Factors associated with home deliveries among women attending childrens’ immunization clinics in Rorya district, Mara region.

Abstract

Background: Maternal and neonatal morbidity and mortality arising from limited access to health care services together with socio-cultural and economic factors are of important global health concern. High number of maternal and neonatal morbidity and mortality may be due to some factors that hinder the use of health care facilities available resulting to home deliveries. In Tanzania the deliveries that occur in health facilities is 63%, the rest occur outside health facilitiesand this varies between zones and regions. Objective: This study aims at identifying the factors associated with home deliveries among women of reproductive age inRorya district, Mara region. Materials and methods: Facilitybased cross sectionalstudy was conducted in Rorya district, in Mara region. A total of 427women who delivered a child in the past two years were enrolled in the study. Informed consent was sought from eligible respondents after being provided with information on the aim of the study, benefits and right to withdrawal. A researcher administered Swahili questionnaire was used to collect information from the study participants. Data was collected on demographic, socio-cultural economic, geographical and facility factors by interviewing the participants through questionnaire that was translated in Swahili language, for one month and analysed using SPSS statistical software version 23. Bivariate analysis was done to find out factors associated with home delivery and later multivariate analysis was done to find out the predictors for home deliveries.

Results: Among the study participants 42.9% had home delivery in their recent childbirth. The most common reasons for home deliveries were transport cost to facilities, cultural and customs, no transport, religious beliefs, husband decision, bad language from health care workers (HCW) as well as poor roads. The factors associated with home delivery were Husband/partner’s age > 50 years (AOR=2.0; 95% CI=1.09-3.88); husband with informal employment (AOR=3.62; 95% CI=2.02-6.49); distance from the health facility> 10km (AOR=2.22; 95% CI=1.07-4.59);no attendance of antenatal care and no history of previous facility delivery (AOR=1.88; 95% CI=1.21-2.93).

Conclusion:There was high proportion (42.9%) of home deliveries among women of reproductive age.Husband/partner’s old age and informal employment; long distance from the health facility, no attendance of antenatal care services and no history of previous delivery in the health facility were major factors associated with homedelivery. Recommendation Programmes aimed at enhancing education on importance of antenatal care and dangers of home delivery to men and women may reduce the problem. Reduction of unemployment rates in men and women by providing entrepreneurship education in order to increase family income and be able cover health costs whenever needed