Poverty and the Evolving Public/Private Divide in Institutional Delivery Care in Egypt and India

Zoe Matthews, University of Southampton
Oona Campbell, London School of Hygiene and Tropical Medicine
Fiifi Amoako Johnson, University of Southampton

Neither the debate on the benefits of public/private mix in maternity provision nor the evidence on poverty-constrained access to skilled attendance have addressed the effects of poverty in a maternity service environment which is increasingly run by Private For Profit or Private Not For Profit providers. In two countries with an increasing share of institutional deliveries, mainly taken up by the private sector, we investigate the determinants of private delivery care focusing on the role of household wealth as an indicator of poverty. Using Demographic and Health Survey data from successive surveys in Egypt and contrasting states of India, we use regression models to investigate the effect of poverty on delivery options over time. Results indicate firstly that private delivery care is increasing rapidly and secondly that poverty influences delivery care choice even after controlling for other factors. Despite this, an increasing proportion of those from the poorest wealth decile are accessing private care.