Spatial, Social, and Institutional Determinants of Child Delivery Place in Rural Mozambique

Whereas the coverage of prenatal care in much of rural sub-Saharan Africa has greatly increased, institutional deliveries continue to lag behind as a substantial share of rural women give birth outside clinic settings and without professional obstetric care. This study uses unique longitudinal data from rural southern Mozambique to examine both the probability of having an institutional delivery and the choice of clinic for institutional delivery as a function of individual and household characteristics and of location and characteristics of maternal and child health facilities. Spatial and multivariate regression analyses are employed to determine both additive and interactive effects of the two groups of factors in the context of high HIV prevalence and a massive scale-up of HIV testing, prophylaxis, and treatment services.