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An assessment of the effect of user fee policy reform on facility-based deliveries in rural Zambia

Overview of attention for article published in BMC Research Notes, December 2016
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Mentioned by

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3 tweeters

Citations

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11 Dimensions

Readers on

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102 Mendeley
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Title
An assessment of the effect of user fee policy reform on facility-based deliveries in rural Zambia
Published in
BMC Research Notes, December 2016
DOI 10.1186/s13104-016-2316-8
Pubmed ID
Authors

Chitalu Miriam Chama-Chiliba, Steven Fredric Koch

Abstract

Improving maternal health outcomes by reducing barriers to accessing maternal health services is a key goal for most developing countries. This paper analyses the effect of user fee removal, which was announced for rural areas of Zambia in April 2006, on the use of public health facilities for childbirth. Data from the 2007 Zambia Demographic and Health Survey, including birth histories for the five years preceding the survey, is linked to administrative data and geo-referenced health facility census data. We exploit a difference-in-differences design, due to a differential change in user fees at the district level; fees were removed in 54 rural districts, but not in the 18 remaining urban districts. We use multilevel modelling to estimate the effect of this policy change, based on 4018 births from May 2002 to September 2007, covering a period before and after the policy announcement in April 2006. The difference-in-difference estimates point to statistically insignificant changes in the proportion of women giving birth at home and in public facilities, but significant changes are found for deliveries in private (faith-based) facilities. Thus, the abolition of delivery fees is found to have some effect on where Zambian mothers choose to have their children born. The removal of user fees has not overcome barriers to the utilisation of delivery services at public facilities. User fee removal may also yield unintended consequences deterring the utilisation of delivery services. Therefore, abolishing user fees, alone, may not be sufficient to affect changes in utilisation; instead, other efforts, such as improving service quality, may have a greater impact.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 102 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 102 100%

Demographic breakdown

Readers by professional status Count As %
Lecturer 23 23%
Student > Master 22 22%
Researcher 9 9%
Student > Ph. D. Student 7 7%
Student > Bachelor 6 6%
Other 11 11%
Unknown 24 24%
Readers by discipline Count As %
Nursing and Health Professions 37 36%
Medicine and Dentistry 13 13%
Social Sciences 6 6%
Economics, Econometrics and Finance 5 5%
Business, Management and Accounting 5 5%
Other 9 9%
Unknown 27 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 December 2016.
All research outputs
#4,948,404
of 9,766,310 outputs
Outputs from BMC Research Notes
#1,047
of 2,418 outputs
Outputs of similar age
#148,583
of 315,428 outputs
Outputs of similar age from BMC Research Notes
#27
of 58 outputs
Altmetric has tracked 9,766,310 research outputs across all sources so far. This one is in the 47th percentile – i.e., 47% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,418 research outputs from this source. They receive a mean Attention Score of 4.6. This one has gotten more attention than average, scoring higher than 53% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 315,428 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 58 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.