scholarly journals Factors Affecting Home Delivery among Women Living in Remote Areas of Rural Zambia: A Cross-Sectional, Mixed-Methods Analysis

2021 ◽  
pp. 1-13
Author(s):  
Ireen Chola Mwape Musonda
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Low Income ◽  
Rural Areas ◽  
Home Delivery ◽  
Childbearing Age ◽  
Long Distance ◽  
Cross Sectional ◽  
Home Deliveries ◽  
At Home

Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low income and gender though having a small percentage. Parity in which the majority were multiparas’ women, attitude was also associated with home deliveries and other unforeseen circumstances such as a funeral and being alone at home at the onset of labour.

Preference of place of delivery and its determinants: a cross-sectional study in Chukha district, Bhutan

2015 ◽  
Vol 1 (1) ◽  
pp. 23-29
Author(s):  
Kencho Wangdi ◽  
Mongal S. Gurung ◽  
Dorji Pelzom ◽  
Tashi Dema ◽  
Sonam Wangdi
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Rural Areas ◽  
Maternal Mortality Ratio ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mortality Ratio ◽  
At Home

Introduction: The estimated global maternal deaths in 2013 was 289000. In Bhutan, Maternal Mortality Ratio has remarkably declined from 770 deaths per 100,000 live births in 1984 to 86 in 2012. However, the maternal mortality ratio still remains high and a high proportion of delivery still take place at homes (26%) despite of adopting 100%institutional delivery policy ever since 2005. This study was carried out to determine the important factors that prevent women from coming to the health facilities for safe delivery. Methods: A cross-sectional study among the women who delivered in Chukha District in 2013 was carried out after seeking ethical approval from Research Ethics Board of Health and World Health Organization. Chukha is a district with the second highest number of population in Bhutan where 55.7% of the people live in rural villages. Results: Out of 899 eligible listed women, 78.1% participated in the study and among the participants 11.5% had delivered at home. The number of home deliveries was higher in rural areas, 17.3%, as compared to urban places, 6.4%. Women who were delivering for third or more times are 2.42 times more likely to give birth at home compared to women who were delivering for the first time. Women residing at places more than three hours away from the health facility were 2.58 times more likely to give birth at home compared to women residing less than three hours away. During their last pregnancy, 99.4% of the participants have sought at least one ANC. Conclusions: This study suggests that the two most important factors associated with home delivery are the distance to health facility from their residences and the parity.

scholarly journals Prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma Municipality in central Tanzania

2020 ◽  
Vol 20 (4) ◽  
pp. 1933-42
Author(s):  
Situ Muhunzi ◽  
James Samwel Ngocho ◽  
Amasha Mwanamsangu ◽  
Leah Sanga ◽  
Hellen Hiza ◽  
...  
Keyword(s):  
Rural Areas ◽  
Transportation Cost ◽  
Cross Sectional Study ◽  
Home Delivery ◽  
Health Facilities ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Multivariable Logistic Regression Model ◽  
Long Distance ◽  
Cross Sectional

Introduction: The objective was to determine the prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma, Tanzania. Methods: A cross-sectional study was conducted amongst women living in Dodoma Municipality. Data were collected using adapted questionnaires and analysed using SPPS version 23. A multivariable logistic regression model was used to assess the independent predictors of home delivery. Results: A total of 425 women of childbearing age were enrolled in this study. The mean (± SD) age of the participants was 28.7 (±7.1) years. The prevalence of home delivery was 35.5% (n=150, 95% CI 30.9 – 40.2). Women with secondary school and above had 93% less odds of home delivery than women who had no education (AOR=0.0795% CI: 0.03-0.18). Women who lived in rural areas (AOR=3.49, 95% CI: 2.12-5.75), and women living more than 5km from health facilities (AOR=2.67, 95% CI: 1.65-4.37) had higher odds of home delivery. The main reasons for home delivery were transportation cost, and long distance to the nearest health facilities. Conclusion: In this population, the prevalence of home delivery remained to be high. To address this more collaborative mul- tisectoral effort like strengthening health education and strengthening maternity waiting homes are needed. Keywords: Women, home delivery, prevalence, factors, Tanzania.

scholarly journals Newborn Care Practices by the Mother / Care Givers’ and Their Knowledge about Signs of Sickness of Neonates

2012 ◽  
Vol 35 (3) ◽  
pp. 90-96 ◽  
Author(s):  
Md Mahbubul Hoque ◽  
Mohammad Faizul Haque Khan ◽  
Jotsna Ara Begum ◽  
MAK Azad Chowdhury ◽  
Lars Ake Persson
Keyword(s):  
Neonatal Mortality ◽  
Newborn Care ◽  
Cost Effective ◽  
Home Delivery ◽  
Prelacteal Feeding ◽  
Cross Sectional ◽  
Institutional Deliveries ◽  
Home Deliveries ◽  
Care Practices ◽  
At Home

Background: Despite proven cost effective intervention, there has been little change in neonatal mortality. In Bangladesh neonatal mortality accounts for two third of infants death. About 90% deliveries take place in home and majority of neonatal death are taking place within 7 days of birth. Information about reasons for delivering at home and newborn care practices will be useful to undertake simple intervention measures by policy makers.Aims and objective: To see the knowledge, perception and behaviour of mothers towards their normal and sick newborn.Methods: A cross sectional study was carried out in Dhaka Shishu Hospital from June to November, 2007. A semistructured, pretested questionnaire was used to interview mothers attending inpatient (IPD) and outpatient department (OPD) of hospital.Results: A total 198 mothers were interviewed. Home deliveries were 35.5% and Institutional were 64.5%. Among the Institutional deliveries 35% (44 out of 127) were planned and tried first at home, but when failed mothers were taken to hospital. Majority (86%) of home deliveries were conducted by Dai/relatives. Umbilical cord was cut with new/boiled blade in 85% of home deliveries and household knife was used in 4% cases. Birth place were not at all heated in all home deliveries. In 32 % of home deliveries babies were given bath within 1 hour of birth and it was 15% in case of hospital deliveries. Forty-eight percent babies of home deliveries were wrapped within 10 minutes. Prelacteal feed was given in 51% of home deliveries in comparison to 23% of institutional deliveries. The rate of initiation of breast feeding within one hour of birth was 52% in home and 35% in institutional deliveries. In all cases breast milk was given within 48 hours. Main reasons cited for delivering at home were preference (43%) and fear about hospital (39%). In case of educated (graduate) mothers 72% deliveries took place at hospital. Less feeding (56%), vomiting (42%), less movement (32%), fever (29%) and cough (27%) could be recognized by mothers as signs of sickness.Conclusion: Home deliveries and poor newborn care practices are commonly found in this study. Traditional birth attendants should be adequately trained as they are conducting majority of home deliveries. Female education is very important to reduce home delivery as it is seen that deliveries of educated mothers are taking place in hospital. High risk traditional newborn care practices like delayed wrapping, early bathing, use of oil in umbilical stump and prelacteal feeding need to be addressed. This study also found that knowledge to identify sickness in newborn is still poor.DOI: http://dx.doi.org/10.3329/bjch.v35i3.10497  Bangladesh J Child Health 2011; Vol 35 (3): 90-96

scholarly journals Deaths From Surgical Conditions In Malawi A Randomised Cross-sectional Nationwide Household Survey

2019 ◽  
Author(s):  
Carlos Gomes Varela ◽  
Sven Young ◽  
Reinou Groen ◽  
Leonard Ngoe Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Facility ◽  
Low Income ◽  
Health Centre ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Surgical Conditions ◽  
At Home

Abstract Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.

scholarly journals Socio Demographic Determinants of Delivery Practice in Rural Women of Bangladesh

2013 ◽  
Vol 1 (2) ◽  
pp. 42-45 ◽  
Author(s):  
Meherunnessa Begum ◽  
Khondoker Bulbul Sarwar ◽  
Nasreen Akther ◽  
Rokshana Sabnom ◽  
Asma Begum ◽  
...  
Keyword(s):  
Maternal Health ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Home Delivery ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
At Home

Background: Every year, world wide, 200 million women become pregnant. The development of urban areas allowed women to receive more care and treatment. However, in rural areas such measures are not available to every woman. Data on delivery practice of rural woman may help the social and public health planners and decision makers to minimize and prevent maternal mortality and morbidity ensuring safe motherhood.Objective: The aim of the study was to observe the delivery practice of rural women of Bangladesh. Materials and method: A cross-sectional study was conducted and data were collected from Dhamrai upazila, Dhaka, Bangladesh in April 2008. Total 159 women of reproductive age group at least having one child were selected purposively to elicit information on various demographic, socioeconomic, cultural and selected programmatic variables including maternal health care and delivery practices. Results: Among the respondents about 55% were literate. Majority (80%) of the respondents delivered at home and most of the them (71%) felt that home delivery was comfortable where as about 29% of the respondents were compelled to deliver at home due to family decision and financial constraint. Among the deliveries about 82% occurred normally and 18.2% were by cesarean section. A considerable percentage of deliveries (49%) were attended by traditional birth attendants. Blade was used for cutting umbilical cord in majority of the cases (74%) who delivered at home. Most of the respondents (90%) took ante natal check up and about 74% were vaccinated by tetanus toxoid. Conclusion: The results of the study suggest that a lot of work is still to do for the policy makers and health planners to target, plan, develop and deliver maternal health services to the rural women of Bangladesh. DOI: http://dx.doi.org/10.3329/dmcj.v1i2.15917 Delta Med Col J. Jul 2013;1(2):42-45

scholarly journals Rubella Vaccination Coverage Among Women of Childbearing Age in Vietnam

2019 ◽  
Vol 16 (10) ◽  
pp. 1741
Author(s):  
Toan Thanh Thi Do ◽  
Anh Ngoc Nguyen ◽  
Xuan Thanh Thi Le ◽  
Ann Pongsakul ◽  
Quang Nhat Nguyen ◽  
...  
Keyword(s):  
Rural Areas ◽  
Compliance Rate ◽  
Immunization Coverage ◽  
Cross Sectional Study ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Long Distance ◽  
Cross Sectional ◽  
Congenital Rubella ◽  
Rubella Vaccination

Despite the availability of effective and safe rubella vaccines for women of childbearing age, prevention and control of congenital rubella syndrome in children remains challenging in Vietnam. In order to examine this issue, we conducted a cross-sectional study, examining the current coverage of rubella vaccination before pregnancy among 807 pregnant women and women with children under 12 months of age in urban and rural districts, Dong Da and Ba Vi, in Hanoi, Vietnam. In this population, we observed an alarming non-compliance rate with rubella vaccination before pregnancy in both localities. Among the 82.0% of participants who remained unvaccinated against this contagious viral infection, 95.8% of them were in Ba Vi district, compared to 68.0% in Dong Da district (p < 0.001). Besides the differences in age, number of children, education levels, primary occupations and monthly incomes among the participants between the two districts, other reasons for noncompliance with rubella vaccination includeddisinterest in rubella vaccination, the high cost and long distance to vaccination sites as well as unawareness of vaccination locations. In addition to addressing the unique socio-economicchallenges behind one’s accessibility to vaccination services in urban and rural areas, our study supports a continued effort in ensuring proper access to and education about pre-pregnancy vaccines and vaccination among women of childbearing age in order to achieve and sustain sufficient immunization coverage of rubella and other vaccine-preventable diseases in both settings.

scholarly journals Deaths from surgical conditions in malawi A randomised cross-sectional nationwide household survey

2019 ◽  
Author(s):  
Carlos Gomes Varela ◽  
Sven Young ◽  
Reinou Groen ◽  
Leonard Ngoe Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Facility ◽  
Low Income ◽  
Health Centre ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Surgical Conditions ◽  
At Home

Abstract Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.

scholarly journals Why women choose to deliver at home in India: a study of prevalence, factors, and socio-economic inequality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ratna Patel ◽  
Strong P. Marbaniang ◽  
Shobhit Srivastava ◽  
Pradeep Kumar ◽  
Shekhar Chauhan
Keyword(s):  
Rural Women ◽  
Rural Areas ◽  
Contact Point ◽  
Decomposition Analysis ◽  
Home Delivery ◽  
Targeted Interventions ◽  
Factors Influencing ◽  
Home Deliveries ◽  
The Government ◽  
At Home

Abstract Background To promote institutional delivery, the Government of India, through the Janani Suraksha Yojana (JSY) program, gives monetary reward to all pregnant women who give birth at the government or private health center. Despite providing cash assistance, a higher number of women are still preferring delivering at home. Therefore, this study sought to determine the prevalence of home births and identifying the factors influencing women’s choice of home deliveries. Methods Data from the National Family Health Survey (NFHS) conducted during 2005–06 and 2015–16 were used in the study. The respondents were women 15–49 years; a sample of 36,850 and 190,898 women in 2005–06 and 2015–16 respectively were included in the study. Multivariate logistic regression was used to determine the factors influencing home delivery. Income-related inequality in home delivery was quantified by the concentration index (CI) and the concentration curve (CC), and decomposition analysis was used to examine the inequality in the prevalence of home deliveries. Results The prevalence of home deliveries has reduced from 58.5% in 2005–06 to 18.9% in 2015–16. The odds of delivering babies at home were lower among women who had full ANC in 2005–06 [AOR: 0.34; CI: 0.28–0.41] and in 2015–16 [AOR: 0.41; CI: 0.38–0.45] and were higher among women with four or higher parity in 2005–06 [AOR: 1.70; CI: 1.49–1.92] and in 2015–19 [AOR: 2.16; CI: 2.03–2.30]. Furthermore, the odds of delivering babies at home were higher among rural women and were lower among women with higher education. It was found that the value of CI increased from − 0.25 to − 0.39 from 2005-06 to 2015–16; this depicts that women delivering babies at home got more concentrated among women from lower socio-economic status. Conclusion There is a need to promote institutional deliveries, particular focus to be given to poor women, women with higher parity, uneducated women, and rural women. ANC is the most concurring contact point for mothers to get relevant information about the risks and complications they may encounter during delivery. Therefore, effort should be directed to provide full ANC. Targeted interventions are called for to bring improvements in rural areas.

scholarly journals DEATHS FROM SURGICAL CONDITIONS IN MALAWI A Randomised Cross-sectional Nationwide Household Survey

2019 ◽  
Author(s):  
Carlos Gomes Varela ◽  
Sven Young ◽  
Reinou Groen ◽  
Leonard Ngoe Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Facility ◽  
Low Income ◽  
Health Centre ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Surgical Conditions ◽  
At Home

Abstract Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

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