth attendants. When partners disagreed, the opinion of the woman was more influential in determining delivery-location. Agreement of partners regarding perceptions about the healthcare system appeared to be an important driver of decisions about delivery-location. These findings suggest that both partners should be included in the decision-making process regarding delivery to raise rates of delivery at facility.
authors.affiliation: Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, Tampa, Florida 33620, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Danforth
authors.forename: M E
authors.initials: ME
authors.lastname: Kruk
authors.forename: P C
authors.initials: PC
authors.lastname: Rockers
authors.forename: G
authors.initials: G
authors.lastname: Mbaruku
authors.forename: S
authors.initials: S
authors.lastname: Galea
mesh_terms: D000328:Adult; D001294:Attitude to Health; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D034462:Dissent and Disputes; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D010820:Physicians; D011247:Pregnancy; D011361:Professional Competence; D012737:Sex Factors; D018454:Spouses; D013636:Tanzania; D055815:Young Adult