scholarly journals Access to institutional delivery care and reasons for home delivery in three districts of Tanzania

Author(s):  
Amon Exavery ◽  
Almamy Malick Kanté ◽  
Mustafa Njozi ◽  
Kassimu Tani ◽  
Henry V Doctor ◽  
...  
2020 ◽  
Vol 18 (1) ◽  
pp. 64-69
Author(s):  
Tulsi Ram Bhandari ◽  
Shreejana Wagle ◽  
Ganesh Dangal

Background: Despite continuous efforts to increase the utilization of institutional delivery care services nearly two-fifths women deliver their babies at home without the assistance of skilled birth attendants (SBA) in Nepal. The skilled care at birth can reduce the high maternal and neonatal mortality. This study explored childbirth practices and women’s perceptions of childbirth and its associated factors.Methods: An exploratory study was conducted in three purposively selected remote villages of Kapilvastu district, from March to May 2017. Face-to-face in-depth interviews were conducted with women who had an under-one year child. We performed a thematic analysis to draw the findings of the study. Results: Women sought institutional delivery care either for long labor-pain or obstructed-delivery. Despite various incentives, people still preferred home for normal deliveries. There was also practiced skilled birth attendant (SBA) assisted home delivery care. Some of the local health workers also advised pregnant-women for assisted home delivery care. People considered childbirth as a normal process. Due to cultural beliefs and norms, people were also reluctant to pursue institutional delivery care services. Financial constraints, poor access to services and expensive transportation services were other underlining causes of home delivery practices. Conclusions: Despite various incentives for institutional delivery care; the study did not spectacle an encouraging reaction. It pointed to the very basic and strong relationship between women’s position in the household and the society and education with childbirth practices. There were limits to how far financial incentives can overcome these obstacles. So, the improvement of the socio-economic conditions of the women would be the viable way-out of the problem.Keywords: Childbirth practices; home delivery; institutional delivery; women’s perception


2017 ◽  
Vol 178 ◽  
pp. 55-65 ◽  
Author(s):  
Sukumar Vellakkal ◽  
Hanimi Reddy ◽  
Adyya Gupta ◽  
Anil Chandran ◽  
Jasmine Fledderjohann ◽  
...  

Author(s):  
Madhumita Mukherjee ◽  
Rashmi Singh ◽  
Amrita Mukherjee ◽  
Madhulekha Bhattacharya

Background: India’s Janany Surakhsha Yojana (JSY) is the largest conditional cash transfer (CCT) program in the world in terms of the number of beneficiaries - covering about 9·5 million (36%) of 26 million women giving birth in India. Eleven States/UTs including Bihar, are still below the National estimate for institutional delivery of 78.9% (NFHS 4). In this study we attempted to find out the status of institutional and home deliveries in district Arwal of Bihar and reasons why in spite of cash incentives a proportion of mothers are opting for home delivery.Methods: A cross sectional descriptive design was used to interview 407 women, who had given birth to a child in previous one year. Focuss group discussions was held with community and health staff to corroborate the interview data.Results: Fifty nine percent of mothers were found to have preferred home delivery over institutional one. Reasons which came to light were home deliveries are cheaper (24.1%), unawareness about JSY (22%), unavailability of transport to reach hospital (22%) and better care being taken at home delivery (20.1%) variables. Older age, having a BPL card, and literacy of husband were found as favoring institutional delivery whereas dissatisfaction during a previous abortion or a livebirth in hospital were both associated with non-use.Conclusions: Better client awareness, strengthening of public health infrastructure, availability of skilled birth attendants at health subcentres (HSCs) and emergency transport in time can reduce number of home deliveries and lead to success of JBSY programme and subsequent reduction in maternal morbidity and mortality.


2019 ◽  
Author(s):  
Dejene Kassa ◽  
Henok Tadele ◽  
Birkneh Tilahun Tadesse ◽  
Akalewold Alemayehu ◽  
Teshome Abuka ◽  
...  

Abstract Background Institutional delivery service utilization is one of the key and proven interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries including Ethiopia occurs at home and is not attended by skilled birth attendants. This study aimed at determining the prevalence of home delivery and associated factors in three districts in Sidama Zone.Methods A cross sectional survey was conducted from 15th- 20th October 2018. A multi-stage sampling design was employed to select 507 women who gave birth 12 months preceding the survey. Quantitative data were collected by using structured, interviewer administered questionnaires. Univariate and multivariate logistic regression models were run to assess factors associated with home delivery. Measures of association between factors and the outcome variable were reported using 95% confidence intervals (CIs) and adjusted odds ratios (aORs).Results The response rate was 495(97.6%). The overall prevalence of home delivery was 113 (28%) with 95%CI (19%, 27%). Maternal rural residence, aOR=7.45(95%CI: 2.23-24.83); illiteracy of mothers, aOR=8.78 (95% CI: 2.33-33.01); those who completed grades 1-4, aOR =3.81(95% CI: 1.16-12.49); mothers who did not know the expected date of delivery, aOR=2.12 (95% CI: 1.21-3.71); mother being merchant, aOR=3.01(95%CI:1.44-6.3) and paternal illiteracy, aOR=3.27, (95% CI: 1.20-8.88) were predictors of home birth.Conclusion The prevalence of skilled birth attendance in the study area has improved from the EDHS 2016 report of 26%. Uneducated, rural and merchant mothers were more likely to deliver at home. Interventions targeting rural and uneducated mothers might help to increase skilled birth attendance in the region.


1970 ◽  
Vol 28 (4) ◽  
Author(s):  
Mohammed Ahmed ◽  
Meaza Demissie ◽  
Araya Abrha Medhanyie ◽  
Alemayehu Worku ◽  
Yemane Berhane

BACKGROUND: Maternal mortality is high in sub-Saharan Africa, and most deaths occur around childbirth. In Ethiopia, most births happen at home without skilled delivery attendants, and particularly, the least utilization of skilled delivery is recorded in Afar Region. The factors that influence this utilization are not well documented in the region where utilization has been low. The aim of this study was to determine the prevalence of utilization of institutional delivery and associated factors.METHODS: A cross-section study with pretested structural questionnaire was conducted from August 5 to September 27, 2015, among women who gave birth within 24 months preceding the survey. A multivariable logistic regression analysis was done to identify factors associated with utilization of institutional delivery.RESULTS: Out of the total 1842 women, only 339(18.4%) of mothers reported having delivered their youngest child at a health facility. Home delivery was preferred due to cultural norms, lowrisk perception, and distance from a health facility. The odds of delivering in a health facility were higher for mothers who attended at least four antenatal visits during the index pregnancy (AOR=3.08,95%CI=1.91-4.96), those whose husbands were educated to secondary school (AOR= 1.86, 95% CI=1.34-2.60), and those that had at least secondary school level education themselves (AOR=1.52, 95% CI=1.03-2.23).CONCLUSION: Utilization of institution delivery among Afar communities is very low, and less educated mothers are lagging behind. Women’s education and full attendance to antenatal care can help increase utilization of skilled delivery services. Qualitativestudies to identify socio-cultural barriers are also essential.


Author(s):  
Divya Sahu ◽  
Shanta P. Khes Beck ◽  
G. P. Soni ◽  
Abha Ekka ◽  
Srishti Dixit ◽  
...  

Background: Janani Suraksha Yojana (JSY) replaces the National Maternity Benefit Scheme. It was launched by the Government of India in April 2005. The aim was to reduce maternal and neonatal mortality by increasing institutional delivery by providing cash incentive to the beneficiaries as well as the link worker ASHA. Objectives of this study was to assess receipt of Janani Suraksha Yojana (JSY) cash incentive and to assess fields of utilization of Janani Suraksha Yojana (JSY) cash incentive.Methods: A Community based cross-sectional study was conducted among 384 mothers delivered within last one year in urban slum of Raipur city. Study centre was department of community medicine, Pt. J.N.M. medical college Raipur, Chhattisgarh. A pre-designed and pre-tested questionnaire was used to interview the study subjects.Results: Out of total 384 study subject’s cheque of JSY cash incentive was received by 70.83%. All (100%) beneficiaries who received cheque was stipulated amount as per JSY guideline. Reasons for not receiving cheque was no availability of BPL card for those who delivered in accredited private health facility. Other reasons were absconded after delivery, unaware of cash incentive, did not go back to get the cheque when called later, patient shifted to another ward. None of the study subjects who delivered at home received the cash incentive cheque. Realization of cheque was not done by 22.79% of study subjects due to complex procedure to open an account in bank. Cash incentive money was utilized in neonatal care, drugs, food, household activities and some deposited in bank.Conclusions: JSY scheme is definitely functioning well in terms of providing cash incentive cheque of JSY on delivery in Government Health facility. There is need to simplify the procedure to open an account so that beneficiaries can avail cash incentive money. There is need to address the problems to receive cheque in home delivery and accredited Private health facility in addition to motivation for institutional delivery.


2020 ◽  
Vol 5 (1) ◽  

Background: Delay in institutional delivery refers to the time interval from the first onset of labour to start to receiving first healthcare. Delay in deciding to seek care (first delay), identifying and reaching medical facility (second delay), and receiving adequate and appropriate treatment (third delay) are three major factors that contribute to maternal death in developing countries. The time interval from the first onset of labour to decision to seek emergency obstetric care from health facility and time longer than the expected time (one hour) is considered as first delay. Objective: This study was aimed to investigate delay in deciding to seek institutional delivery care and associated factors among mothers attending public health facilities in Dawuro zone. Methods: Institution based cross-sectional study was employed from March 1-30, 2017. Consecutive sampling technique was used to interview mothers who presented to health facilities to receive delivery service. Data were collected using structured interviewer administered questionnaire. Results: Total of 394 mothers were participated in the study. One hundred sixty six [42%] of the study subjects were delayed in making decision to seek delivery service utilization from health facilities. A significant relationship was found between mother’s residence in rural areas, mother’s educational level primary and below, average monthly income of the family < 1000 ETB & mother’s antenatal care visit less than 4 times and first delay (maternal delay to seek institutional delivery care). Conclusion: Significant number [42%] of mothers delayed in making decision to seek delivery service utilization from health facilities. Therefore, strategies to identify determinants of delay in making decision to seek institutional delivery service and enhance practices for further reduction in this delay is needed.


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