Table 3

Adjusted* associations of place of delivery with residential distance to the nearest primary health facility, among those who delivered between 2012 and 2017 in rural Mali

Institutional delivery (yes vs no)*†OR (95% CI)P value
Residence within 6.5 km of a facility‡ 0.65 (0.56 to 0.76) <0.01
Residence beyond 6.5 km of a facility‡1.04 (0.93 to 1.16)0.47
Age (years)
 20–341.00
 15–19 1.39 (1.04 to 1.87) 0.03
 35–490.92 (0.81 to 1.05)0.21
Married and monogamous1.00
Polygamous with first wife1.03 (0.87 to 1.23)0.71
Polygamous with second or higher order wife0.98 (0.82 to 1.16)0.80
Single, widowed, divorced or separated 0.58 (0.36 to 0.95) 0.03
Ethnicity
 Dogon1.00
 Peulh0.71 (0.46 to 1.09)0.12
 Others0.85 (0.50 to 1.47)0.57
No formal education1.00
Education any school (madrasah or French) 1.43 (1.15 to 1.77) <0.01
Occupation
 Housewife1.00
 Small business or trader 1.37 (1.12 to 1.68) <0.01
Socioeconomic status
 Poorest1.00
 Poor0.95 (0.76 to 1.17)0.61
 Middle1.06 (0.84 to 1.33)0.63
 Rich1.01 (0.82 to 1.24)0.94
 Richest1.03 (0.82 to 1.29)0.79
Season
 Hot (March–May)1.00
 June1.25 (0.99 to 1.57)0.06
 July1.46 (1.12 to 1.90)0.01
 August1.09 (0.91 to 1.30)0.37
 September1.04 (0.82 to 1.30)0.76
 October–November1.11 (0.94 to 1.32)0.21
 Cold (December–February)1.12 (0.95 to 1.32)0.18
Birth year
 20121.00
 20131.00 (0.85 to 1.19)0.96
 20141.11 (0.93 to 1.33)0.25
 20151.11 (0.93 to 1.33)0.24
 20161.17 (0.99 to 1.39)0.07
 20170.60 (0.18 to 2.02)0.41
  • Association shown in bold is statistically significant and the confidence interval exclude 1.

  • *Non-linear relationship modelled using one-knot linear spline with a knot at 6.5 km. The OR is for facility delivery with trained attendant compared with home birth with untrained attendant as the reference group.

  • †Adjusted for year of delivery, season of delivery, maternal age, marital status, ethnicity, maternal education, maternal occupation, wealth index and clustering of women in villages.

  • ‡Percentage of facility deliveries out of all deliveries is 38.7 (=3062/7922). In the two distance categories <6.5 km and ≥6.5 km these percentages are 49.3 and 22.7, respectively.