Length of Stay After Childbirth in 92 Countries and Associated Factors in 30 Low- and Middle-Income Countries: Compilation of Reported Data and a Cross-sectional Analysis from Nationally Representative Surveys

Campbell, O, Cegolon, L, Macleod, D and Benova, L. 2016. Length of Stay After Childbirth in 92 Countries and Associated Factors in 30 Low- and Middle-Income Countries: Compilation of Reported Data and a Cross-sectional Analysis from Nationally Representative Surveys. [Online]. PLOS Medicine. Available from: https://doi.org/10.1371/journal.pmed.1001972

Campbell, O, Cegolon, L, Macleod, D and Benova, L. Length of Stay After Childbirth in 92 Countries and Associated Factors in 30 Low- and Middle-Income Countries: Compilation of Reported Data and a Cross-sectional Analysis from Nationally Representative Surveys [Internet]. PLOS Medicine; 2016. Available from: https://doi.org/10.1371/journal.pmed.1001972

Campbell, O, Cegolon, L, Macleod, D and Benova, L (2016). Length of Stay After Childbirth in 92 Countries and Associated Factors in 30 Low- and Middle-Income Countries: Compilation of Reported Data and a Cross-sectional Analysis from Nationally Representative Surveys. [Data Collection]. PLOS Medicine. https://doi.org/10.1371/journal.pmed.1001972

Description

Background: Following childbirth, women need to stay sufficiently long in health facilities to receive adequate care. Little is known about length of stay following childbirth in low- and middle-income countries or its determinants. Methods and Findings: We described length of stay after facility delivery in 92 countries. We then created a conceptual framework of the main drivers of length of stay, and explored factors associated with length of stay in 30 countries using multivariable linear regression. Finally, we used multivariable logistic regression to examine the factors associated with stays that were “too short” (<24 h for vaginal deliveries and <72 h for cesarean-section deliveries). Across countries, the mean length of stay ranged from 1.3 to 6.6 d: 0.5 to 6.2 d for singleton vaginal deliveries and 2.5 to 9.3 d for cesarean-section deliveries. The percentage of women staying too short ranged from 0.2% to 83% for vaginal deliveries and from 1% to 75% for cesarean-section deliveries. Our conceptual framework identified three broad categories of factors that influenced length of stay: need-related determinants that required an indicated extension of stay, and health-system and woman/family dimensions that were drivers of inappropriately short or long stays. The factors identified as independently important in our regression analyses included cesarean-section delivery, birthweight, multiple birth, and infant survival status. Older women and women whose infants were delivered by doctors had extended lengths of stay, as did poorer women. Reliance on factors captured in secondary data that were self-reported by women up to 5 y after a live birth was the main limitation. Conclusions: Length of stay after childbirth is very variable between countries. Substantial proportions of women stay too short to receive adequate postnatal care. We need to ensure that facilities have skilled birth attendants and effective elements of care, but also that women stay long enough to benefit from these. The challenge is to commit to achieving adequate lengths of stay in low- and middle-income countries, while ensuring any additional time is used to provide high-quality and respectful care.

Methods

Data capture method	Unknown
Date (Date submitted to LSHTM repository)	8 March 2016
Language(s) of written materials	English

People & Groups

Data Creators	Campbell, O, Cegolon, L, Macleod, D and Benova, L
LSHTM Faculty/Department	Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Participating Institutions	London School of Hygiene & Tropical Medicine, London, United Kingdom

Projects

Additional Information

Date Deposited	22 Apr 2016 10:08
Last Modified	25 Mar 2022 09:29
Publisher	PLOS Medicine

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Description: Percentage of all deliveries (not stratified by mode of delivery) with length of stay <12 h and 12–23 h, totalling to percentage <24 h.

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