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Table 4 Antenatal care (ANC), facility, and macro-level factors identified in relation to facility-based delivery in sub-Saharan Africa

From: Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review

Antenatal care factor Country in which it was studied Direction of influence Cites
Attended ANC Kenya ANC attendance linked to higher likelihood of FBD [31]
Timing of first ANC visit (early onset of ANC) Tanzania; Ghana Earlier ANC initiation linked to greater likelihood of FBD; Later ANC linked to FBD [49, 50]
Number of ANC visits Burkina Faso; Ghana; Ivory Coast; Kenya; Malawi; Tanzania Fewer ANC visits linked to lower likelihood of FBD; 3+, 4+ visits linked to higher rates of FBD [14, 15, 25, 2730, 51]
Saw doctor at ANC Ghana Seeing a doctor at ANC linked to greater FBD [49, 54]
Quality of ANC Ghana Higher perceived quality linked to greater FBD [54]
Being advised to deliver in a facility during ANC Ghana; Kenya; Tanzania Higher likelihood of FBD [21, 28, 30, 34, 50]
FACILITY FACTOR    
Distance to facility Burkina Faso; Ghana; Kenya; Malawi; Mali; Nigeria; Senegal; Tanzania; Uganda; Zambia Greater distance, lower likelihood of FBD [15, 21, 22, 25, 34, 36, 44, 48],[50, 51, 59, 69, 70]
Cost Ghana; Nigeria; Uganda Greater cost associated with lower likelihood of FBD [48, 6365, 70, 71]
Promptness of care Nigeria Perception of promptness of care linked to greater utilization [48]
Perceived quality of delivery care Ghana; Nigeria; Tanzania Individual perceptions about higher quality of care linked to higher FBD rates. One study showed no relationship between community perceptions of quality and individual FBD [34, 48, 60, 65, 71]
Presence of any provider, presence of OB/GYN, 24-hour availability of provider Nigeria Higher likelihood of FBD [48, 71]
Availability of medicine, equipment, emergency obstetric care Nigeria; Tanzania; Uganda; Zambia Increased FBD when medicine, equipment, higher level of emergency obstetric care available [48, 53, 69, 72]
Staff attitudes / behavior Nigeria; Swaziland; Tanzania; Uganda Negative staff attitudes, abusive treatment at hands of HCPs related to lower FBD [48, 63, 66, 67, 72]
Culturally unacceptable Nigeria; Swaziland Less likely to deliver in a facility [63, 66]
Previous delivery with male provider Senegal Less likely to deliver in a facility [62]
Electricity, running water, radio communication at facility Uganda Presence of infrastructure linked to higher FBD rates [53]
MACRO-LEVEL FACTOR    
Government share of health care spending 42 low-income countries Greater percentage of government spending, greater likelihood of SBA [23]
Female literacy rates (education) 42 low-income countries Higher rates of female literacy in a country associated with higher rates of SBA [23, 26]
Total health expenditures per capita 42 low-income countries Higher total health expenditures per capita associated with higher rates of SBA [23, 37]
Gross national income per capita 21 sub-Saharan African countries Higher gross national income per capita linked to FBD [20]