Factors contributing to delay in seeking emergency obstetric care at Sengerema designated district hospital, Mwanza region.

Abstract

A hospital-based, cross-sectional study was conducted in both urban and rural population of Sengerema district who received health care at the hospital between early May to the end of June 2000. The aim of this study was to determine factors contributing to delay in seeking emergency obstetric care among women who received care at Sengerema designated district hospital. A total of 172 women aged between 16 to 48 years were interviewed. A convenient sampling technique was used and a person to person interview using questionnaire was used in quantitative method. Among these women, a purposeful sample of 10 women were selected, two from each of the five divisions in the district for in-depth interview. The results showed that the overall proportion of women delayed to report to the emergency obstetric care was 54.1 % (93/172). The results also showed that 61.6% of the decision makers on the place of delivery were men giving women little chance to decide for their own health; 72.1 % of the economic power belonged to men; 77.9% of the respondents had no access to transport especially at night; 44.6% of women decided to seek care after eight hours of labour or disease; 31.2% of women who reported late to the hospital were as a result of waiting for labour to start and 10.8% due to financial problems . . - ------- ~ --------~~ .. - ---- ~~- --- ~-- ix In this cross-sectional study, age, parity, income, distance, travelling time, problems during pregnancy and waiting time were significantly associated with reporting time to the emergency obstetric care (E.O.C). Delay in seeking health care during emergency obstetric care was found to be significant public health problem among the community of Sengerema women. Some of the factors contributing to delay in the district were scarce EOC facilities, transport to EOC were not readily available, long distance to the EOC and health workers in health facilities delay to make appropriate diagnosis and timely referral to the EOC. So the Ministry of Health has to design possible ways to improve the working condition and continue train its staff for capacity building. The district health management team has to design appropriate strategies on how best to conduct on job training to the whole district and locate areas with lack of qualified staff and advise the local government to give them chance to recruit competent health workers. To upgrade health centres into EOC the local government and the community has to contribute funds to be used even in maintenance of the centre. The community must also take role in encouraging these women to deliver in health facilities and mobilise transport during emergencies so as to reduce maternal mortality and morbidity in this country. It should focus mainly to people in the peripheral marginalised community which, lack referral infrastructure. ---- - -- - - - .- ~- .. - . -- _._-- ~.- ~ - - -~--