Discharge time from healthcare facilities after birth in Tanzania : A secondary analysis of Demographic and Health Surveys from 2015-16 and 2022

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Following facility-based birth, it is recommended to monitor the health of women and newborns in the facility. In Tanzania, a third of women who give birth in a health facility report not receiving a health check during their stay. Duration of stay and factors influencing them are not well documented in Tanzania. We describe postpartum length-of-stay at two time-points, 2015/2016 and 2022 in Tanzania, and explore factors associated with early discharge. Methods We analysed secondary data from two Demographic and Health Surveys: n = 3,582 from 2015-16 and n = 4,618 women from 2022 who had a livebirth in a health facility during the three years preceding the survey. Early discharge was defined as discharge < 24hours after vaginal birth and < 72 hours after a caesarean birth. We describe the percentage of early discharge at both DHS time-points and explore factors associated with it using 2022 data with multivariate logistic regression, separately by mode of birth. Results Almost half of women who had a vaginal birth were discharged early in 2015-16, compared to 30.3% in 2022, while early discharge increased among women who had a caesarean section from 17.2% in 2015-16 to 25.2% in 2022. The odds of early discharge were higher in Zanzibar compared to Eastern zone, and factors associated with early discharge included level of facility, frequency of antenatal care visits, maternal education and newborn underweight status. Conclusions Despite progress in reducing short postpartum stays after vaginal births, early postpartum discharge affected a third of the women giving birth in Tanzania. Disparities between regions and facility levels suggest potential inconsistencies in the application of postpartum guidelines, warranting the need to determine and address the underlying causes, standardize practice and ensure equitable access to quality postpartum care. maternal newborn healthcare facility childbirth postpartum postnatal household survey Tanzania vaginal birth caesarean section demographic and health survey Figures Figure 1 Figure 2 Introduction Maternal and newborn mortality remains high globally with an estimated 287,000 maternal deaths in 2020 and 2.3 million neonatal deaths in 2022, whereby most of these deaths occur in low- and middle-income countries (LMIC) [ 1 , 2 ]. Common causes of maternal deaths include haemorrhage, hypertensive disorders and sepsis, and most maternal deaths occur in the postpartum period [ 3 ]. Additionally, around 1.9 million intrapartum stillbirths occurred in 2021 and one million newborns died in 2022 during the first hours after birth [ 4 ]. This highlights the need for early postnatal care (PNC) during the first week after birth, for closely monitoring the mother’s and newborn’s health, and detecting and managing complications timely [ 5 , 6 ]. The latest World Health Organization (WHO) recommendations advise a minimum 24 hours stay in a healthcare facility after vaginal birth, enabling continuous care and monitoring for women and newborns [ 5 ]. The WHO underscores the importance of delivering these recommendations within an appropriate model of PNC, tailored to fit the needs, resources and local contexts of countries or regions [ 5 ]. A model of PNC refers to the organization of care provision elements such as length-of-stay after facility-based childbirth, and the provider, location, frequency, timing, duration of postnatal checks. Evidence to inform the organization of PNC models remains limited, as highlighted by two Cochrane reviews showing gaps in research on postpartum length-of-stay and the frequency, timing, and duration of home visits [ 7 – 9 ]. As a result, PNC models and the recommended length-of-stay after childbirth vary globally, with many LMIC countries offering stays too short to provide PNC of adequate quality [ 10 , 11 ]. Several factors determine the timing of discharge, and these are complex and at multiple levels of the socio-ecological framework, and vary globally [ 10 , 12 ]. This underscores the need to examine postpartum length-of-stay in healthcare facilities and its determinants. In Tanzania, the maternal mortality ratio was estimated at 104 per 100,000 livebirths, and the neonatal mortality ratio was 14 per 1,000 livebirths in 2022 [ 13 ]. National policies have paid closer attention to expanding the availability of facility-based childbirth care, increasing the percentage of births in facilities with skilled birth attendants and improving the availability of management for obstetric complications [ 14 , 15 ]. As a result, progress has been made over the last decades, leading to 85% of livebirths being attended by a skilled healthcare professional [ 13 ]. The National Postpartum Care guidelines of the Tanzanian Ministry of Health (MoH) recommends that women and newborns stay 24 hours at the healthcare facility after birth [ 15 ]. This period allows monitoring vital signs and bleeding, early initiation of exclusive breastfeeding and counselling parents on hygiene, family planning, danger sign identification and umbilical care, amongst others [ 16 ]. However, evidence on practices surrounding length-of-stay and determinants of discharge is lacking in Tanzania. This study describes the change in postpartum length-of-stay in healthcare facilities and percentage of early discharge between two time-points, 2015/2016 and 2022 among women who gave birth in healthcare facilities in Tanzania, and determines factors (socio-demographic, economic, facility-level, women’s needs and obstetric history and newborn characteristics) associated with early discharge. Methods Study setting Tanzania, located in Eastern Africa, is a lower-middle income country comprising 31 administrative regions [ 13 ]. The healthcare system follows a pyramidal structure with primary healthcare (including community care) at the base and the National Referral Hospital at the apex [ 17 ]. Most facilities in Tanzania provide childbirth services, and one in five offers comprehensive emergency obstetric and newborn care (CEmONC), which encompasses services such as blood transfusions and caesarean sections [ 17 ]. Most livebirths (81%) occur in a healthcare facility, with 75% of them occurring in governmental facilities [ 13 ]. Adherence to the recommended number and timing of PNC check-ups is low in the country and challenges to quality of care have been repeatedly described [ 18 – 21 ]. One third of women reported receiving a postnatal check-up within four hours of birth, and 44% reported not having received any postnatal checks [ 13 ]. Less than 10% of newborns were reported to receive the first postnatal check-up within the first hour of birth [ 13 ]. Notable regional variability is observed within the country both in terms of maternal and newborn PNC, with coverage being higher in urban compared to rural areas [ 13 , 22 ]. Qualitative evidence suggests that healthcare providers often acknowledge having insufficient time, resources and space which prevents them from providing the quality of postnatal education they aspire to deliver, and require them to reduce the time that women spend in the healthcare facility postpartum [ 23 – 25 ]. Study design, data and population This is a quantitative cross-sectional study using secondary data from two Tanzanian Demographic and Health Surveys (DHS): 2015–2016 and 2022. DHS are nationally representative household surveys of key health and population indicators [ 26 ]. Figure 1 shows the flowchart of inclusion/exclusion by survey year. We included women aged 15–49 years at the survey time, and whose most recent livebirth occurred in a healthcare facility within three years preceding each survey. Births occurring earlier than three years before the survey, and stillbirths, were excluded because they were not captured in both surveys. Outcome and independent variables The outcome of interest is postpartum length-of-stay, representing the time that women spent in a healthcare facility after their most recent livebirth and before discharge. The DHS questionnaire includes the question: “ How long after (NAME) was delivered did you stay there? ”, where the answers are continuous and expressed in hours, days or weeks. We unified the unit of time to hours accounting for the bias introduced by the unit of time according to Campbell et al [ 10 ], and excluded outliers with length-of-stay > 3 weeks (Fig. 1 , n = 16 in 2015-16 and n = 24 in 2022). The continuous variable was categorised as early discharge depending on women’s reported mode of birth. Based on the Tanzanian MoH’s postpartum care guideline and WHO PNC recommendations, early discharge was defined as discharge before 24 hours for women who had a vaginal birth, and before 72 hours for those who gave birth by caesarean section [ 5 , 15 ]. Independent variables, described in Additional File 1, Table S1 , were selected based on a thorough literature review and following the conceptual framework of determinants of postpartum length-of-stay developed by Campbell et al [ 10 ]. We included factors theoretically linked to postpartum length-of-stay and available in the DHS datasets, and spanning four levels: 1) socio-demographic and economic factors (zone, residence, union and cohabiting status, maternal age at index childbirth, education, household wealth index); 2) Facility characteristics and perception of care quality (facility level and ownership, whether women shared bed during stay, spent time without mattress on the floor, were denied care, delayed to leave facility because could not pay or if they had access to a toilet; 3) women’s obstetric history (mode of birth, parity at index birth, antenatal care frequency during index pregnancy, multiple births, previous terminated pregnancy); and 4) newborn characteristics (sex, underweight at birth, newborn survival/time of death). Analysis We described sample characteristics by survey year with frequencies and percentages with 95% confidence intervals. Length-of-stay was described separately by mode of birth (vaginal and caesarean section) and survey year, both as a continuous variable in hours (median) and categorized as early discharge vs. not. Results were displayed in tables and visualized in graphs. Associations between early discharge and independent variables were explored with logistic regression using data from 2022 DHS survey, separately by mode of birth (Additional file 1 Figure S1 ). Factors with p-value < 0.2 were included in multivariable logistic regression models. The variable on newborn survival was excluded from the regression model among women who had a cesarean section because of small sample size in sub-categories. We used Stata SE v.16, and statistical significance level was set at p-value < 0.05. All analyses adjusted for the stratified sampling strategy and sampling weights of the DHS. Missing values Three (0.1%) women in 2015-16 and 36 (0.7%) in 2022 had missing values for length-of-stay and were excluded (Fig. 1 ). Their characteristics are described in Additional file 1 Table S2 . The independent variable ‘newborn weight’ had 213 missing values in 2015-16 and 334 in 2022. In the 2022 survey, there were missing values for the variables on self-reported quality and respectful care. Two of these variables were eligible to be included in the multivariable logistic regression model on early discharge. We conducted a sensitivity analysis by excluding the variables from the models (Additional file 1 Table S3), which showed no impact on direction, strength, or significance of associations. Results Sample characteristics Table 1 describes characteristics of 3,582 and 4,618 women who had their most recent livebirth in a healthcare facility in the three years preceding the 2015–16 and 2022 DHS surveys. In both periods, the most common age group at birth was 20-24 years. 51.6% in 2015–16 and 38.9% in 2022 reported giving birth in a hospital. The percentage of women giving birth in government-owned facilities was 80.5% in 2015–16 and 91.6% in 2022. Births by caesarean section were reported by 10.1% of women in 2015-16 and 13.1% in 2022. Table 1 – Characteristics of women (15-49) who had their most recent livebirth in a healthcare facility in the three years preceding the DHS survey. DHS 2015-16 (n=3582) DHS 2022 (n=4618) Characteristics n (%)† 95%CI n (%)† 95%CI Socio-demographic and economic factors Zone Western 285 (9.8%) [8.1;11.8] 416 (10.4%) [8.9;12.0] Northern 291 (10.3%) [8.6;12.2] 372 (9.5%) [8.4;10.8] Central 334 (10.7%) [9.1;12.5] 375 (9.5%) [8.2;10.9] Southern highlands 347 (7.2%) [6.2;8.3] 408 (6.6%) [5.9;7.3] Southern 195 (5.3%) [4.3;6.6] 219 (5.1%) [3.9;6.4] South west highlands 384 (10.1%) [8.3;12.4] 622 (10.1%) [8.9;11.5] Lake 771 (23.7%) [21.6;25.9] 999 (30.4%) [27.4;33.6] Eastern 452 (20.1%) [17.8;22.5] 497 (15.4%) [13.4;17.6] Zanzibar 523 (2.8%) [2.4;3.2] 710 (3.0%) [2.6;3.4] Residence Rural 2401 (62.0%) [59.2;64.7] 3109 (67.5%) [62.6;71.9] Urban 1181 (38.0%) [35.3;40.8] 1509 (32.5%) [28.1;37.4] Union and cohabiting status at time of survey Not in union/not living with a partner 888 (26.2%) [24.3;28.1] 1260 (28.0%) [26.4;29.6] Living with a partner 2694 (73.8%) [71.9;75.7] 3358 (72.0%) [70.4;73.6] Maternal age at index childbirth 13-19 years 429 (13.3%) [11.9;14.9] 419 (10.0%) [8.9;11.2] 20-24 years 990 (28.3%) [26.6;30.0] 1200 (26.9%) [25.3;28.5] 25-29 years 838 (23.3%) [21.6;25.1] 1210 (26.3%) [24.7;27.9] 30-34 years 653 (18.2%) [16.6;19.8] 845 (17.6%) [16.3;18.9] 35-49 years 672 (16.9%) [15.6;18.3] 944 (19.2%) [17.9;20.5] Highest completed education level No formal education 481 (13.1%) [11.6;14.8] 727 (16.1%) [14.4;17.8] Primary education 2135 (64.0%) [61.7;66.3] 2381 (56.3%) [54.4;58.2] Secondary or higher 966 (22.9%) [20.9;24.9] 1510 (27.6%) [25.6;29.8] Household wealth index Poorest 618 (17.3%) [15.1;19.7] 796 (17.5%) [15.4;19.8] Poorer 648 (20.4%) [18.4;22.5] 862 (19.7%) [17.9;21.6] Middle 654 (19.5%) [17.7;21.4] 928 (20.7%) [19.1;22.5] Richer 715 (21.5%) [19.6;23.6] 991 (21.3%) [19.6;23.2] Richest 947 (21.3%) [18.9;23.7] 1041 (20.8%) [18.0;23.9] Facility characteristics and perception of care quality Facility level Dispensary/clinic 880 (25.3%) [22.9;27.8] 1425 (33.0%) [30.4;35.8] Health center 849 (23.1%) [20.8;25.5] 1248 (28.1%) [26.0;30.3] Hospital 1853 (51.6%) [48.8;54.4] 1945 (38.9%) [36.2;41.6] Facility Ownership Governmental 2962 (80.5%) [77.9;82.8] 4256 (91.6%) [90.2;92.9] Non-governmental 620 (19.5%) [17.2;22.1] 362 (8.4%) [7.1;9.8] Day of birth Weekend 1009 (28.5%) [26.7;30.4] 1182 (24.8%) [23.4;26.3] Weekday 2573 (71.5%) [69.6;73.3] 3436 (75.2%) [73.7;76.6] Shared bed during stay* n/a 558 (11.3%) [9.9;12.7] Spent time without mattress on the floor* n/a 119 (3.0%) [2.3;3.7] Was denied care because could not pay* n/a 150 (3.9%) [3.2;4.8] Was delayed in leaving facility because could not pay* n/a 141 (3.8%) [3.0;4.6] Access to toilet* n/a 3887 (84.2%) [82.7;85.6] Women's needs and obstetric history Mode of birth Vaginal 3258 (89.9%) [88.4;91.3] 3994 (86.9%) [85.4;88.3] Caesarean section 324 (10.1%) [8.7;11.6] 624 (13.1%) [11.7;14.6] Parity at index birth Primiparous 1075 (31.9%) [30.1;33.9] 1133 (24.9%) [23.4;26.5] Multiparous 2-4 1681 (47.9%) [45.7;50.0] 2400 (53.5%) [51.5;55.4] Grand multiparous 5+ 826 (20.2%) [18.6;21.8] 1085 (21.6%) [20.0;23.3] Number of ANC visits during index pregnancy None 28 (0.9%) [0.5;1.4] 447 (9.3%) [8.2;10.6] 1-3 visits 1596 (43.1%) [40.9;45.3] 976 (21.0%) [19.3;22.7] 4 or more visits 1958 (56.0%) [53.8;58.3] 3195 (69.7%) [67.7;71.6] Multiple birth 67 (1.7%) [1.2;2.2] 75 (1.8%) [1.3;2.5] Ever had a terminated pregnancy 609 (16.4%) [15.0;17.8] 627 (12.6%) [11.5;13.8] Newborn characteristics Newborn sex Boy 1851 (53.1%) [51.2;55.0] 2362 (51.7%) [49.9;53.4] Girl 1731 (46.9%) [44.9;48.8] 2256 (48.3%) [46.6;50.0] Newborn underweight status at birth β Underweight (<2500g) 216 (6.1%) [5.2;7.2] 311 (7.3%) [6.3;8.2] Not underweight (≥2500g) 3153 (93.9%) [92.8;94.8] 3973 (92.7%) [91.8;93.6] Newborn survival Survived until survey 3462 (96.6%) [95.9;97.2] 4518 (97.7%) [96.9;98.2] Died on/before discharge 47 (1.3%) [0.9;1.8] 46 (1.1%) [0.7;1.7] Died after discharge 73 (2.1%) [1.6;2.7] 54 (1.2%) [0.9;1.7] Abbreviations: Antenatal care (ANC); Confidence interval (CI); Demographic and Health Survey (DHS). †Percentages are calculated based on the weights of the DHS data. *Missing values: shared bed n=1; Spent time on floor n=3; denied care n=2; delayed to leave n=13; access to toilet n=8. β n=213 missing values for newborn's weight at birth in 2015-16; n=334 missing values in 2022. n/a – not available on the 2015-6 DHS. Postpartum length-of-stay and early discharge Among women who had a vaginal birth, the median time spent in the facility increased from 16 [IQR = 6-36] in 2015-16 to 24 hours [IQR = 12-36] in 2022. Among women who gave birth by caesarean section, the median time spent in the facility was 84 hours in both survey years. Additional file 1 Table S4 describes postpartum length-of-stay and early discharge in 2015-16 and 2022. Figure 2 shows the percentage of women discharged early from healthcare facilities by mode of birth and survey year. Among women who had a vaginal birth, 54.8% [95% CI = 52.4;57.2] were discharged early in 2015-16 and 30.3% [95% CI=28.2; 32.5] in 2022. The percentage of early discharge among women who had a caesarean section was 17.2% [95% CI = 11.3;25.3] in 2015-16 and 25.2% [95% CI = 21.3;29.5] in 2022. Factors associated with early discharge – DHS 2022 The results of bivariate and multivariable logistic regression determining factors associated with early discharge are in Table 2 for women who had a vaginal birth and Table 3 for women who had a caesarean section. Vaginal birth Fourteen factors associated with early discharge with a p-value≤0.2 in bivariate regression were included in the multivariable model. Upon adjusting, three factors were significantly associated with early discharge among women who had a vaginal birth: zone, facility level and number of ANC checks. The odds of early discharge were higher in Zanzibar (aOR=6.3) and South west highlands (aOR=1.8) compared to Eastern zone; while the odds of early discharge were lower in Southern Highlands (aOR=0.5) compared to Eastern zone. The odds of early discharge among women who gave birth in a health centre were 1.5 times higher compared to those who gave birth in a hospital. Similarly, the odds of early discharge among those who gave birth in a dispensary/clinic were 3.7 times higher than hospital-based births. Women who had no ANC checks during the index pregnancy had lower odds of early discharge compared to those who had at least four checks (Table 2). Caesarean section For women who had a caesarean section, eight factors were included in the multivariable regression model. Upon adjusting, three factors were significantly associated with early discharge: education level, level of facility of birth, and newborn underweight status at birth. Women who had no formal education had 0.3 times lower odds of early discharge compared to those who completed primary education. Women who had caesarean section in a lower-level facility (health centre/dispensary/clinic) had 3.3 times the odds of early discharge compared to those who had it in a hospital. Women whose newborns were underweight had five times lower odds of early discharge compared to those whose babies weighed ≥2500g at birth (Table 3). Table 2 – Bivariate and multivariable logistic regression of factors and early discharge among women who had their most recent vaginal birth in a healthcare facility in the three years preceding the DHS 2022 (total n=3994*) Characteristics cOR [95%CI] p-value aOR [95%CI] p-value Socio-demographic and economic factors Zone † Western 0.8 [0.5;1.2] 0.232 0.6 [0.4;1.0] 0.063 Northern 1.0 [0.6;1.4] 0.804 1.2 [07;1.9] 0.500 Central 0.8 [0.6;1.2] 0.320 0.7 [0.5;1.1] 0.154 Southern highlands 0.5 [0.3;0.8] 0.003 0.5 [0.3;0.8] 0.006 Southern 1.4 [0.8;2.4] 0.237 0.9 [0.6;1.5] 0.717 South west highlands 2.3 [1.6;3.2] <0.001 1.8 [1.2;2.8] 0.004 Lake 0.7 [0.5;1.0] 0.042 0.8 [0.5;1.1] 0.136 Eastern ref ref Zanzibar 3.7 [2.7;5.0] <0.001 6.3 [4.0;9.8] <0.001 Residence Rural ref ref Urban 0.7 [0.6;0.9] 0.012 1.0 [0.7;1.3] 0.920 Union and cohabiting status at time of survey Not in union/not living with a partner ref ref Living with a partner 1.2 [0.9;1.5] 0.082 1.2 [0.9;1.4] 0.193 Maternal age at index childbirth 13-19 years 0.9 [0.7;1.3] 0.718 1.0 [0.7;1.4] 0.851 20-24 years ref ref 25-29 years 1.1 [0.8;1.4] 0.475 1.0 [0.8;1.4] 0.827 30-34 years 1.2 [0.9;1.5] 0.134 1.2 [0.8;1.6] 0.391 35-49 years 1.3 [1.0;1.6] 0.045 1.1 [0.8;1.7] 0.503 Highest completed education level No formal education 1.2 [0.9;1.5] 0.147 1.0 [0.8;1.3] 0.772 Primary education ref ref Secondary or higher 0.8 [0.7;1.0] 0.149 0.9 [0.8;1.7] 0.503 Household wealth index Poorest 1.1 [0.9;1.5] 0.329 1.0 [0.7;1.4] 0.959 Poorer 0.8 [0.6;1.1] 0.120 0.8 [0.6;1.1] 0.151 Middle ref ref Richer 0.9 [0.7;1.1] 0.247 0.9 [0.7;1.2] 0.526 Richest 0.8 [0.6;1.1] 0.119 0.9 [0.6;1.3] 0.414 Facility characteristics and perception of care quality Facility level † Dispensary/clinic 3.2 [2.4;4.2] <0.001 3.7 [2.7;5.1] <0.001 Health center 1.2 [0.9;1.6] 0.118 1.5 [1.1;2.0] 0.012 Hospital ref ref Facility ownership Governmental ref ref Non-governmental 0.6 [0.4;0.9] 0.016 0.9 [0.6;1.4] 0.588 Day of birth Weekend ref Weekday 1.0 [0.9;1.2] 0.720 Shared bed during stay No ref Yes 1.1 [0.8;1.4] 0.680 Spent time without a mattress on the floor No ref Yes 1.1 [0.6;1.9] 0.797 Was denied care because could not pay No ref ref Yes 0.7 [0.4;1.2] 0.158 0.7 [0.8;1.6] 0.463 Was delayed in leaving facility because could not pay No ref ref Yes 0.5 [0.3;0.9] 0.016 0.6 [0.3;1.2] 0.122 Access to toilet No ref Yes 1.0 [0.8;1.3] 0.826 Women's needs and obstetric history Parity at index birth Primiparous ref ref Multiparous 2-4 1.3 [1.0;1.6] 0.034 1.0 [0.7;1.3] 0.796 Grand multiparous 5+ 1.6 [1.3;1.9] <0.001 1.1 [0.8;1.6] 0.559 Number of ANC visits during index pregnancy † None 0.7 [0.5;1.0] 0.079 0.6 [0.4;0.9] 0.023 1-3 visits 1.1 [0.9;1.3] 0.536 1.0 [0.8; 1.2] 0.710 4 or more visits ref ref Multiple birth No ref Yes 0.6 [0.3;1.4] 0.224 Ever had a terminated pregnancy No ref Yes 1.0 [0.8;1.3] 0.904 Newborn characteristics Newborn sex Boy ref Girl 0.9 [0.8;1.2] 0.817 Newborn underweight status at birth Not underweight ≥2500g ref ref Underweight <2500g 0.7 [0.5;0.9] 0.032 0.8 [0.5;1.1] 0.114 Newborn survival Survived until survey ref ref Died on/before discharge 0.5 [0.2;1.3] 0.154 0.4 [0.1;1.3] 0.117 Died after discharge 0.5 [0.2;1.2] 0.135 0.7 [0.3;1.7] 0.392 Abbreviations: Antenatal care (ANC); Confidence interval (CI); Crude odds ratio (cOR); Adjusted odds ratio (aOR). *n=323 missing values between the variables ‘delayed to leave the facility’ and ‘newborn weight’. †Factors with significant association with early discharge after vaginal birth in the multivariable model Table 3 – Bivariate and multivariable logistic regression of factors and early discharge among women who had their most recent livebirth by cesarean section in a healthcare facility within three years of DHS 2022 (n=624) Characteristics cOR [95%CI] p-value aOR [95%CI] p-value Socio-demographic and economic factors Zone † Western 0.7 [0.2;2.0] 0.508 0.8 [0.2;2.7] 0.704 Northern 0.8 [0.4;1.5] 0.426 0.8 [0.4;1.8] 0.590 Central 1.0 [0.5;2.2] 0.902 1.5 [0.6;4.0] 0.363 Southern highlands 0.5 [0.3;1.0] 0.050 0.6 [0.3;1.3] 0.171 Southern 0.7 [0.2;2.0] 0.490 0.9 [0.3;2.8] 0.841 South west highlands 0.7 [0.3;1.5] 0.385 0.8 [0.4;2.0] 0.683 Lake 1.0 [0.4;2.4] 0.966 1.3 [0.5;3.3] 0.514 Eastern ref ref Zanzibar 1.4 [0.5;3.7] 0.503 1.9 [0.7;5.1] 0.230 Residence Rural ref ref Urban 1.4 [0.9;2.2] 0.097 1.5 [0.9;2.5] 0.099 Union and cohabiting status at time of survey Not in union/not living with a partner ref Living with a partner 0.9 [0.6;1.5] 0.807 Maternal age at index childbirth 13-19 years 1.4 [0.5;3.5] 0.521 20-24 years ref 25-29 years 1.2 [0.6;2.1] 0.600 30-34 years 1.6 [0.8;3.1] 0.179 35-49 years 0.8 [0.4;1.6] 0.474 Highest completed education level reached † No formal education 0.3 [0.1; 0.8] 0.022 0.3 [0.1;0.9] 0.031 Primary education ref ref Secondary or higher 1.1 [0.7; 1.6] 0.689 1.0 [0.6;1.7] 0.975 Household wealth index Poorest 0.4 [0.1;1.3] 0.124 0.6 [0.2;1.6] 0.289 Poorer 1.1 [0.5;2.2] 0.822 1.3 [0.6;2.8] 0.552 Middle ref Ref Richer 1.4 [0.7;2.7] 0.301 1.5 [0.8;2.9] 0.259 Richest 1.3 [0.7;2.5] 0.400 1.5 [0.7;3.2] 0.251 Facility characteristics and perception of care quality Facility level † Lower level facilities - Health center/dispensary/clinic 2.3 [1.4;3.8] 0.001 3.3 [2.0;5.5] <0.001 Hospital ref ref Facility Ownership Governmental ref ref Non-governmental 0.6 [0.3;1.2] 0.181 0.8 [0.4;1.5] 0.424 Day of birth Weekend ref Weekday 0.8 [0.5;1.4] 0.507 Shared bed during stay No ref Yes 1.4 [0.7;2.7] 0.388 Spent time without a mattress on the floor No ref ref Yes 2.5 [0.8;8.1] 0.117 1.7 [0.5;5.7] 0.410 Was denied care because could not pay No ref Yes 1.1 [0.4;2.9] 0.835 Was delayed in leaving facility because could not pay No ref Yes 1.4 [0.5;3.6] 0.488 Access to toilet No ref Yes 0.7 [0.4;1.3] 0.290 Women's needs and obstetric history Parity at index birth Primiparous ref Multiparous 2-4 1.1 [0.7;1.7] 0.732 Multiparous 5+ 0.7 [0.4;1.4] 0.327 Number of ANC visits during index pregnancy None 1.2 [0.5;2.6] 0.730 1-3 visits 0.9 [0.5;1.6] 0.658 4 or more visits ref Multiple birth No ref Yes 0.9 [0.3;3.2] 0.966 Ever had a terminated pregnancy No ref Yes 0.7 [0.4;1.4] 0.316 Newborn characteristics Newborn sex Boy ref Girl 1.0 [0.7;1.5] 0.888 Newborn underweight status at birth † Not underweight ≥2500g ref ref Underweight <2500g 0.2 [0.1;0.7] 0.013 0.2 [0.1;0.7] 0.014 Abbreviations: Antenatal care (ANC); Confidence interval (CI); Crude odds ratio (cOR); Adjusted odds ratio (aOR).*n=23 missing values between the variables ‘delayed to leave the facility’ and ‘newborn weight’. †Factors with significant association with early discharge after cesarean birth in the multivariable model. Discussion This paper describes change between two time periods in postpartum length-of-stay and early discharge from healthcare facilities in Tanzania, and factors associated with it among women who had a livebirth in the three years preceding DHS 2022. A third of women who gave birth in a health facility were discharged in <24 hours after a vaginal birth and <72 hours after a caesarean section in 2022. Between 2015-16 and 2022, the percentage of early discharge among women who had a vaginal birth (<24 hours) declined, and the opposite was observed among postpartum women discharged <72 hours after a caesarean birth. Significant regional differences in early postpartum discharge exist, and factors associated with early discharge included level of facility of birth, frequency of ANC visits, maternal education and newborn underweight status. Over the examined period, the percentage of women discharged <24 hours after a vaginal birth nearly halved. The MoH’s recommendation of 24 hour stays did not change during this period [15, 16]. The observed change is possibly linked to incremental efforts applied over time to implement those recommendations. Traditionally, women who give birth vaginally are perceived by care providers as having low-risk and possibly discharged earlier than 24 hours. The observed trend could signal a shift from these perceptions and a targeted effort to monitor women and newborns for longer hours postpartum. It is also possible that the upgrading of lower-level facilities to provide surgery care [27] increased bed space availability, particularly in higher level healthcare facilities, potentially reducing the need to discharge women early to create space for others [25]. The percentage of early discharge among women who gave birth via caesarean section (<72 hours) increased between the two periods (from 17% in 2015-6 to 25% in 2022). Globally, postpartum length-of-stay after caesarean section is declining over time [28]; the ERAS program [29] which aims to reduce recovery time post-surgery has been partially implemented in Tanzania, however it is unlikely that it would have an impact at the national level considering that it is not fully institutionalised. During the COVID-19 pandemic, postpartum length-of-stay declined at a faster rate, as women preferred leaving the facility quickly and providers aimed to decongest facilities and reduce risk of infection transmission [30-32]. The data included in this study covers the period of the pandemic – a period when reductions in postpartum length-of-stay were among adaptations implemented in the Tanzanian National referral hospital [32]. Another hypothesis is that the increase in the caesarean section rate (from 7% to 10%) [13] could mean that a larger percentage of all caesarean sections were among women without major complications (e.g. scheduled caesarean section), suggesting that more women who had a caesarean section could recover and leave the health facility earlier. Another possibility is that the demand for post-operative beds increased with the increasing caesarean section rate beyond bed availability and women were discharged earlier to make space for others [25]. Last, it is possible that fewer women were being detained for unpaid fees [33-35] in 2022 and were able to leave the facility earlier, although more research is needed to explore these hypotheses. Despite the reduction in percentage of early postpartum discharge over time, it was documented among a third of women included in the study. This proportion of early discharge following vaginal birth in Tanzania is comparable to estimates in Cameroon (29.7%) [36], India (22.3%) [37], and Eswatini (22%); and higher than Malawi (10%) [38]. Early discharge <72 hours after a caesarean birth was higher in Tanzania compared to Cameroon (15.1%) and India (12.8%) [36, 37]. This suggests challenges related to prioritization of immediate PNC, guideline implementation, space availability, staffing, among other health-system issues hindering provision of quality care in the immediate postpartum period [39]. The results of the multivariable analysis show that early discharge is determined by health-system level factors. Women who gave birth in lower-level facilities might be less likely to suffer from complications compared to women who birth in higher-level facilities, therefore might be considered by providers that they can recover and be discharged before the recommended length-of-stay. This higher odds of early discharge in lower-level facilities could also be a result of having less resources, including infrastructure, space availability, and human resources, compared to hospitals. Additionally, this signals a potential difference in adherence to guidelines between the levels of the healthcare system. In a context where lower-level facilities are being upgraded to provide CEmONC [27], efforts should be made to ensure the same quality of care is available across all healthcare facilities. The results also highlight geographic differences with early discharge being higher in Zanzibar compared to other geographic zones. This could be a result of lack of space availability in Zanzibar due to congestion of hospitals leading to discharging women as soon as safe for them to free-up beds. Another explanation could be that there is inconsistent implementation of recommendations between zones, suggesting potential inequalities in the provision and quality of immediate postpartum care, and ultimately maternal and newborn healthcare outcomes. Several factors at different levels could be barriers to postnatal care guideline implementation such as the inadequate adaptation of guidelines, limited incorporation of women-centred approaches, and insufficient prioritization of PNC within health systems, policy frameworks, and financial allocations [39]. Proxies of known risk factors for women such as age, parity, multiple births, previous termination, had no significant association with early discharge in our findings. Similar findings were noted in Guinea [11], suggesting that timing of discharge is mostly determined by organizational decisions rather than to meet women’s needs and preferences. Additionally, factors related to women’s perception of quality of care were not significantly associated with early discharge, suggesting that women’s experience of care are not taken into consideration when deciding time of discharge. On the other hand, women whose newborns were born underweight had lower odds of being discharged early after a caesarean section. One hypothesis is that some births by caesarean section were indicated by complications such as pre-eclampsia to prevent further deterioration in the mother. In these cases, the newborn may be underweight/premature, and mother and baby stay longer to recover. However, it is not clear in DHS data if women who stay longer with the newborn continue to receive care and be clinically followed. Women who had no ANC checks had lower odds of early discharge compared to those who had four or more (Table 2). This could mean that women who had more ANC checks received more content of care (e.g. in terms of counselling on breastfeeding) that could have signalled to providers that they are more ‘ready’ to leave the health facility prior to 24 hours. From another perspective, the lack of ANC attendance might have signalled to healthcare providers that women could be at higher risk and require more postnatal counselling and longer monitoring. Contrary to the literature [10, 36], our results showed that higher education level was associated with higher odds of early discharge following birth by caesarean section. Women with lower education may be more at risk of maternal morbidity [40] therefore needing to stay longer in the facility for recovery. Additionally, it is possible that women with lower education stayed longer in the facility to ensure full recovery before discharge as providers acknowledge their vulnerability and attempt to counter the possibility that they might not return for an outpatient postnatal check [41]. On the other hand, it is also possible that women with higher levels of education have more social capital and better conditions to recover at home, and are therefore more capable of negotiating earlier discharge [10]. Implications for research and practice Implications for future research include the need for in-depth understanding of factors underlying the incomplete adherence to recommendations leading to early discharge. This includes qualitative research and exploration of postnatal care guideline implementation in Tanzania, especially at lower-level (primary) healthcare facilities. Also of interest is exploring the content, frequency and quality of immediate postnatal care and discharge preparedness, and women and care providers’ preferences. Future research should also explore effects of length-of-stay on maternal and newborn outcomes in low-resource settings. From the practice side, our study highlights the need to ensure that the conditions needed for guideline implementation, including facility infrastructure for enabling positive immediate postnatal period, are consistently available in all levels of healthcare facilities and across regions to reduce inequalities in care provision and access to quality care among all women. There is a need to integrate person-centred care in recommendations and practice, to involve women and families in decisions of postpartum discharge by adopting participatory approaches that take into consideration available resources, care providers’ needs, and women’s and families’ choices and preferences. Strengths and limitations This study presents nationally representative estimates and periodic change in early discharge in Tanzania, and informs recommendations to improve immediate postnatal care in Tanzania. Nonetheless, some limitations of the work exist, including the absence of information on maternal and newborn complications during pregnancy, intrapartum and postpartum which are important determinants of length-of-stay [42, 43]. The analysis also allowed to explore issues with data quality related to specific variables in the Tanzanian DHS, especially those related to respectful quality care which at one point signal overreporting of good quality of care leading us to drop some variables from the analysis (e.g. birth companionship prevalence was ~80% in 2022 DHS data while the literature shows that this value is overestimated [44]). Other reporting bias including recall bias are possible to affect the data quality – for example a proportion of women who had a caesarean section reported having it in a dispensary which is a level of facility that is not usually equipped to provide caesarean sections. Excluding women who stayed longer than 3 weeks as outliers could exclude some women who had severely premature newborns or other complications, however we used this cut-off consistently with previous research on the topic [10]. Conclusion Despite reduction of short postpartum stays after vaginal births, early postpartum discharge affected a third of the women giving birth in Tanzania. Early discharge could be introducing a preventable risk of missing the identification and treatment of complications, considering that around one in five women who give birth in a health facility in Tanzania reported not receiving a postnatal check [41]. Inequalities and inconsistencies in guideline application were identified in the study, warranting the need to ensure equitable provision of adequate quality of postnatal care in all geographic zones and levels of healthcare facilities. More attention to improving immediate and longer-term postnatal care is recommended at the national level. Declarations Ethics approval and consent to participate This secondary data analysis was waved from an ethics review by the ethics committee at the Institute of Tropical Medicine, Antwerp. DHS protocols and questionnaires were reviewed and approved by ICF institutional review board and by a review board in Tanzania. Prior to participation, all participants provided informed consent emphasizing voluntary participation, and parents/guardians of adolescent participants provided consent. The conduct of data collection and processing ensures protection of privacy and confidentiality of participants [45]. The analysed secondary data were anonymised to protect participant confidentiality. Availability of data and materials This paper uses secondary data that were made available by the DHS program at the time that the database was acquired. Authors do not hold ownership of the data and this reason prevents us from sharing the data with the manuscript. Competing interests The authors have declared that no competing interests exist. Funding This work did not receive any direct funding. The Research Foundation—Flanders (FWO) partly supported LB as part of her Senior Postdoctoral Fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors’ contributions AS conceptualised the study, analysed the data. LA and AS drafted the first version of the manuscript. AK, NH, ABP, TvdA and LB reviewed and provided critical input to the data analysis plan. All authors contributed to the interpretation of the results, and reviewed and approved the final version of the manuscript. Acknowledgements We would like to acknowledge the women who took the time to respond to the survey. References World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. In. Geneva; 2023. United Nations Inter-agency Group for Child Mortality Estimation (UNIGME). Levels & Trends in Child Mortality: Report 2023, Estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation, United Nations Children’s Fund. In. New York; 2024. Cresswell JA, Alexander M, Chong MYC, Link HM, Pejchinovska M, Gazeley U, Ahmed SMA,Chou D, Moller A-B, Simpson Det al: Global and regional causes of maternal deaths 2009–20: a WHO systematic analysis. The Lancet Global Health . United Nations Inter-agency Group for Child Mortality Estimation. Never Forgotten - The situation of stillbirth around the globe. Report of the United Nations Inter-agencyGroup for Child Mortality Estimation. In.; 2022. World Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience. Geneva: World Health Organization; 2022. Smith H, Harvey C, Portela A. Discharge preparation and readiness after birth: a scoping review of global policies, guidelines and literature. BMC Pregnancy Childbirth. 2022;22(1):281. Yonemoto N, Dowswell T, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Cochrane Database Syst Reviews 2017(8). Mespreuve A-S, Apers L, Moller A-B, Galle A. Postnatal quality of care measures for mothers and newborns at home: A scoping review. PLOS Global Public Health. 2024;4(8):e0003498. Brown S, Small R, Argus B, Davis P, Krastev A. Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database Syst Reviews 2002(3). Campbell OMR, Cegolon L, Macleod D, 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. PLoS Med. 2016;13(3):e1001972. Semaan A, Grovogui FM, Delvaux T, Housseine N, van den Akker T, Delamou A, Beňová L. Length-of-stay and factors associated with early discharge after birth in health facilities in Guinea by mode of birth: Secondary analysis of Demographic and Health Survey 2018. PLOS Glob Public Health. 2024;4(10):e0003786. Cegolon L, Campbell O, Alberico S, Montico M, Mastrangelo G, Monasta L, Ronfani L, Barbone F. Length of stay following vaginal deliveries: A population based study in the Friuli Venezia Giulia region (North-Eastern Italy), 2005–2015. PLoS ONE. 2019;14(1):e0204919. Ministry of Health (MoH). [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF: Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022 Key Indicators Report. In. Dodoma, Tanzania and Rockville, Maryland, USA: MoH, NBS, OCGS, and ICF; 2023. Straneo M, Beňová L, van den Akker T, Pembe AB, Smekens T, Hanson C. No increase in use of hospitals for childbirth in Tanzania over 25 years: Accumulation of inequity among poor, rural, high parity women. PLOS Global Public Health. 2022;2(8):e0000345. Ministry of Health Community Development Gender Elderly and Children - The United Republic of Tanzania. National Postpartum Care Guidelines. In.; 2019. Ministry of Health and Social Welfare - Tanzania. National Postnatal Care Guidelines. In. Dar es Salaam; 2012. Ministry of Health Community Development Gender Elderly and Children - United Republic of Tanzania. Health Sector Strategic Plan July 2021 – June 2026 (HSSP V) - Leaving no one behind. In.; 2021. Madaj B, Gopalakrishnan S, Quach A, Filiaci S, Traore A, Bakusa D, Mdegela M, Yousofzai AW, Rahmanzai AJ, Kodindo G. Where is the ‘C’in antenatal care and postnatal care: A multi-country survey of availability of antenatal and postnatal care in low‐and middle‐income settings. BJOG: Int J Obstet Gynecol. 2022;129(9):1546–57. Kruk ME, Hermosilla S, Larson E, Mbaruku GM. Bypassing primary care clinics for childbirth: a cross-sectional study in the Pwani region, United Republic of Tanzania. Bull World Health Organ. 2014;92(4):246–53. Hanson C, Ronsmans C, Penfold S, Maokola W, Manzi F, Jaribu J, Mbaruku G, Mshinda H, Tanner M, Schellenberg J. Health system support for childbirth care in Southern Tanzania: results from a health facility census. BMC Res Notes. 2013;6(1):435. Baker U, Peterson S, Marchant T, Mbaruku G, Temu S, Manzi F, Hanson C. Identifying implementation bottlenecks for maternal and newborn health interventions in rural districts of the United Republic of Tanzania. Bull World Health Organ. 2015;93(6):380–9. Langa N, Bhatta T. The rural-urban divide in Tanzania: Residential context and socioeconomic inequalities in maternal health care utilization. PLoS ONE. 2020;15(11):e0241746. Dol J, Kohi T, Campbell-Yeo M, Tomblin Murphy G, Aston M, Mselle L. Exploring maternal postnatal newborn care postnatal discharge education in Dar es Salaam, Tanzania: Barriers, facilitators and opportunities. Midwifery. 2019;77:137–43. Macdonald D, Aston M, Murphy GT, Jefferies K, Mselle LT, Price S, O’Hearn S, White M, Mbekenga C, Kohi TW. Providing postpartum care with limited resources: Experiences of nurse-midwives and obstetricians in urban Tanzania. Women Birth. 2019;32(3):e391–8. McMahon SA, Mohan D, LeFevre AE, Mosha I, Mpembeni R, Chase RP, Baqui AH, Winch PJ. You should go so that others can come; the role of facilities in determining an early departure after childbirth in Morogoro Region, Tanzania. BMC Pregnancy Childbirth. 2015;15:328. The Demographic. and Health Surveys Program [https://dhsprogram.com/]. Kapologwe NA, Meara JG, Kengia JT, Sonda Y, Gwajima D, Alidina S, Kalolo A. Development and upgrading of public primary healthcare facilities with essential surgical services infrastructure: a strategy towards achieving universal health coverage in Tanzania. BMC Health Serv Res. 2020;20(1):218. Semaan A, Vercoutere A, Ezeanochie M, Afolabi BB, Mery G, Gadama L, Kascak P, Galadanci HS, Akker Tvd, Benova L. Change in maternal postpartum length of stay in health facilities during COVID-19: Analysis of population representative data from 33 countries with six nested comparative case studies. In.; 2024 - under review. Kifle F, Kenna P, Daniel S, Maswime S, Biccard B. A scoping review of Enhanced Recovery After Surgery (ERAS), protocol implementation, and its impact on surgical outcomes and healthcare systems in Africa. Perioperative Med. 2024;13(1):86. Semaan A, Audet C, Huysmans E, Afolabi B, Assarag B, Banke-Thomas A, Blencowe H, Caluwaerts S, Campbell OMR, Cavallaro FL, et al. Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic. BMJ Global Health. 2020;5(6):e002967. Semaan A, Dey T, Kikula A, Asefa A, Delvaux T, Langlois EV, van den Akker T, Benova L. Separated during the first hours—Postnatal care for women and newborns during the COVID-19 pandemic: A mixed-methods cross-sectional study from a global online survey of maternal and newborn healthcare providers. PLOS Global Public Health. 2022;2(4):e0000214. Semaan A, Banke-Thomas A, Amongin D, Babah O, Dioubate N, Kikula A, Nakubulwa S, Ogein O, Adroma M, Anzo Adiga W, et al. We are not going to shut down, because we cannot postpone pregnancy’: a mixed-methods study of the provision of maternal healthcare in six referral maternity wards in four sub-Saharan African countries during the COVID-19 pandemic. BMJ Global Health. 2022;7(2):e008063. Kruk ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plann. 2014;33(1):e26–33. Sando D, Ratcliffe H, McDonald K, Spiegelman D, Lyatuu G, Mwanyika-Sando M, Emil F, Wegner MN, Chalamilla G, Langer A. The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy Childbirth. 2016;16(1):236. Bishanga DR, Massenga J, Mwanamsangu AH, Kim Y-M, George J, Kapologwe NA, Zoungrana J, Rwegasira M, Kols A, Hill K, et al. Women’s Experience of Facility-Based Childbirth Care and Receipt of an Early Postnatal Check for Herself and Her Newborn in Northwestern Tanzania. Int J Environ Res Public Health. 2019;16(3):481. Fouogue JT, Semaan A, Smekens T, Day L-T, Filippi V, Mitsuaki M, Fouelifack FY, Kenfack B, Fouedjio JH, Delvaux T, et al. Length of stay and determinants of early discharge after facility-based childbirth in Cameroon: analysis of the 2018 Demographic and Health Survey. BMC Pregnancy Childbirth. 2023;23(1):575. Kumar P, Dhillon P. Length of stay after childbirth in India: a comparative study of public and private health institutions. BMC Pregnancy Childbirth. 2020;20(1):181. Tsiga-Ahmed FI, Jalo RI, Ibrahim UM, Kwaku AA, Umar AA, Sanusi SM, Amole TG. Length-of-stay after a health facility birth and associated factors: analysis of data from three Sub-Saharan African countries. Ghana Med J. 2022;56(2):100–9. Beňová L, Semaan A, Portela A, Bonet M, van den Akker T, Pembe AB, Moran A, Duclos D. Facilitators and barriers of implementation of routine postnatal care guidelines for women: A systematic scoping review using critical interpretive synthesis. J global health 2023, 13. Kern-Goldberger AR, Nigel M, D. BC MFA, Gyamfi-Bannerman C. Disparities in obstetric morbidity by maternal level of education. J Maternal-Fetal Neonatal Med. 2022;35(24):4682–6. Mohan D, Gupta S, LeFevre A, Bazant E, Killewo J, Baqui AH. Determinants of postnatal care use at health facilities in rural Tanzania: multilevel analysis of a household survey. BMC Pregnancy Childbirth. 2015;15(1):282. Ghebremeskel GG, Kahsay MT, Gulbet ME, Mehretab AG. Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea. BMC Pregnancy Childbirth. 2023;23(1):613. Essien SK, Chireh B, Melese KG, Essien JK. Predictors of prolonged hospitalization after vaginal birth in Ghana: A comparative study. PLOS Global Public Health. 2022;2(1):e0000100. Housseine N, Punt MC, Mohamed AG, Said SM, Maaløe N, Zuithoff NPA, Meguid T, Franx A, Grobbee DE, Browne JL, et al. Quality of intrapartum care: direct observations in a low-resource tertiary hospital. Reproductive Health. 2020;17(1):36. Protecting the privacy of DHS Survey Respondents. [ https://dhsprogram.com/Methodology/Protecting-the-Privacy-of-DHS-Survey-Respondents.cfm] Additional Declarations No competing interests reported. Supplementary Files Additionalfile1Variabledefinitionsmissingdataandadditionalanalyses.pdf Additionalfile2STROBEchecklist.docx Cite Share Download PDF Status: Published Journal Publication published 14 Jan, 2026 Read the published version in BMC Health Services Research → Version 1 posted Editorial decision: Revision requested 17 Dec, 2025 Reviews received at journal 12 Dec, 2025 Reviewers agreed at journal 30 Nov, 2025 Reviews received at journal 24 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers agreed at journal 14 Aug, 2025 Reviewers agreed at journal 14 Aug, 2025 Reviews received at journal 12 Aug, 2025 Reviewers agreed at journal 12 Aug, 2025 Reviewers invited by journal 11 Aug, 2025 Editor invited by journal 18 Jul, 2025 Editor assigned by journal 18 Jul, 2025 Submission checks completed at journal 18 Jul, 2025 First submitted to journal 16 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Kikula","email":"","orcid":"","institution":"Institute of Tropical Medicine","correspondingAuthor":false,"prefix":"","firstName":"Amani","middleName":"","lastName":"Kikula","suffix":""},{"id":500682097,"identity":"33e8a704-5392-4373-bb9e-031b38682b63","order_by":3,"name":"Thomas van den Akker","email":"","orcid":"","institution":"Leiden University Medical Centre","correspondingAuthor":false,"prefix":"","firstName":"Thomas","middleName":"van den","lastName":"Akker","suffix":""},{"id":500682098,"identity":"30f89ac5-2746-483b-beb9-0f003f1a253b","order_by":4,"name":"Andrea Barnabas Pembe","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Andrea","middleName":"Barnabas","lastName":"Pembe","suffix":""},{"id":500682099,"identity":"26980e86-4255-4bcd-ae8e-181df4c63036","order_by":5,"name":"Lenka Beňová","email":"","orcid":"","institution":"Institute of Tropical Medicine","correspondingAuthor":false,"prefix":"","firstName":"Lenka","middleName":"","lastName":"Beňová","suffix":""},{"id":500682100,"identity":"6a532533-304e-4418-82da-f80d337f5220","order_by":6,"name":"Natasha Housseine","email":"","orcid":"","institution":"University of Copenhagen","correspondingAuthor":false,"prefix":"","firstName":"Natasha","middleName":"","lastName":"Housseine","suffix":""}],"badges":[],"createdAt":"2025-07-16 16:08:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7141902/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7141902/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12913-026-14035-x","type":"published","date":"2026-01-14T16:29:26+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":89417466,"identity":"d2c54a0e-af48-474c-a0b4-3a81f3efb344","added_by":"auto","created_at":"2025-08-19 17:36:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":5487097,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFlowchart of inclusion criteria and final sample size of women who participated in the Tanzania DHS (unweighted percentages shown)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-7141902/v1/0106baed7d97cfcb727633d5.png"},{"id":89417151,"identity":"25e30963-481a-41c4-8426-62b663025946","added_by":"auto","created_at":"2025-08-19 17:28:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":890880,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePercentage of early discharge* among women who had their most recent livebirth in the three years preceding the survey, by mode of birth and DHS survey year.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-7141902/v1/06fd8a366675cbe6a120164e.png"},{"id":100614735,"identity":"794f850f-ae21-4573-b99e-687fca6e43c1","added_by":"auto","created_at":"2026-01-19 17:23:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":10487680,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7141902/v1/c6c61b67-b2e6-4800-86a4-17aed5beab40.pdf"},{"id":89417469,"identity":"04d5866d-fd6d-476f-80a4-76b3146d1343","added_by":"auto","created_at":"2025-08-19 17:36:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":386782,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile1Variabledefinitionsmissingdataandadditionalanalyses.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7141902/v1/72a2c12a5e51993dec9dda95.pdf"},{"id":89417153,"identity":"f3287f8d-ac02-45b1-a630-a5dd42d9bb28","added_by":"auto","created_at":"2025-08-19 17:28:03","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":33476,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile2STROBEchecklist.docx","url":"https://assets-eu.researchsquare.com/files/rs-7141902/v1/397cf639d5175585a39bdefa.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Discharge time from healthcare facilities after birth in Tanzania : A secondary analysis of Demographic and Health Surveys from 2015-16 and 2022","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMaternal and newborn mortality remains high globally with an estimated 287,000 maternal deaths in 2020 and 2.3\u0026nbsp;million neonatal deaths in 2022, whereby most of these deaths occur in low- and middle-income countries (LMIC) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Common causes of maternal deaths include haemorrhage, hypertensive disorders and sepsis, and most maternal deaths occur in the postpartum period [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Additionally, around 1.9\u0026nbsp;million intrapartum stillbirths occurred in 2021 and one million newborns died in 2022 during the first hours after birth [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This highlights the need for early postnatal care (PNC) during the first week after birth, for closely monitoring the mother\u0026rsquo;s and newborn\u0026rsquo;s health, and detecting and managing complications timely [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe latest World Health Organization (WHO) recommendations advise a minimum 24 hours stay in a healthcare facility after vaginal birth, enabling continuous care and monitoring for women and newborns [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The WHO underscores the importance of delivering these recommendations within an appropriate model of PNC, tailored to fit the needs, resources and local contexts of countries or regions [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. A model of PNC refers to the organization of care provision elements such as length-of-stay after facility-based childbirth, and the provider, location, frequency, timing, duration of postnatal checks. Evidence to inform the organization of PNC models remains limited, as highlighted by two Cochrane reviews showing gaps in research on postpartum length-of-stay and the frequency, timing, and duration of home visits [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. As a result, PNC models and the recommended length-of-stay after childbirth vary globally, with many LMIC countries offering stays too short to provide PNC of adequate quality [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Several factors determine the timing of discharge, and these are complex and at multiple levels of the socio-ecological framework, and vary globally [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. This underscores the need to examine postpartum length-of-stay in healthcare facilities and its determinants.\u003c/p\u003e\u003cp\u003eIn Tanzania, the maternal mortality ratio was estimated at 104 per 100,000 livebirths, and the neonatal mortality ratio was 14 per 1,000 livebirths in 2022 [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. National policies have paid closer attention to expanding the availability of facility-based childbirth care, increasing the percentage of births in facilities with skilled birth attendants and improving the availability of management for obstetric complications [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. As a result, progress has been made over the last decades, leading to 85% of livebirths being attended by a skilled healthcare professional [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The National Postpartum Care guidelines of the Tanzanian Ministry of Health (MoH) recommends that women and newborns stay 24 hours at the healthcare facility after birth [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This period allows monitoring vital signs and bleeding, early initiation of exclusive breastfeeding and counselling parents on hygiene, family planning, danger sign identification and umbilical care, amongst others [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, evidence on practices surrounding length-of-stay and determinants of discharge is lacking in Tanzania. This study describes the change in postpartum length-of-stay in healthcare facilities and percentage of early discharge between two time-points, 2015/2016 and 2022 among women who gave birth in healthcare facilities in Tanzania, and determines factors (socio-demographic, economic, facility-level, women\u0026rsquo;s needs and obstetric history and newborn characteristics) associated with early discharge.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eStudy setting\u003c/span\u003e\u003c/p\u003e\u003cp\u003eTanzania, located in Eastern Africa, is a lower-middle income country comprising 31 administrative regions [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The healthcare system follows a pyramidal structure with primary healthcare (including community care) at the base and the National Referral Hospital at the apex [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Most facilities in Tanzania provide childbirth services, and one in five offers comprehensive emergency obstetric and newborn care (CEmONC), which encompasses services such as blood transfusions and caesarean sections [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Most livebirths (81%) occur in a healthcare facility, with 75% of them occurring in governmental facilities [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Adherence to the recommended number and timing of PNC check-ups is low in the country and challenges to quality of care have been repeatedly described [\u003cspan additionalcitationids=\"CR19 CR20\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. One third of women reported receiving a postnatal check-up within four hours of birth, and 44% reported not having received any postnatal checks [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Less than 10% of newborns were reported to receive the first postnatal check-up within the first hour of birth [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Notable regional variability is observed within the country both in terms of maternal and newborn PNC, with coverage being higher in urban compared to rural areas [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Qualitative evidence suggests that healthcare providers often acknowledge having insufficient time, resources and space which prevents them from providing the quality of postnatal education they aspire to deliver, and require them to reduce the time that women spend in the healthcare facility postpartum [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eStudy design, data and population\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThis is a quantitative cross-sectional study using secondary data from two Tanzanian Demographic and Health Surveys (DHS): 2015\u0026ndash;2016 and 2022. DHS are nationally representative household surveys of key health and population indicators [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the flowchart of inclusion/exclusion by survey year. We included women aged 15\u0026ndash;49 years at the survey time, and whose most recent livebirth occurred in a healthcare facility within three years preceding each survey. Births occurring earlier than three years before the survey, and stillbirths, were excluded because they were not captured in both surveys.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eOutcome and independent variables\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe outcome of interest is postpartum length-of-stay, representing the time that women spent in a healthcare facility after their most recent livebirth and before discharge. The DHS questionnaire includes the question: \u0026ldquo;\u003cem\u003eHow long after (NAME) was delivered did you stay there?\u003c/em\u003e\u0026rdquo;, where the answers are continuous and expressed in hours, days or weeks. We unified the unit of time to hours accounting for the bias introduced by the unit of time according to Campbell et al [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], and excluded outliers with length-of-stay\u0026thinsp;\u0026gt;\u0026thinsp;3 weeks (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, n\u0026thinsp;=\u0026thinsp;16 in 2015-16 and n\u0026thinsp;=\u0026thinsp;24 in 2022). The continuous variable was categorised as early discharge depending on women\u0026rsquo;s reported mode of birth. Based on the Tanzanian MoH\u0026rsquo;s postpartum care guideline and WHO PNC recommendations, early discharge was defined as discharge before 24 hours for women who had a vaginal birth, and before 72 hours for those who gave birth by caesarean section [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIndependent variables, described in Additional File 1, Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e, were selected based on a thorough literature review and following the conceptual framework of determinants of postpartum length-of-stay developed by Campbell et al [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. We included factors theoretically linked to postpartum length-of-stay and available in the DHS datasets, and spanning four levels: 1) socio-demographic and economic factors (zone, residence, union and cohabiting status, maternal age at index childbirth, education, household wealth index); 2) Facility characteristics and perception of care quality (facility level and ownership, whether women shared bed during stay, spent time without mattress on the floor, were denied care, delayed to leave facility because could not pay or if they had access to a toilet; 3) women\u0026rsquo;s obstetric history (mode of birth, parity at index birth, antenatal care frequency during index pregnancy, multiple births, previous terminated pregnancy); and 4) newborn characteristics (sex, underweight at birth, newborn survival/time of death).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAnalysis\u003c/span\u003e\u003c/p\u003e\u003cp\u003eWe described sample characteristics by survey year with frequencies and percentages with 95% confidence intervals. Length-of-stay was described separately by mode of birth (vaginal and caesarean section) and survey year, both as a continuous variable in hours (median) and categorized as early discharge vs. not. Results were displayed in tables and visualized in graphs. Associations between early discharge and independent variables were explored with logistic regression using data from 2022 DHS survey, separately by mode of birth (Additional file 1 Figure \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e). Factors with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 were included in multivariable logistic regression models. The variable on newborn survival was excluded from the regression model among women who had a cesarean section because of small sample size in sub-categories. We used Stata SE v.16, and statistical significance level was set at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. All analyses adjusted for the stratified sampling strategy and sampling weights of the DHS.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eMissing values\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThree (0.1%) women in 2015-16 and 36 (0.7%) in 2022 had missing values for length-of-stay and were excluded (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Their characteristics are described in Additional file 1 Table \u003cspan refid=\"MOESM2\" class=\"InternalRef\"\u003eS2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003eThe independent variable \u0026lsquo;newborn weight\u0026rsquo; had 213 missing values in 2015-16 and 334 in 2022. In the 2022 survey, there were missing values for the variables on self-reported quality and respectful care. Two of these variables were eligible to be included in the multivariable logistic regression model on early discharge. We conducted a sensitivity analysis by excluding the variables from the models (Additional file 1 Table S3), which showed no impact on direction, strength, or significance of associations.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cu\u003eSample characteristics\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 describes characteristics of 3,582 and 4,618 women who had their most recent livebirth in a healthcare facility in the three years preceding the 2015\u0026ndash;16 and 2022 DHS surveys. In both periods, the most common age group at birth was 20-24 years. 51.6% in 2015\u0026ndash;16 and 38.9% in 2022 reported giving birth in a hospital. The percentage of women giving birth in government-owned facilities was 80.5% in 2015\u0026ndash;16 and 91.6% in 2022. Births by caesarean section were reported by 10.1% of women in 2015-16 and 13.1% in 2022.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable 1\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e \u0026ndash; Characteristics of women (15-49) who had their most recent livebirth in a healthcare facility in the three years preceding the DHS survey.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable width=\"688\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"298\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"161\"\u003e\n\u003cp\u003e\u003cstrong\u003eDHS 2015-16 (n=3582)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"181\"\u003e\n\u003cp\u003e\u003cstrong\u003eDHS 2022 (n=4618)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"49\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u003cstrong\u003en (%)\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u003cstrong\u003e95%CI\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e\u003cstrong\u003en (%)\u0026dagger;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u003cstrong\u003e95%CI\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"32\" width=\"49\"\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic and economic factors\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eZone\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eWestern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e285 (9.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.1;11.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e416 (10.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.9;12.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eNorthern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e291 (10.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.6;12.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e372 (9.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.4;10.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eCentral\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e334 (10.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[9.1;12.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e375 (9.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.2;10.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eSouthern highlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e347 (7.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[6.2;8.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e408 (6.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[5.9;7.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eSouthern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e195 (5.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[4.3;6.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e219 (5.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[3.9;6.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eSouth west highlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e384 (10.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.3;12.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e622 (10.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.9;11.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eLake\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e771 (23.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[21.6;25.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e999 (30.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[27.4;33.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eEastern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e452 (20.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[17.8;22.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e497 (15.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[13.4;17.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eZanzibar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e523 (2.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[2.4;3.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e710 (3.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[2.6;3.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eRural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2401 (62.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[59.2;64.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3109 (67.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[62.6;71.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eUrban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1181 (38.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[35.3;40.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1509 (32.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[28.1;37.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eUnion and cohabiting status at time of survey \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eNot in union/not living with a partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e888 (26.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[24.3;28.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1260 (28.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[26.4;29.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eLiving with a partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2694 (73.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[71.9;75.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3358 (72.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[70.4;73.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eMaternal age at index childbirth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e13-19 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e429 (13.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[11.9;14.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e419 (10.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.9;11.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e20-24 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e990 (28.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[26.6;30.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1200 (26.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[25.3;28.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e25-29 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e838 (23.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[21.6;25.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1210 (26.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[24.7;27.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e30-34 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e653 (18.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[16.6;19.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e845 (17.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[16.3;18.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e35-49 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e672 (16.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[15.6;18.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e944 (19.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[17.9;20.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eHighest completed education level \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eNo formal education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e481 (13.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[11.6;14.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e727 (16.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[14.4;17.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003ePrimary education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2135 (64.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[61.7;66.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e2381 (56.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[54.4;58.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eSecondary or higher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e966 (22.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[20.9;24.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1510 (27.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[25.6;29.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eHousehold wealth index\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003ePoorest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e618 (17.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[15.1;19.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e796 (17.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[15.4;19.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003ePoorer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e648 (20.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[18.4;22.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e862 (19.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[17.9;21.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eMiddle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e654 (19.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[17.7;21.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e928 (20.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[19.1;22.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eRicher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e715 (21.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[19.6;23.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e991 (21.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[19.6;23.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eRichest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e947 (21.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[18.9;23.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1041 (20.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[18.0;23.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"15\" width=\"49\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility characteristics and perception of care quality\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility level\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eDispensary/clinic\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e880 (25.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[22.9;27.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1425 (33.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[30.4;35.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eHealth center\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e849 (23.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[20.8;25.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1248 (28.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[26.0;30.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eHospital\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1853 (51.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[48.8;54.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1945 (38.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[36.2;41.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility Ownership\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eGovernmental\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2962 (80.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[77.9;82.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e4256 (91.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[90.2;92.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eNon-governmental\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e620 (19.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[17.2;22.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e362 (8.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[7.1;9.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eDay of birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eWeekend\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1009 (28.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[26.7;30.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1182 (24.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[23.4;26.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eWeekday\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2573 (71.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[69.6;73.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3436 (75.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[73.7;76.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eShared bed during stay*\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;n/a\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e558 (11.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[9.9;12.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eSpent time without mattress on the floor*\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;n/a\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e119 (3.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[2.3;3.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eWas denied care because could not pay*\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;n/a\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e150 (3.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[3.2;4.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eWas delayed in leaving facility because could not pay*\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;n/a\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e141 (3.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[3.0;4.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eAccess to toilet*\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003en/a\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3887 (84.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[82.7;85.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"13\" width=\"49\"\u003e\n\u003cp\u003e\u003cstrong\u003eWomen's needs and obstetric history\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eMode of birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eVaginal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e3258 (89.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[88.4;91.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3994 (86.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[85.4;88.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eCaesarean section\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e324 (10.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.7;11.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e624 (13.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[11.7;14.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eParity at index birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003ePrimiparous\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1075 (31.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[30.1;33.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1133 (24.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[23.4;26.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eMultiparous 2-4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1681 (47.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[45.7;50.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e2400 (53.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[51.5;55.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eGrand multiparous 5+\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e826 (20.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[18.6;21.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e1085 (21.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[20.0;23.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eNumber of ANC visits during index pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e28 (0.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[0.5;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e447 (9.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[8.2;10.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e1-3 visits\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1596 (43.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[40.9;45.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e976 (21.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[19.3;22.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e4 or more visits\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1958 (56.0%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[53.8;58.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3195 (69.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[67.7;71.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eMultiple birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e67 (1.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[1.2;2.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e75 (1.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[1.3;2.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eEver had a terminated pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e609 (16.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[15.0;17.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e627 (12.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[11.5;13.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"10\" width=\"49\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn sex\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eBoy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1851 (53.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[51.2;55.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e2362 (51.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[49.9;53.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eGirl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1731 (46.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[44.9;48.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e2256 (48.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[46.6;50.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn underweight status at birth\u003csup\u003e\u0026beta;\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eUnderweight (\u0026lt;2500g)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e216 (6.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[5.2;7.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e311 (7.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[6.3;8.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eNot underweight (\u0026ge;2500g)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e3153 (93.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[92.8;94.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e3973 (92.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[91.8;93.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn survival\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eSurvived until survey\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e3462 (96.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[95.9;97.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e4518 (97.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[96.9;98.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eDied on/before discharge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e47 (1.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[0.9;1.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e46 (1.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[0.7;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"298\"\u003e\n\u003cp\u003eDied after discharge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e73 (2.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[1.6;2.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"105\"\u003e\n\u003cp\u003e54 (1.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"76\"\u003e\n\u003cp\u003e[0.9;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: Antenatal care (ANC); Confidence interval (CI); Demographic and Health Survey (DHS). \u0026dagger;Percentages are calculated based on the weights of the DHS data. *Missing values: shared bed n=1; Spent time on floor n=3; denied care n=2; delayed to leave n=13; access to toilet n=8.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e\u0026beta;\u003c/sup\u003en=213 missing values for newborn's weight at birth in 2015-16; n=334 missing values in 2022.\u003c/p\u003e\n\u003cp\u003en/a \u0026ndash; not available on the 2015-6 DHS.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003ePostpartum length-of-stay and early discharge\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eAmong women who had a vaginal birth, the median time spent in the facility increased from 16 [IQR = 6-36] in 2015-16 to 24 hours [IQR = 12-36] in 2022. Among women who gave birth by caesarean section, the median time spent in the facility was 84 hours in both survey years. Additional file 1 Table S4 describes postpartum length-of-stay and early discharge in 2015-16 and 2022. Figure 2 shows the percentage of women discharged early from healthcare facilities by mode of birth and survey year. Among women who had a vaginal birth, 54.8% [95% CI = 52.4;57.2] were discharged early in 2015-16 and 30.3% [95% CI=28.2; 32.5] in 2022. The percentage of early discharge among women who had a caesarean section was 17.2% [95% CI = 11.3;25.3] in 2015-16 and 25.2% [95% CI = 21.3;29.5] in 2022.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eFactors associated with early discharge \u0026ndash; DHS 2022\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe results of bivariate and multivariable logistic regression determining factors associated with \u0026nbsp;early discharge are in Table 2 for women who had a vaginal birth and Table 3 for women who had a caesarean section.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cu\u003eVaginal birth\u003c/u\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFourteen factors associated with early discharge with a p-value\u0026le;0.2 in bivariate regression were included in the multivariable model. Upon adjusting, three factors were significantly associated with early discharge among women who had a vaginal birth: zone, facility level and number of ANC checks. The odds of early discharge were higher in Zanzibar (aOR=6.3) and South west highlands (aOR=1.8) compared to Eastern zone; while the odds of early discharge were lower in Southern Highlands (aOR=0.5) compared to Eastern zone. The odds of early discharge among women who gave birth in a health centre were 1.5 times higher compared to those who gave birth in a hospital. Similarly, the odds of early discharge among those who gave birth in a dispensary/clinic were 3.7 times higher than hospital-based births. Women who had no ANC checks during the index pregnancy had lower odds of early discharge compared to those who had at least four checks (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cu\u003eCaesarean section\u003c/u\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFor women who had a caesarean section, eight factors were included in the multivariable regression model. Upon adjusting, three factors were significantly associated with early discharge: education level, level of facility of birth, and newborn underweight status at birth. Women who had no formal education had 0.3 times lower odds of early discharge compared to those who completed primary education. Women who had caesarean section in a lower-level facility (health centre/dispensary/clinic) had 3.3 times the odds of early discharge compared to those who had it in a hospital. Women whose newborns were underweight had five times lower odds of early discharge compared to those whose babies weighed \u0026ge;2500g at birth (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable 2\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e \u0026ndash; Bivariate and multivariable logistic regression of factors and early discharge among women who had their most recent \u003c/strong\u003e\u003cstrong\u003e\u003cu\u003evaginal birth\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e in a healthcare facility in the three years preceding the DHS 2022 (total n=3994*)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable width=\"608\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003ctd width=\"38\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u003cstrong\u003ecOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u003cstrong\u003eaOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"32\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic and economic factors\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eZone\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eWestern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.5;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.232\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.4;1.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.063\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNorthern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.6;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.804\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [07;1.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.500\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eCentral\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.6;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.320\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.5;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.154\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSouthern highlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.5 [0.3;0.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.003\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.5 [0.3;0.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.006\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSouthern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.4 [0.8;2.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.237\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.6;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.717\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSouth west highlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e2.3 [1.6;3.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.8 [1.2;2.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.004\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eLake\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.5;1.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.042\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.5;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.136\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eEastern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eZanzibar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e3.7 [2.7;5.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e6.3 [4.0;9.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eRural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eUrban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.6;0.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.012\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.7;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.920\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eUnion and cohabiting status at time of survey\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNot in union/not living with a partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eLiving with a partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [0.9;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.082\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [0.9;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.193\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eMaternal age at index childbirth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e13-19 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.7;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.718\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.7;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.851\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e20-24 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e25-29 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.8;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.475\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.8;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.827\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e30-34 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [0.9;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.134\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [0.8;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.391\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e35-49 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.3 [1.0;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.045\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.8;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.503\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eHighest completed education level\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo formal education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [0.9;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.147\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.8;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.772\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePrimary education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSecondary or higher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.7;1.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.149\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.8;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.503\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eHousehold wealth index\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePoorest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.9;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.329\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.7;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.959\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePoorer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.6;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.120\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.6;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.151\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eMiddle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eRicher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.7;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.247\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.7;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.526\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eRichest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.6;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.119\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.6;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.414\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"25\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility characteristics and perception of care quality\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility level\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eDispensary/clinic\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e3.2 [2.4;4.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e3.7 [2.7;5.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eHealth center\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.2 [0.9;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.118\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.5 [1.1;2.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.012\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eHospital\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility ownership\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eGovernmental\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNon-governmental\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.4;0.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.016\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.6;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.588\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eDay of birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eWeekend\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eWeekday\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.9;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.720\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eShared bed during stay\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.8;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.680\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eSpent time without a mattress on the floor\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.6;1.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.797\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eWas denied care because could not pay\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.4;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.158\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.8;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.463\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eWas delayed in leaving facility because could not pay\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.5 [0.3;0.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.016\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.3;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.122\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eAccess to toilet\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.8;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.826\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"14\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eWomen's needs and obstetric history\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eParity at index birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePrimiparous\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eMultiparous 2-4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.3 [1.0;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.034\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.7;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.796\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eGrand multiparous 5+\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.6 [1.3;1.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.8;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.559\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNumber of ANC visits during index pregnancy\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.5;1.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.079\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.4;0.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.023\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e1-3 visits\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.1 [0.9;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.536\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.8; 1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.710\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e4 or more visits\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eMultiple birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.3;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.224\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eEver had a terminated pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.8;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.904\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"10\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn sex\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eBoy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eGirl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.8;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.817\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn underweight status at birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNot underweight \u0026ge;2500g\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eUnderweight \u0026lt;2500g\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.5;0.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.032\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.5;1.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.114\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn survival\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSurvived until survey\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eDied on/before discharge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.5 [0.2;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.154\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.4 [0.1;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.117\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eDied after discharge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.5 [0.2;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.135\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.7 [0.3;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.392\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: Antenatal care (ANC); Confidence interval (CI); Crude odds ratio (cOR); Adjusted odds ratio (aOR). *n=323 missing values between the variables \u0026lsquo;delayed to leave the facility\u0026rsquo; and \u0026lsquo;newborn weight\u0026rsquo;. \u0026dagger;Factors with significant association with early discharge after vaginal birth in the multivariable model\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable 3\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e \u0026ndash; Bivariate and multivariable logistic regression of factors and early discharge among women who had their most recent livebirth by \u003c/strong\u003e\u003cstrong\u003e\u003cu\u003ecesarean section\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e in a healthcare facility within three years of DHS 2022 (n=624)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable width=\"611\"\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003ctd width=\"38\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u003cstrong\u003ecOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u003cstrong\u003eaOR [95%CI]\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"32\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic and economic factors\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eZone\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eWestern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.7 [0.2;2.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.508\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.2;2.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.704\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNorthern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.8 [0.4;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.426\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.4;1.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.590\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eCentral\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.0 [0.5;2.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.902\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.5 [0.6;4.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.363\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSouthern highlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.5 [0.3;1.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.050\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.3;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.171\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSouthern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.7 [0.2;2.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.490\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.9 [0.3;2.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.841\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSouth west highlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.7 [0.3;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.385\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.4;2.0]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.683\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eLake\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.0 [0.4;2.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.966\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.3 [0.5;3.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.514\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eEastern\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eZanzibar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.4 [0.5;3.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.503\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.9 [0.7;5.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.230\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eRural\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eUrban\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.4 [0.9;2.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.097\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.5 [0.9;2.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.099\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eUnion and cohabiting status at time of survey\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNot in union/not living with a partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eLiving with a partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.9 [0.6;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.807\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eMaternal age at index childbirth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e13-19 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.4 [0.5;3.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;0.521\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e20-24 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e25-29 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.2 [0.6;2.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.600\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e30-34 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.6 [0.8;3.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.179\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e35-49 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.8 [0.4;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.474\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eHighest completed education level reached\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo formal education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.3 [0.1; 0.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;0.022\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.3 [0.1;0.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;0.031\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePrimary education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eSecondary or higher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.1 [0.7; 1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.689\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.0 [0.6;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.975\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eHousehold wealth index\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePoorest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.4 [0.1;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.124\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.6 [0.2;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.289\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePoorer\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.1 [0.5;2.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.822\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.3 [0.6;2.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.552\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eMiddle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eRef\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eRicher\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.4 [0.7;2.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.301\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.5 [0.8;2.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.259\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eRichest\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.3 [0.7;2.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.400\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.5 [0.7;3.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.251\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"24\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility characteristics and perception of care quality\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility level\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eLower level facilities - Health center/dispensary/clinic\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2.3 [1.4;3.8]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e3.3 [2.0;5.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eHospital\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eFacility Ownership\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eGovernmental\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNon-governmental\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.6 [0.3;1.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.181\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.8 [0.4;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.424\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eDay of birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eWeekend\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eWeekday\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.8 [0.5;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.507\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eShared bed during stay\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.4 [0.7;2.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.388\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eSpent time without a mattress on the floor\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e2.5 [0.8;8.1]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.117\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e1.7 [0.5;5.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.410\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eWas denied care because could not pay\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.1 [0.4;2.9]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.835\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eWas delayed in leaving facility because could not pay\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.4 [0.5;3.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.488\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eAccess to toilet\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.7 [0.4;1.3]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.290\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"14\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eWomen's needs and obstetric history\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eParity at index birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003ePrimiparous\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eMultiparous 2-4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.1 [0.7;1.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.732\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eMultiparous 5+\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.7 [0.4;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.327\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNumber of ANC visits during index pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.2 [0.5;2.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;0.730\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e1-3 visits\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.9 [0.5;1.6]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.658\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e4 or more visits\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eMultiple birth\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.9 [0.3;3.2]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.966\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eEver had a terminated pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.7 [0.4;1.4]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.316\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"6\" width=\"38\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn sex\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eBoy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eGirl\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e1.0 [0.7;1.5]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.888\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003e\u003cstrong\u003eNewborn underweight status at birth\u003c/strong\u003e\u0026dagger;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eNot underweight \u0026ge;2500g\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003eref\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"293\"\u003e\n\u003cp\u003eUnderweight \u0026lt;2500g\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"85\"\u003e\n\u003cp\u003e0.2 [0.1;0.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.013\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"82\"\u003e\n\u003cp\u003e0.2 [0.1;0.7]\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"57\"\u003e\n\u003cp\u003e0.014\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: Antenatal care (ANC); Confidence interval (CI); Crude odds ratio (cOR); Adjusted odds ratio (aOR).*n=23 missing values between the variables \u0026lsquo;delayed to leave the facility\u0026rsquo; and \u0026lsquo;newborn weight\u0026rsquo;. \u0026dagger;Factors with significant association with early discharge after cesarean birth in the multivariable model.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis paper describes change between two time periods in postpartum length-of-stay and early discharge from healthcare facilities in Tanzania, and factors associated with it among women who had a livebirth in the three years preceding DHS 2022. A third of women who gave birth in a health facility were discharged in \u0026lt;24 hours after a vaginal birth and \u0026lt;72 hours after a caesarean section in 2022. Between 2015-16 and 2022, the percentage of early discharge among women who had a vaginal birth (\u0026lt;24 hours) declined, and the opposite was observed among postpartum women discharged \u0026lt;72 hours after a caesarean birth. Significant regional differences in early postpartum discharge exist, and factors associated with early discharge included level of facility of birth, frequency of ANC visits, maternal education and newborn underweight status.\u003c/p\u003e\n\u003cp\u003eOver the examined period, the percentage of women discharged \u0026lt;24 hours after a vaginal birth nearly halved. The MoH’s recommendation of 24 hour stays did not change during this period [15, 16]. The observed change is possibly linked to incremental efforts applied over time to implement those recommendations. Traditionally, women who give birth vaginally are perceived by care providers as having low-risk and possibly discharged earlier than 24 hours. The observed trend could signal a shift from these perceptions and a targeted effort to monitor women and newborns for longer hours postpartum. It is also possible that the upgrading of lower-level facilities to provide surgery care [27] increased bed space availability, particularly in higher level healthcare facilities, potentially reducing the need to discharge women early to create space for others [25].\u003c/p\u003e\n\u003cp\u003eThe percentage of early discharge among women who gave birth via caesarean section (\u0026lt;72 hours) increased between the two periods (from 17% in 2015-6 to 25% in 2022). Globally, postpartum length-of-stay after caesarean section is declining over time [28]; the ERAS program [29] which aims to reduce recovery time post-surgery has been partially implemented in Tanzania, however it is unlikely that it would have an impact at the national level considering that it is not fully institutionalised. During the COVID-19 pandemic, postpartum length-of-stay declined at a faster rate, as women preferred leaving the facility quickly and providers aimed to decongest facilities and reduce risk of infection transmission [30-32]. The data included in this study covers the period of the pandemic – a period when reductions in postpartum length-of-stay were among adaptations implemented in the Tanzanian National referral hospital [32]. Another hypothesis is that the increase in the caesarean section rate (from 7% to 10%) [13] could mean that a larger percentage of all caesarean sections were among women without major complications (e.g. scheduled caesarean section), suggesting that more women who had a caesarean section could recover and leave the health facility earlier. Another possibility is that the demand for post-operative beds increased with the increasing caesarean section rate beyond bed availability and women were discharged earlier to make space for others [25]. Last, it is possible that fewer women were being detained for unpaid fees [33-35] in 2022 and were able to leave the facility earlier, although more research is needed to explore these hypotheses.\u003c/p\u003e\n\u003cp\u003eDespite the reduction in percentage of early postpartum discharge over time, it was documented among a third of women included in the study. This proportion of early discharge following vaginal birth in Tanzania is comparable to estimates in Cameroon (29.7%) [36], India (22.3%) [37], and Eswatini (22%); and higher than Malawi (10%) [38]. Early discharge \u0026lt;72 hours after a caesarean birth was higher in Tanzania compared to Cameroon (15.1%) and India (12.8%) [36, 37]. This suggests challenges related to prioritization of immediate PNC, guideline implementation, space availability, staffing, among other health-system issues hindering provision of quality care in the immediate postpartum period [39]. The results of the multivariable analysis show that early discharge is determined by health-system level factors. Women who gave birth in lower-level facilities might be less likely to suffer from complications compared to women who birth in higher-level facilities, therefore might be considered by providers that they can recover and be discharged before the recommended length-of-stay. This higher odds of early discharge in lower-level facilities could also be a result of having less resources, including infrastructure, space availability, and human resources, compared to hospitals. Additionally, this signals a potential difference in adherence to guidelines between the levels of the healthcare system. In a context where lower-level facilities are being upgraded to provide CEmONC [27], efforts should be made to ensure the same quality of care is available across all healthcare facilities. The results also highlight geographic differences with early discharge being higher in Zanzibar compared to other geographic zones. This could be a result of lack of space availability in Zanzibar due to congestion of hospitals leading to discharging women as soon as safe for them to free-up beds. Another explanation could be that there is inconsistent implementation of recommendations between zones, suggesting potential inequalities in the provision and quality of immediate postpartum care, and ultimately maternal and newborn healthcare outcomes. Several factors at different levels could be barriers to postnatal care guideline implementation such as the inadequate adaptation of guidelines, limited incorporation of women-centred approaches, and insufficient prioritization of PNC within health systems, policy frameworks, and financial allocations [39].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProxies of known risk factors for women such as age, parity, multiple births, previous termination, had no significant association with early discharge in our findings. Similar findings were noted in Guinea [11], suggesting that timing of discharge is mostly determined by organizational decisions rather than to meet women’s needs and preferences. Additionally, factors related to women’s perception of quality of care were not significantly associated with early discharge, suggesting that women’s experience of care are not taken into consideration when deciding time of discharge. On the other hand, women whose newborns were born underweight had lower odds of being discharged early after a caesarean section. One hypothesis is that some births by caesarean section were indicated by complications such as pre-eclampsia to prevent further deterioration in the mother. In these cases, \u0026nbsp;the newborn may be underweight/premature, and mother and baby stay longer to recover. However, it is not clear in DHS data if women who stay longer with the newborn continue to receive care and be clinically followed.\u0026nbsp;Women who had no ANC checks had lower odds of early discharge compared to those who had four or more (Table 2).\u0026nbsp;This could mean that women who had more ANC checks received more content of care (e.g. in terms of counselling on breastfeeding) that could have signalled to providers that they are more ‘ready’ to leave the health facility prior to 24 hours. From another perspective, the lack of ANC attendance might have signalled to healthcare providers that women could be at higher risk and require more postnatal counselling and longer monitoring.\u003c/p\u003e\n\u003cp\u003eContrary to the literature [10, 36], our results showed that higher education level was associated with higher odds of early discharge following birth by caesarean section. Women with lower education may be more at risk of maternal morbidity\u0026nbsp;[40]\u0026nbsp;therefore needing to stay longer in the facility for recovery. Additionally, it is possible that women with lower education stayed longer in the facility to ensure full recovery before discharge as providers acknowledge their vulnerability and attempt to counter the possibility that they might not return for an outpatient postnatal check\u0026nbsp;[41]. On the other hand, it is also possible that women with higher levels of education have more social capital and better conditions to recover at home, and are therefore more capable of negotiating earlier discharge\u0026nbsp;[10].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eImplications for research and practice\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eImplications for future research include the need for in-depth understanding of factors underlying the incomplete adherence to recommendations leading to early discharge. This includes \u0026nbsp;qualitative research and exploration of postnatal care guideline implementation in Tanzania, especially at lower-level (primary) healthcare facilities. Also of interest is exploring the content, frequency and quality of immediate postnatal care and discharge preparedness, and women and care providers’ preferences. Future research should also explore effects of length-of-stay on maternal and newborn outcomes in low-resource settings.\u003c/p\u003e\n\u003cp\u003eFrom the practice side, our study highlights the need to ensure that the conditions needed for guideline implementation, including facility infrastructure for enabling \u0026nbsp;positive immediate postnatal period, are consistently available in all levels of healthcare facilities and across regions to reduce inequalities in care provision and access to quality care among all women. There is a need to integrate person-centred care in recommendations and practice, to involve women and families in decisions of postpartum discharge by adopting participatory approaches that take into consideration available resources, care providers’ needs, and women’s and families’ choices and preferences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eStrengths and limitations\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study presents nationally representative estimates and periodic change in early discharge in Tanzania, and informs recommendations to improve immediate postnatal care in Tanzania. Nonetheless, some limitations of the work exist, including the absence of information on maternal and newborn complications during pregnancy, intrapartum and postpartum which are important determinants of length-of-stay [42, 43]. The analysis also allowed to explore issues with data quality related to specific variables in the Tanzanian DHS, especially those related to respectful quality care which at one point signal overreporting of good quality of care leading us to drop some variables from the analysis (e.g. birth companionship prevalence was ~80% in 2022 DHS data while the literature shows that this value is overestimated [44]). Other reporting bias including recall bias are possible to affect the data quality – for example a proportion of women who had a caesarean section reported having it in a dispensary which is a level of facility that is not usually equipped to provide caesarean sections. Excluding women who stayed longer than 3 weeks as outliers could exclude some women who had severely premature newborns or other complications, however we used this cut-off consistently with previous research on the topic [10].\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eDespite reduction of short postpartum stays after vaginal births, early postpartum discharge affected a third of the women giving birth in Tanzania. Early discharge could be introducing a preventable risk of missing the identification and treatment of complications, considering that around one in five women who give birth in a health facility in Tanzania reported not receiving a postnatal check [41]. Inequalities and inconsistencies in guideline application were identified in the study, warranting the need to ensure equitable provision of adequate quality of postnatal care in all geographic zones and levels of healthcare facilities. More attention to improving immediate and longer-term postnatal care is recommended at the national level.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cu\u003eEthics approval and consent to participate\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThis secondary data analysis was waved from an ethics review by the ethics committee at the Institute of Tropical Medicine, Antwerp. DHS protocols and questionnaires were reviewed and approved by ICF institutional review board and by a review board in Tanzania. Prior to participation, all participants provided informed consent emphasizing voluntary participation, and parents/guardians of adolescent participants provided consent. The conduct of data collection and processing ensures protection of privacy and confidentiality of participants [45]. The analysed secondary data were anonymised to protect participant confidentiality.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAvailability of data and materials\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThis paper uses secondary data that were made available by the DHS program at the time that the database was acquired. Authors do not hold ownership of the data and this reason prevents us from sharing the data with the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eCompeting interests\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have declared that no competing interests exist.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eFunding\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThis work did not receive any direct funding. The Research Foundation—Flanders \u0026nbsp;(FWO) partly supported LB as part of her Senior Postdoctoral Fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAuthors’ contributions\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eAS conceptualised the study, analysed the data. LA and AS drafted the first version of the manuscript. AK, NH, ABP, TvdA and LB reviewed and provided critical input to the data analysis plan. All authors contributed to the interpretation of the results, and reviewed and approved the final version of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAcknowledgements\u0026nbsp;\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to acknowledge the women who took the time to respond to the survey.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. In. Geneva; 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUnited Nations Inter-agency Group for Child Mortality Estimation (UNIGME). Levels \u0026amp; Trends in Child Mortality: Report 2023, Estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation, United Nations Children\u0026rsquo;s Fund. In. New York; 2024.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCresswell JA, Alexander M, Chong MYC, Link HM, Pejchinovska M, Gazeley U, Ahmed SMA,Chou D, Moller A-B, Simpson Det al: Global and regional causes of maternal deaths 2009\u0026ndash;20: a WHO systematic analysis. \u003cem\u003eThe Lancet Global Health\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUnited Nations Inter-agency Group for Child Mortality Estimation. Never Forgotten - The situation of stillbirth around the globe. Report of the United Nations Inter-agencyGroup for Child Mortality Estimation. In.; 2022.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience. Geneva: World Health Organization; 2022.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSmith H, Harvey C, Portela A. Discharge preparation and readiness after birth: a scoping review of global policies, guidelines and literature. BMC Pregnancy Childbirth. 2022;22(1):281.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYonemoto N, Dowswell T, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Cochrane Database Syst Reviews 2017(8).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMespreuve A-S, Apers L, Moller A-B, Galle A. Postnatal quality of care measures for mothers and newborns at home: A scoping review. PLOS Global Public Health. 2024;4(8):e0003498.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrown S, Small R, Argus B, Davis P, Krastev A. Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database Syst Reviews 2002(3).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCampbell OMR, Cegolon L, Macleod D, 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. PLoS Med. 2016;13(3):e1001972.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSemaan A, Grovogui FM, Delvaux T, Housseine N, van den Akker T, Delamou A, Beňov\u0026aacute; L. Length-of-stay and factors associated with early discharge after birth in health facilities in Guinea by mode of birth: Secondary analysis of Demographic and Health Survey 2018. PLOS Glob Public Health. 2024;4(10):e0003786.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCegolon L, Campbell O, Alberico S, Montico M, Mastrangelo G, Monasta L, Ronfani L, Barbone F. Length of stay following vaginal deliveries: A population based study in the Friuli Venezia Giulia region (North-Eastern Italy), 2005\u0026ndash;2015. PLoS ONE. 2019;14(1):e0204919.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMinistry of Health (MoH). [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF: Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022 Key Indicators Report. In. Dodoma, Tanzania and Rockville, Maryland, USA: MoH, NBS, OCGS, and ICF; 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStraneo M, Beňov\u0026aacute; L, van den Akker T, Pembe AB, Smekens T, Hanson C. No increase in use of hospitals for childbirth in Tanzania over 25 years: Accumulation of inequity among poor, rural, high parity women. PLOS Global Public Health. 2022;2(8):e0000345.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMinistry of Health Community Development Gender Elderly and Children - The United Republic of Tanzania. National Postpartum Care Guidelines. In.; 2019.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMinistry of Health and Social Welfare - Tanzania. National Postnatal Care Guidelines. In. Dar es Salaam; 2012.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMinistry of Health Community Development Gender Elderly and Children - United Republic of Tanzania. Health Sector Strategic Plan July 2021 \u0026ndash; June 2026 (HSSP V) - Leaving no one behind. In.; 2021.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMadaj B, Gopalakrishnan S, Quach A, Filiaci S, Traore A, Bakusa D, Mdegela M, Yousofzai AW, Rahmanzai AJ, Kodindo G. Where is the \u0026lsquo;C\u0026rsquo;in antenatal care and postnatal care: A multi-country survey of availability of antenatal and postnatal care in low‐and middle‐income settings. BJOG: Int J Obstet Gynecol. 2022;129(9):1546\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKruk ME, Hermosilla S, Larson E, Mbaruku GM. Bypassing primary care clinics for childbirth: a cross-sectional study in the Pwani region, United Republic of Tanzania. Bull World Health Organ. 2014;92(4):246\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHanson C, Ronsmans C, Penfold S, Maokola W, Manzi F, Jaribu J, Mbaruku G, Mshinda H, Tanner M, Schellenberg J. Health system support for childbirth care in Southern Tanzania: results from a health facility census. BMC Res Notes. 2013;6(1):435.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBaker U, Peterson S, Marchant T, Mbaruku G, Temu S, Manzi F, Hanson C. Identifying implementation bottlenecks for maternal and newborn health interventions in rural districts of the United Republic of Tanzania. Bull World Health Organ. 2015;93(6):380\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLanga N, Bhatta T. The rural-urban divide in Tanzania: Residential context and socioeconomic inequalities in maternal health care utilization. PLoS ONE. 2020;15(11):e0241746.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDol J, Kohi T, Campbell-Yeo M, Tomblin Murphy G, Aston M, Mselle L. Exploring maternal postnatal newborn care postnatal discharge education in Dar es Salaam, Tanzania: Barriers, facilitators and opportunities. Midwifery. 2019;77:137\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMacdonald D, Aston M, Murphy GT, Jefferies K, Mselle LT, Price S, O\u0026rsquo;Hearn S, White M, Mbekenga C, Kohi TW. Providing postpartum care with limited resources: Experiences of nurse-midwives and obstetricians in urban Tanzania. Women Birth. 2019;32(3):e391\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMcMahon SA, Mohan D, LeFevre AE, Mosha I, Mpembeni R, Chase RP, Baqui AH, Winch PJ. You should go so that others can come; the role of facilities in determining an early departure after childbirth in Morogoro Region, Tanzania. BMC Pregnancy Childbirth. 2015;15:328.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThe Demographic. and Health Surveys Program [https://dhsprogram.com/].\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKapologwe NA, Meara JG, Kengia JT, Sonda Y, Gwajima D, Alidina S, Kalolo A. Development and upgrading of public primary healthcare facilities with essential surgical services infrastructure: a strategy towards achieving universal health coverage in Tanzania. BMC Health Serv Res. 2020;20(1):218.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSemaan A, Vercoutere A, Ezeanochie M, Afolabi BB, Mery G, Gadama L, Kascak P, Galadanci HS, Akker Tvd, Benova L. Change in maternal postpartum length of stay in health facilities during COVID-19: Analysis of population representative data from 33 countries with six nested comparative case studies. In.; 2024 - under review.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKifle F, Kenna P, Daniel S, Maswime S, Biccard B. A scoping review of Enhanced Recovery After Surgery (ERAS), protocol implementation, and its impact on surgical outcomes and healthcare systems in Africa. Perioperative Med. 2024;13(1):86.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSemaan A, Audet C, Huysmans E, Afolabi B, Assarag B, Banke-Thomas A, Blencowe H, Caluwaerts S, Campbell OMR, Cavallaro FL, et al. Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic. BMJ Global Health. 2020;5(6):e002967.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSemaan A, Dey T, Kikula A, Asefa A, Delvaux T, Langlois EV, van den Akker T, Benova L. Separated during the first hours\u0026mdash;Postnatal care for women and newborns during the COVID-19 pandemic: A mixed-methods cross-sectional study from a global online survey of maternal and newborn healthcare providers. PLOS Global Public Health. 2022;2(4):e0000214.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSemaan A, Banke-Thomas A, Amongin D, Babah O, Dioubate N, Kikula A, Nakubulwa S, Ogein O, Adroma M, Anzo Adiga W, et al. We are not going to shut down, because we cannot postpone pregnancy\u0026rsquo;: a mixed-methods study of the provision of maternal healthcare in six referral maternity wards in four sub-Saharan African countries during the COVID-19 pandemic. BMJ Global Health. 2022;7(2):e008063.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKruk ME, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman LP. Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey. Health Policy Plann. 2014;33(1):e26\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSando D, Ratcliffe H, McDonald K, Spiegelman D, Lyatuu G, Mwanyika-Sando M, Emil F, Wegner MN, Chalamilla G, Langer A. The prevalence of disrespect and abuse during facility-based childbirth in urban Tanzania. BMC Pregnancy Childbirth. 2016;16(1):236.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBishanga DR, Massenga J, Mwanamsangu AH, Kim Y-M, George J, Kapologwe NA, Zoungrana J, Rwegasira M, Kols A, Hill K, et al. Women\u0026rsquo;s Experience of Facility-Based Childbirth Care and Receipt of an Early Postnatal Check for Herself and Her Newborn in Northwestern Tanzania. Int J Environ Res Public Health. 2019;16(3):481.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFouogue JT, Semaan A, Smekens T, Day L-T, Filippi V, Mitsuaki M, Fouelifack FY, Kenfack B, Fouedjio JH, Delvaux T, et al. Length of stay and determinants of early discharge after facility-based childbirth in Cameroon: analysis of the 2018 Demographic and Health Survey. BMC Pregnancy Childbirth. 2023;23(1):575.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKumar P, Dhillon P. Length of stay after childbirth in India: a comparative study of public and private health institutions. BMC Pregnancy Childbirth. 2020;20(1):181.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTsiga-Ahmed FI, Jalo RI, Ibrahim UM, Kwaku AA, Umar AA, Sanusi SM, Amole TG. Length-of-stay after a health facility birth and associated factors: analysis of data from three Sub-Saharan African countries. Ghana Med J. 2022;56(2):100\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBeňov\u0026aacute; L, Semaan A, Portela A, Bonet M, van den Akker T, Pembe AB, Moran A, Duclos D. Facilitators and barriers of implementation of routine postnatal care guidelines for women: A systematic scoping review using critical interpretive synthesis. J global health 2023, 13.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKern-Goldberger AR, Nigel M, D. BC MFA, Gyamfi-Bannerman C. Disparities in obstetric morbidity by maternal level of education. J Maternal-Fetal Neonatal Med. 2022;35(24):4682\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMohan D, Gupta S, LeFevre A, Bazant E, Killewo J, Baqui AH. Determinants of postnatal care use at health facilities in rural Tanzania: multilevel analysis of a household survey. BMC Pregnancy Childbirth. 2015;15(1):282.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGhebremeskel GG, Kahsay MT, Gulbet ME, Mehretab AG. Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea. BMC Pregnancy Childbirth. 2023;23(1):613.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEssien SK, Chireh B, Melese KG, Essien JK. Predictors of prolonged hospitalization after vaginal birth in Ghana: A comparative study. PLOS Global Public Health. 2022;2(1):e0000100.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHousseine N, Punt MC, Mohamed AG, Said SM, Maal\u0026oslash;e N, Zuithoff NPA, Meguid T, Franx A, Grobbee DE, Browne JL, et al. Quality of intrapartum care: direct observations in a low-resource tertiary hospital. Reproductive Health. 2020;17(1):36.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eProtecting the privacy of DHS Survey Respondents. [\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://dhsprogram.com/Methodology/Protecting-the-Privacy-of-DHS-Survey-Respondents.cfm]\u003c/span\u003e\u003cspan address=\"https://dhsprogram.com/Methodology/Protecting-the-Privacy-of-DHS-Survey-Respondents.cfm]\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"maternal, newborn, healthcare facility, childbirth, postpartum, postnatal, household survey, Tanzania, vaginal birth, caesarean section, demographic and health survey","lastPublishedDoi":"10.21203/rs.3.rs-7141902/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7141902/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eCare during the immediate postpartum period is critical for women and newborn\u0026rsquo;s health. Following facility-based birth, it is recommended to monitor the health of women and newborns in the facility. In Tanzania, a third of women who give birth in a health facility report not receiving a health check during their stay. Duration of stay and factors influencing them are not well documented in Tanzania. We describe postpartum length-of-stay at two time-points, 2015/2016 and 2022 in Tanzania, and explore factors associated with early discharge.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe analysed secondary data from two Demographic and Health Surveys: n\u0026thinsp;=\u0026thinsp;3,582 from 2015-16 and n\u0026thinsp;=\u0026thinsp;4,618 women from 2022 who had a livebirth in a health facility during the three years preceding the survey. Early discharge was defined as discharge\u0026thinsp;\u0026lt;\u0026thinsp;24hours after vaginal birth and \u0026lt;\u0026thinsp;72 hours after a caesarean birth. We describe the percentage of early discharge at both DHS time-points and explore factors associated with it using 2022 data with multivariate logistic regression, separately by mode of birth.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAlmost half of women who had a vaginal birth were discharged early in 2015-16, compared to 30.3% in 2022, while early discharge increased among women who had a caesarean section from 17.2% in 2015-16 to 25.2% in 2022. The odds of early discharge were higher in Zanzibar compared to Eastern zone, and factors associated with early discharge included level of facility, frequency of antenatal care visits, maternal education and newborn underweight status.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eDespite progress in reducing short postpartum stays after vaginal births, early postpartum discharge affected a third of the women giving birth in Tanzania. Disparities between regions and facility levels suggest potential inconsistencies in the application of postpartum guidelines, warranting the need to determine and address the underlying causes, standardize practice and ensure equitable access to quality postpartum care.\u003c/p\u003e","manuscriptTitle":"Discharge time from healthcare facilities after birth in Tanzania : A secondary analysis of Demographic and Health Surveys from 2015-16 and 2022","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-19 17:27:58","doi":"10.21203/rs.3.rs-7141902/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-17T07:02:14+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-12T17:59:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236808856506986769050759244402900810329","date":"2025-11-30T17:16:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-24T19:19:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"15787218638627025610912105644774013630","date":"2025-08-20T10:30:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"4504192128620168763872409342203441596","date":"2025-08-14T17:49:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324159542298526507838173731193145674508","date":"2025-08-14T05:35:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-12T08:49:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281954039330345965079666388548284543509","date":"2025-08-12T08:30:55+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-11T12:44:25+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-18T07:46:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-18T05:21:54+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-18T05:18:54+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-07-16T16:02:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"10238739-eb71-41a7-8d8b-84d2a7a213d4","owner":[],"postedDate":"August 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-19T16:46:57+00:00","versionOfRecord":{"articleIdentity":"rs-7141902","link":"https://doi.org/10.1186/s12913-026-14035-x","journal":{"identity":"bmc-health-services-research","isVorOnly":false,"title":"BMC Health Services Research"},"publishedOn":"2026-01-14 16:29:26","publishedOnDateReadable":"January 14th, 2026"},"versionCreatedAt":"2025-08-19 17:27:58","video":"","vorDoi":"10.1186/s12913-026-14035-x","vorDoiUrl":"https://doi.org/10.1186/s12913-026-14035-x","workflowStages":[]},"version":"v1","identity":"rs-7141902","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7141902","identity":"rs-7141902","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}