You are here

Article Text

Article menu

Download PDFPDF

XML
Original research
Improving the demand for birth registration: a discrete choice experiment in Ethiopia
  1. Mahari Yihdego1,
  2. Ayanaw Amogne1,
  3. Selamawit Desta2,
  4. Yoonjoung Choi3,
  5. Solomon Shiferaw4,
  6. Assefa Seme4,
  7. Li Liu2,
  8. Stéphane Helleringer2
  1. 1PMA Ethiopia Project, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia
  2. 2School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  3. 3iSquared, Information x Insight, Severna Park, MD, USA
  4. 4Department of Reproductive Health and Health Service Management, Addis Ababa University, Addis Ababa, Ethiopia
  1. Correspondence to Dr Stéphane Helleringer; sheller7{at}jhu.edu

Abstract

Introduction Birth registration remains limited in most low and middle-income countries. We investigated which characteristics of birth registration facilities might determine caregivers’ decisions to register children in Ethiopia.

Methods We conducted a discrete choice experiment in randomly selected households in Addis Ababa and the Southern Nations, Nationalities, and People’s Region. We interviewed caregivers of children 0–5 years old. We asked participants to make eight choices between pairs of hypothetical registration facilities. These facilities were characterised by six attributes selected through a literature review and consultations with local stakeholders. Levels of these attributes were assigned at random using a fractional design. We analysed the choice data using mixed logit models that account for heterogeneity in preferences across respondents. We calculated respondents’ willingness to pay to access registration facilities with specific attributes. We analysed all data separately by place of residence (urban vs rural).

Results Seven hundred and five respondents made 5614 choices. They exhibited preferences for registration facilities that charged lower fees for birth certificates, that required shorter waiting time to complete procedures and that were located closer to their residence. Respondents preferred registration facilities that were open on weekends, and where they could complete procedures in a single visit. In urban areas, respondents also favoured registration facilities that remained open for extended hours on weekdays, and where the presence of only one of the parents was required for registration. There was significant heterogeneity between respondents in the utility derived from several attributes of registration facilities. Willingness to pay for access to registration facilities with particular attributes was larger in urban than rural areas.

Conclusion In these regions of Ethiopia, changes to the operating schedule of registration facilities and to application procedures might help improve registration rates. Discrete choice experiments can help orient initiatives aimed at improving birth registration.

  • child health
  • cross-sectional survey
  • other study design
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjgh-2019-002209

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Handling editor Seye Abimbola

    • Twitter @helleringer143

    • Contributors MY, YC, SS, AS, LL and SH designed the study. MY, AA and SD collected the data and oversaw the quality control. AA and SH prepared and analysed the data. SH wrote the first draft of the paper. All authors reviewed and contributed to the draft paper, contributed to the interpretation of the analysis and approved the final submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement We consulted with staff from the Vital Events Registration Agency (VERA) in designing the survey experiment. Dissemination events are being planned at VERA in the coming months.

    • Patient consent for publication Not required.

    • Ethics approval The Institutional Review Boards of the School of Public Health at Johns Hopkins University and of Addis Ababa University approved the protocol. All respondents provided oral informed consent before participating.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon request. They will soon be made publicly available via the PMA website.