Womens birth experiences Reasons for choice of a place for delivery among mothers in Zanzibar North region

Abstract

More than half a million women die each year of pregnancy or pregnancy related conditions. Most of these are in the third world countries. In Tanzania the Maternal Mortality Rate (MMR) is presently 578 per 100,000 live births in Tanzania mainland and 377 per 100000 live births in Zanzibar. The single most critical intervention for safe motherhood is to ensure that women receive care during delivery by skilled health personnel. However only 47% of women in Tanzania deliver at a health facility. In Tanzania and especially Zanzibar we see a dearth of research on maternal health and especially choices made by the users or potential users of maternal health services. This study therefore aimed to find out the factors influencing choice of delivery place among mothers in Zanzibar north region. It also addressed the levels of patient satisfaction with services either in the health facility or at home compared to the birth experiences of those who changed birth place in the last five years. The methodology used was a cross sectional survey using a questionnaire with closed and open ended questions which was administered to 300 respondents with the assistance of four research assistants. Analysis was done by entering the data in spss program and generating appropriate outputs for reporting and discussion. 56.7 % of the respondents delivered the last born child at home. The factors affecting this choice were found to be spouse's education, parity, ward of residence and cost of delivery. Also significant were employment status, mothers' education, ANC attendance and marital status. The most common reason found for health facility delivery was that the health facility is a safer place to deliver while the most commonly stated reason for home deliveries were the cost of health facility delivery being too high and the distance to the health facility being too far. Satisfaction with birth experience was high both for those who delivered in the health facility and at home. For those who delivered at home there were high satisfaction levels with the services provided by the TBA if present. It is recommended that the government should provide sufficient delivery supplies to the public health facilities so that delivery services can in reality be free. There should also be continuing research on women's perspectives regarding their needs.