Elsevier

SSM - Population Health

Volume 16, December 2021, 100955
SSM - Population Health

Prevalence of home birth among 880,345 women in 67 low- and middle-income countries: A meta-analysis of Demographic and Health Surveys

https://doi.org/10.1016/j.ssmph.2021.100955Get rights and content
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Highlights

  • Home births occurred in approximately 3 out of 10 women in LMIC.

  • Women without education presented the highest proportions of home births.

  • Women in rural areas generally had a higher proportion of home births.

Abstract

Objective

The objective of this study was to determine the prevalence of home birth in low-middle income countries (LMIC) according to geographic area and sociodemographic characteristics between 2000 and 2019.

Methods

A meta-analysis was carried out using the most recent demographic and health surveys as a data source (total countries: 67). A random-effects meta-analysis was obtained to calculate pooled prevalence estimates of home birth for all the countries included and by geographic region of the world. Likewise, a subgroup analysis was performed to estimate the prevalence of home birth according to the sociodemographic factors considered for this study.

Results

The global prevalence of home birth was 28% (95% CI: 0.24–0.33), with the lowest prevalence in the region of Europe & Central Asia (5%, 95% CI: 0.03–0.07) and the highest in East Asia & Pacific region (38%, 95% CI: 0.26–0.51). Twelve countries had proportions of home births greater than 50% (seven belonged to the Sub-Saharan Africa region). The countries with the highest proportion of home births were Chad (78%), Ethiopia (73%), and Niger and Yemen (70% each). Concerning the wealth index, in general, the richest quintile (quintile 5) presented the lowest proportion of home births. In contrast, the poorest (quintile 1) generally had the highest prevalence of home births. Regarding educational level, women without education presented the highest proportions of home births in general. In relation to the area of residence, in almost all the countries studied, women in rural areas generally had a higher proportion of home births than those in urban areas.

Conclusions

Home births occurred in approximately 3 out of 10 women in LMIC. There are also differences in the proportion of home births according to socioeconomic factors such as educational level, wealth index, and rurality.

Keywords

Home childbirth
Birth setting
Health surveys
Developing countries
Meta-analysis

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