The role of social and material inequalities in use of biomedical obstetric care: combining logistic regression with ethnographic insight in rural Tanzania

Sydney A Spangler, University of North Carolina at Chapel Hill

Increasing availability of biomedical care at childbirth is widely recommended to improve global maternal-newborn outcomes and achieve Millennium Development Goals Four and Five. However, strategies aimed at accomplishing this objective do not appear to be reaching the poor. The purpose of this study is to better understand use of biomedical obstetric care in rural Tanzania where this care is being supplied. Specifically, it seeks to explain how and why different social and material positions among women affect their decisions and actions in relation to childbirth care. In order to approach the aims comprehensively, a mixed-method research design was used. The quantitative component evaluates statistics from a population-based survey while the qualitative component analyzes detailed ethnographic data on the perceptions and experiences of childbearing women. Findings indicate that states and processes of inequality operating at various levels are deeply implicated in the type of care women seek and receive at childbirth.