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Home Delivery Vs Health Facility Delivery [message #21721] Sun, 13 December 2020 09:44 Go to next message
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



Re: Home Delivery Vs Health Facility Delivery [message #21727 is a reply to message #21721] Mon, 14 December 2020 09:11 Go to previous messageGo to next message
Bridgette-DHS is currently offline  Bridgette-DHS
Messages: 2443
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.
Re: Home Delivery Vs Health Facility Delivery [message #21728 is a reply to message #21727] Mon, 14 December 2020 09:30 Go to previous messageGo to next message
shujaat.smc@gmail.com is currently offline  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
Re: Home Delivery Vs Health Facility Delivery [message #21732 is a reply to message #21728] Mon, 14 December 2020 10:33 Go to previous messageGo to next message
Bridgette-DHS is currently offline  Bridgette-DHS
Messages: 2443
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.

Re: Home Delivery Vs Health Facility Delivery [message #21757 is a reply to message #21732] Tue, 15 December 2020 07:32 Go to previous message
shujaat.smc@gmail.com is currently offline  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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