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Background Uptake of delivery and postnatal care remains low in Low and Middle-Income Countries (LMICs), where 99% of global maternal deaths take place. However, the potential impact of antenatal depression on use of institutional delivery and postnatal care has seldom been examined. This study aimed to examine whether antenatal depressive symptoms are associated with use of maternal health care services. Methods A population-based prospective study was conducted in Sodo District, Southern Ethiopia. Depressive symptoms were assessed during pregnancy with a locally validated, Amharic version of the Patient Health Questionnaire (PHQ-9). A cut off score of five or more indicated possible depression. A total of 1251 women were interviewed at a median of 8 weeks (4–12 weeks) after delivery. Postnatal outcome variables were: institutional delivery care utilization, type of delivery, i.e. spontaneous or assisted, and postnatal care utilization. Multivariate logistic regression was used to examine the association between antenatal depressive symptoms and the outcome variables. Results High levels of antenatal depressive symptoms (PHQ score 5 or higher) were found in 28.7% of participating women. Nearly two-thirds, 783 women (62.6%), delivered in healthcare institutions. After adjusting for potential confounders, women with antenatal depressive symptoms had increased odds of reporting institutional birth [adjusted Odds Ratio (aOR) =1.42, 95% Confidence Interval (CI): 1.06, 1.92] and increased odds of reporting having had an assisted delivery (aOR = 1.72, 95% CI: 1.10, 2.69) as compared to women without these symptoms. However, the increased odds of institutional delivery among women with antenatal depressive symptoms was associated with unplanned delivery care use mainly due to emergency reasons (aOR = 1.62, 95% CI: 1.09, 2.42) rather than planning to deliver in healthcare institutions. Conclusion Improved detection and treatment of antenatal depression has the potential to increase planned institutional delivery and reduce perinatal complications, thus contributing to a reduction in maternal morbidity and mortality.

Over the years, the term private sector development has been misunderstood and misconstrued-variously vilified and sanctified. During the decade of the 1990s, the role of the private sector in economic development received increasing attention, with controversy surrounding such issues as privatization and corporate scandals. The Private Sector in Development: Entrepreneurship, Regulation, and Competitive Disciplines provides the first comprehensive treatment of the topic.Central to the discussion is the design of public policy that promotes an appropriate balance between competition and regulation. This book places special emphasis on the means by which private initiative is channeled into socially useful directions, particularly job creation and basic service delivery for good people. Finally, there is discussion of the implications of private sector involvement for policies of development institutions. Written principally for policy makers and their advisers, The Private Sector in Development thoroughly explores the challenges inherent in creating public policy that encourages and enhances the development role of the private sector.If global poverty is to be reduced, the private sector, by almost unanimous assent these days, is crucial. The authors offer a broad-ranging and balanced assessment of how to build workable market mechanisms in developing countries.