Factors influencing the place of delivery in the rural region of Labrousse, Hati

Objectives The objective of this study is to determine factors that influence the place of delivery in the rural region of Labrousse, Haiti Design This study employed a cross-sectional survey design to collect data using an anonymous interview guide comprising structured questions and made up of two parts: 1- Identification of personal and socio-cultural parameters. 2-Identification of the reasons for the place of the last childbirth. Setting The study was conducted fromSeptember to November 2017 in Notre-Dame of Lourdes of Labrousse community health center and the area catered to by it. Labrousse is a rural community located in the 3rd communal section of Miragoâne about 19 kilometers from the main road, in the department of Nippes. Participants The survey included 92 women aged 13–46 years, live in the area who had at least one birth in the last 1–3 years by the time of data collection. Results 75% of women gave birth to their last child at home. 76% of home births were assisted by a matron or traditional practitioner. age, religion, level of education of mothers and fathers, distance between home and health facility, availability of transportation and prenatal follow-up are significant factors (P <0.05) that influence the choice of delivery place. Conclusion Acting on the factors influencing the delivery place in Labrousse would make it possible to bridge this gap between the number of home births and the number of births in healthcare facility.

Preferences and Practices regarding Delivery Place: A community-based cross-sectional study in Agra city, Uttar Pradesh

Background: Understanding preferences and practices for delivery place among women would assist in better resource utilization for skilled attendants. Objectives: To study factors influencing women’s preference and practice regarding their place of delivery. Methods: A community based cross-sectional study was conducted in Agra from 1st October 2018 to 31st October 2020. Multi-stage random sampling was used. Data was collected using semi-structured interview schedule. Both bivariate and multivariate analysis was done. Result: Majority (72.67%) of women had preference for delivery at government hospital while 19.67% for private hospital and only 7.67% for home. In actual practice, 58.33% had delivered at government hospital and 32.33% delivered at private hospital while 9.33 % at home. On multiple-logistic regression analysis, parity found to have significant association with preference of delivery at government hospital. Preference for delivery in private hospital was found to be significant with OBC caste and in women whose husband has skilled/highly-skilled occupation. In actual practice, Government hospital as delivery place found to have significant association with parity and presence of ASHA. Private hospital as a delivery place found significant with literate mothers and parity. Conclusion: Majority had preferred and practiced institutional delivery, preferring government hospital over private hospital. In actual practice, delivery at private hospital as well as home delivery out-numbered the preferred proportion.

Timely Initiation of Complementary Feeding and Associated Factors Among Children aged 6-23 Months in Negelle Arsi District, Southern Ethiopia, 2019: A Community-Based Cross-Sectional Study

Background: The period of transition from exclusive breastfeeding to family foods, referred to as complementary feeding, covers a child from 6-23 months of age. According to World Health Organization 2015; untimely initiation of complementary feeding has negative effect on child health, growth and development and an important cause of under nutrition in children less than 5 years of age which is an underlying cause of more than 40% of morbidity and mortality. Objective: To assess the Timely Initiation of Complementary Feeding practice and Associated factors among children aged 6-23 Months in Nagelle Arsi District, Southern Ethiopia, 2019.Methods: A community-based cross-sectional study was carried out. Systematic random sampling method was used to select 400 study participants. Data was collected using structured questionnaire using face to face interview. The collected data was coded, entered in to Epi-Info version 7 and then exported to SPSS version 21 for analysis.Descriptive statistics, binary and multiple logistic regressions were used for data analysis at 95% confidence intervals. A p-value <0.05 was considered to declare statistical significance. Results: Out of 398 study participants, the proportion of timely initiated complementary feeding was 296 (74.4%) at 95%CI: (70.14, 78.66). In this study Postnatal care follow up [AOR=2.484; 95% CI: (1.478, 4.176)], ANC follow up [AOR=2.221; 95% CI: (1.276, 3.876)] and maternal counseling about timely initiation of complementary feeding at delivery place were positively associated with timely initiation of complementary feeding practice [AOR=2.362; 95% CI: (1.399, 3.986)].Conclusion and recommendation: In this study, three-fourth (74.4%) of children were initiated complementary food at six months of age which was lower than the WHO cut-off point of >80%. ANC follow up, having postnatal care visits and being counseled about timely initiation of complementary feeding at place of delivery were significantly associated with timely initiation of complementary feeding. Therefore promoting ANC follow up, postnatal care visits and counseling about timely initiation of complementary feeding at delivery place were recommended to the concerned bodies to improve the coverage of timely initiation of complementary feeding practice.

Factors affecting the choice of delivery place in a rural area in Laos: A qualitative analysis

Background Home delivery (HD) without skilled birth attendants (SBAs) are considered crucial risk factors increasing maternal and child mortality rates in Loa PDR. While a few studies in the literature discuss the choice of delivery in remote areas of minority ethnic groups; our work aims to identify factors that indicated their delivery place, at home or in the health facilities. Methods A community-based qualitative study was conducted between February and March 2020. Three types of interviews were implemented, In-depth interviews with 16 women of eight rural villages who delivered in the last 12 months in Xepon District, Savannakhet Province, Lao PDR. Also, three focus group discussions (FGDs) with nine HCPs and key-informant interviews of ten VHVs were managed. Factors affecting the choice of the delivery place were categorized according to the social-ecological model. Results Our sample included five Tri women and two Mangkong women in the HD group, while the FD group included three Tri women, two Mangkong women, one Phoutai woman, two Laolung women and one Vietnamese. Our investigation inside the targeted minority showed that both positive perceptions of home delivery (HD) and low-risk perception minorities were the main reasons for the choice of HD, on the individual level. On the other hand, fear of complication, the experience of stillbirth, and prolonged labour pain during HD were reasons for facility-based delivery (FD). Notably, the women in our minority reported no link between their preference and their language, while the HCPs dated the low knowledge to the language barrier. On the interpersonal level, the FD women had better communication with their families, and better preparation for delivery compared to the HD group. The FD family prepared cash and transportation using their social network. At the community level, the trend of the delivery place had shifted from HD to FD. Improved accessibility and increased knowledge through community health education were the factors of the trend. At the societal (national policy) level, the free delivery policy and limitation of HCPs’ assisted childbirth only in health facilities were the factors of increasing FD, while the absence of other incentives like transportation and food allowance was the factor of remaining of HD. Conclusions Based on the main findings of this study, we urge the enhancement of family communication on birth preparedness and birthplace. Furthermore, our findings support the need to educate mothers, especially those of younger ages, about their best options regarding the place of delivery. We propose implementing secondary services of HD to minimize the emergency risks of HD. We encourage local authorities to be aware of the medical needs of the community especially those of pregnant females and their right for a free delivery policy.

Exploring the reasons and factors influencing the choice of home delivery of births in rural Bangladesh: a community-based cross-sectional study

PurposeThe aim of this study was to explore the reasons for preferring home as a birth delivery place and identify the socio-economic and cultural factors influencing the choice of delivery place in rural Bangladesh.Design/methodology/approachThe data for the study come from a community-based cross-sectional study conducted among 464 mothers in a rural sub-district of Bangladesh in 2019. Respondents were selected randomly from the frame listing all mothers with inclusion criteria, using a two-stage cluster sampling design. Data were collected through a face-to-face interview. Both descriptive and inferential statistics and logistic regression models were used for data analysis.FindingsThe results indicate a very high rate (58%) of home delivery. About 20% mothers never received ANC visit. Preference for home delivery was high (63%). Mothers with no education, aged 30 and above, multi-parity, low wealth status, lack of knowledge about institutional delivery, no or <4 ANC visits, received no advice about the delivery place, no pregnancy complications, decision about health care, and prior plan for home delivery were identified as significant predictors of home delivery. Cost of services, cultural practices and attitude towards health facility, lack of a female delivery assistant, perceived fear of caesarian section, poor quality of services, and lack of knowledge about maternity services appeared as important barriers for institutional delivery.Originality/valueBased on primary data from a rural area, this study would help understand reasons and factors affecting home delivery and developing an appropriate strategy for the improvement of institutional delivery and maternity care services in Bangladesh.

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

Factors Related To Delivery Place Selection Among Pregnant Women In Jambi In 2020

This study aims to determine the factors related to the choice of delivery place. This research is an analytic survey research with cross sectional design. The sampling technique in this study was conducted with a total sampling method of 108 pregnant women. Data was collected using a questionnaire that had been tested for validity and reliability and was processed with the Chi-Square statistical test. The results showed that 61.1% of pregnant women chosed non-health facilities (home) in the selection of labor, then the statistical test found a significant relationship between economic status / income (ρ value = 0.008) and husband / family support (ρ value = 0.005 ) with the delivery place selection, other factors not related delivery place selection are education (ρ value = 0.231), knowledge (ρ value = 0.826) and distance (ρ value = 0.099).

The effects of changes in distance to nearest health facility on under-5 mortality and health care utilization in rural Malawi, 1980–1998

Background Despite important progress, the burden of under-5 mortality remains unacceptably high, with an estimated 5.3 million deaths in 2018. Lack of access to health care is a major risk factor for under-5 mortality, and distance to health care facilities has been shown to be associated with less access to care in multiple contexts, but few such studies have used a counterfactual approach to produce causal estimates. Methods We combined retrospective reports on 18,714 births between 1980 and 1998 from the 2000 Malawi Demographic and Health Survey with a 1998 health facility census that includes the date of construction for each facility, including 335 maternity or maternity/dispensary facilities built in rural areas between 1980 and 1998. We estimated associations between distance to nearest health facility and (i) under-5 mortality, using Cox proportional hazards models, and (ii) maternal health care utilization (antenatal visits prior to delivery, place of delivery, receiving skilled assistance during delivery, and receiving a check-up following delivery), using linear probability models. We also estimated the causal effect of reducing the distance to nearest facility on those outcomes, using a two-way fixed effects approach. Findings We found that greater distance was associated with higher mortality (hazard ratio 1.007 for one additional kilometer [95%CI 1.001 to 1.014]) and lower health care utilization (for one additional kilometer: 1.2 percentage point (pp) increase in homebirth [95%CI 0.8 to 1.5]; 0.8 pp. decrease in at least three antenatal visits [95% CI − 1.4 to − 0.2]; 1.2 pp. decrease in skilled assistance during delivery [95%CI − 1.6 to − 0.8]). However, we found no effects of a decrease in distance to the nearest health facility on the hazard of death before age 5 years, nor on antenatal visits prior to delivery, place of delivery, or receiving skilled assistance during delivery. We also found that reductions in distance decrease the probability that a woman receives a check-up following delivery (2.4 pp. decrease for a 1 km decrease [95%CI 0.004 to 0.044]). Conclusion Reducing under-5 mortality and increasing utilization of care in rural Malawi and similar settings may require more than the construction of new health infrastructure. Importantly, the effects estimated here likely depend on the quality of health care, the availability of transportation, the demand for health services, and the underlying causes of mortality, among other factors.

The effects of changes in distance to nearest health facility on under-5 mortality and health care utilization in rural Malawi, 1980-1998

Background: Despite important progress, the burden of under-5 mortality remains unacceptably high, with an estimated 5.3 million deaths in 2018. Lack of access to health care is a major risk factor for under-5 mortality, and distance to health care facilities has been shown to be associated with less access to care in multiple contexts, but few such studies have used a counterfactual approach to produce causal estimates. Methods: We combined retrospective reports on 18,714 births between 1980 and 1998 from the 2000 Malawi Demographic and Health Survey with a 1998 health facility census that includes the date of construction for each facility, including 335 maternity or maternity/dispensary facilities built in rural areas between 1980 and 1998. We estimated associations between distance to nearest health facility and (i) under-5 mortality, using Cox proportional hazards models, and (ii) maternal health care utilization (antenatal visits prior to delivery, place of delivery, receiving skilled assistance during delivery, and receiving a check-up following delivery), using linear probability models. We also estimated the causal effect of reducing the distance to nearest facility on those outcomes, using a two-way fixed effects approach. Findings: We found that greater distance was associated with higher mortality (hazard ratio 1.007 for one additional kilometer [95%CI 1.001 to 1.014]) and lower health care utilization (for one additional kilometer: 1.2 percentage point (pp) increase in homebirth [95%CI 0.8 to 1.5]; 0.8pp decrease in at least three antenatal visits [95% CI -1.4 to -0.2]; 1.2pp decrease in skilled assistance during delivery [95%CI -1.6 to -0.8]). However, we found no effects of a decrease in distance to the nearest health facility on the hazard of death before age five years, nor on antenatal visits prior to delivery, place of delivery, or receiving skilled assistance during delivery. We also found that reductions in distance decrease the probability that a woman receives a check-up following delivery (2.4pp decrease for a one kilometer decrease [95%CI 0.004 to 0.044]). Conclusion: Reducing under-5 mortality and increasing utilization of care in rural Malawi and similar settings may require more than the construction of new health infrastructure. Importantly, the effects estimated here likely depend on the quality of health care, the availability of transportation, the demand for health services, and the underlying causes of mortality, among other factors.