Gabrysch S, et al. - Via a secondary analysis of surveillance data on 119,244 pregnancies from two large population-based cluster-randomized controlled trials in Brong Ahafo, Ghana, experts evaluated whether childbirth in facilities decreased the mortality by quantifying the influence of major determinants of facility birth (cluster-level facility birth, wealth, education, and distance to childbirth care) on various mortality outcomes, while also acknowledging quality of care. In any of the mortality outcomes, greater proportions of facility births in a cluster were not associated with reductions. In comparison to those who were poorer, in women who were richer, facility births were much more prevalent, however, mortality was not lower among them or their babies. Women who were highly educated had lower mortality risks in contrast to less-educated women, except first-day and early neonatal mortality. Compared to women who lived farther from childbirth facilities, a substantially greater proportion of women living in areas near to childbirth facilities had facility births and cesarean sections, however, mortality risks were not lowered regardless of this increased service use. Lower risk of intrapartum stillbirth and of composite mortality results were discovered among women who resided in areas closer to facilities that offered comprehensive emergency obstetric care, emergency newborn care, or high-quality routine care, or to facilities that had providers with satisfactory competence in comparison to those women who resided in areas where these services were farther away. Hence, facility birth did not significantly convey a survival advantage for women or babies and should only be suggested in facilities who are able of giving emergency obstetric and newborn care and capable of safeguarding uncomplicated births.