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Home Delivery Vs Health Facility Delivery [message #21721]

Sun, 13 December 2020 09:44

shujaat.smc@gmail.com is currently offline

shujaat.smc@gmail.com
Messages: 75
Registered: July 2020

Senior Member

Dear DHS Representative,

I am using BR-file Pakistan DHS 2017-18.

I have estimated NMR for variables including the place of delivery.

I make a new variable "Place of Delivery" [POD] using variable m15. I merge category code 11 & 12 as "Home" and 21 till 96 as a "health facility".

When I use this newly generated variable to estimate NMR, stata output shows that those women who had a delivery at home had NMR of 23/1000 live birth, and those having health facilities had NMR of 31/1000 live birth.

Quest: Since Pakistan has the highest neonatal mortality rate in the world and I am looking for its determinant but for Place of delivery information I am getting is not acceptable at all.

How I can explain this unusual finding what should I write in a scientific paper about not including this important indicator (Univariate analysis is showing HR for House 0.85 with p-value 0.498) of both maternal and neonatal health since health facility delivery is one of the tools to decrease neonatal mortality.

Looking forward to your reply.

Best Regards

Dr. Hussain

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Re: Home Delivery Vs Health Facility Delivery [message #21727 is a reply to message #21721]

Mon, 14 December 2020 09:11

Bridgette-DHS
Messages: 3214
Registered: February 2013

Senior Member

Following is a response from DHS Research & Data Analysis Director, Tom Pullum:

It is possible that in a few cases (we hope only a few) a facility is associated with infection or malpractice, but it is more likely that this finding is the result of selectivity. Women with a difficult pregnancy tend to have more antenatal visits and to be referred to a facility for the birth. It's similar to someone with a severe illness being taken to a hospital and dying in the hospital. The visit to the hospital was not the cause of the death; hopefully the visit to the hospital improved the chance of survival. You will find this statistical relationship in many DHS surveys. It's an example of correlation but not causation.

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Re: Home Delivery Vs Health Facility Delivery [message #21728 is a reply to message #21727]

Mon, 14 December 2020 09:30

shujaat.smc@gmail.com
Messages: 75
Registered: July 2020

Senior Member

Dear Tom Pullum, Good Morning!

Thanks for your kind reply.

I would request you to please share the link of the specific article/paper you are referring to, this will save time and will lead to the point you have directed me without any distraction.

Best Regards

Dr. Hussain

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Re: Home Delivery Vs Health Facility Delivery [message #21732 is a reply to message #21728]

Mon, 14 December 2020 10:33

Bridgette-DHS
Messages: 3214
Registered: February 2013

Senior Member

Following is a response from DHS Research & Data Analysis Director, Tom Pullum:

Analytical Study #46 (https://www.dhsprogram.com/pubs/pdf/AS46/AS46.pdf) is relevant to this issue.

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Re: Home Delivery Vs Health Facility Delivery [message #21757 is a reply to message #21732]

Tue, 15 December 2020 07:32

shujaat.smc@gmail.com
Messages: 75
Registered: July 2020

Senior Member

Dear Tom Pullum,

Thanks a lot. Highly obliged.

Best Regards

Dr. Hussain

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