NAIROBI, 28 September 2009 (IRIN) - When pregnant women in Tanzania choose whether to give birth at home or in a clinic, the attitude of health workers and availability of drugs are more important factors than cost and distance to the clinic, a new study suggests.

The study, published in the September 2009 American Journal of Public Health, scored the results of 1,203 respondents in rural western Tanzania on health system factors influencing women’s delivery decisions. It provided two hypothetical clinic situations characterised by attributes such as distance, cost, type of provider, attitude of provider, drugs and equipment and free transport for scoring.

"If our finding - that women are willing to trade longer distance, higher cost, having to find transport, and higher-level providers for higher-quality of care — is supported by other research, it would be particularly salient as Tanzania’s government decides how to allocate funds from the health budget."

Skilled birth attendants have been identified as crucial in reducing maternal mortality as they are trained to diagnose obstetric complications and manage or refer them, notes the report. In 2004, only 33.6 percent of women living in rural Tanzania reported delivering their last child in a health facility. The maternal mortality ratio in Tanzania is estimated at 950 per 100,000 live births.

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