Eliciting women’s preferences for place of child birth at a peri-urban setting in Nairobi, Kenya: A discrete choice experiment

• DOI: 10.1371/journal.pone.0242149
• Publication Date: 2020-12-10T21:08:59Z
• Authors: Jackline Oluoch-A...; Mary B. Adam; Francis Wafula; Gilbert K’okwaro
• Keywords: Mixed logit; Discrete choice

Objective Maternal and newborn mortality rates are high in peri-urban areas cities Kenya, yet little is known about what drives women’s decisions on where to deliver. This study aimed at understanding preferences place of childbirth how sociodemographic factors shape these preferences. Methods used a Discrete Choice Experiment (DCE) quantify the relative importance attributes choice within setting Nairobi, Kenya. Participants were women aged 18–49 years, who had delivered six health facilities. The DCE consisted attributes: cleanliness, availability medical equipment drug supplies, attitude healthcare worker, cost delivery services, quality clinical distance an opt-out alternative. Each woman received eight questions. A conditional logit model established strength mixed was assess for selected changed based their characteristics. Results 411 participated Experiment, response rate 97.6% completed 20,080 tasks. Health facility cleanliness found have strongest association with (β = 1.488 p<0.001) followed respectively by supplies 1.435 p<0.001). alternative 1.424 came third. care workers 1.347, p<0.001), services 0.385, 0.339, 0.0002 ranked 4 th 7 respectively. Women younger main income earners having stronger preference clean Older married kind workers. Conclusions preferred both technical process indicators care. DCE’s can lead development person-centered strategies that take into account improve maternal outcomes.