Determinants of Institutional Delivery in Rural Uttar Pradesh: Choice of Delivery Location

Access to quality care during pregnancy and especially at delivery seems to be the crucial factor in explaining the disparity in maternal health status. The choice of place of delivery has consistently been found to be associated with maternal and neonatal outcomes. The objective of the present paper is to understand the determinants of delivery location-institutional (public or private) and home; and reasons for non-utilization of facility for delivery care. The District Level Household Survey (2002-04) data for Rural Uttar Pradesh have been used, adopting the conceptual framework of Andersen Behavioural Model. A multinomial Logistic regression analysis was conducted to assess the determinants of home, public and private facilities for delivery. Most of the delivery had taken place at home, with public and private sector accounting for only seven percent and nine percent respectively. Women with higher birth order and those residing far from Primary health centres had greater odds of delivering at home than public facility, while maternal education, Antenatal care visits, regions and pregnancy complications are the significant predictor of institutional delivery. The results indicate that, after controlling for other variables access to health facilities do not have much effect on choice of public facility over home/private. Regional analysis showed significant differentials in reasons for not delivering at health facility. Given the predominance of home deliveries in the rural Uttar Pradesh, every attempt should be made to ensure that these are attended by trained birth attendants.