Retrospective, community based, comparative study of home and health centre deliveries in three compounds of Lusaka Urban
Sikasote, Janet Precious Banda
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A descriptive, retrospective survey of home births and health centre births was conducted in three compounds of Lusaka urban from October to December, 1995.A total of 164 women were interviewed. All these were women who had delivered a baby in the period from 1st August, 1994 to 31st August, 1995. 82 were home births and 82 were health facility births.The specific objectives of the study were to compare the outcome of home and health centre deliveries and to determine factors influencing place of delivery and antenatal clinic attendance. 4,762 households were visited, this yielded a total of 1223 deliveries in the year under study with 137 home births.A questionnaire was administered to all home births found, who fulfilled the inclusion criteria. The same questionnaire was also administered to the next closest health facility birth to each home birth. Of the 164 women interviewed, no difference was found in the outcome of home deliveries compared to that of health facility deliveries.The women delivering at home tended to be of higher parity. Most of them also had a previous home birth.Literacy did not seem to have an effect on place of delivery nor on antenatal clinic attendance. The majority of women appeared aware of the reasons for attending antenatal clinic but were unaware of the importance of early registration. Of all the home births, only 2.5% (2) were assisted by a trained person, the remainder were either delivered by an untrained person or were unassisted deliveries.Charging for deliveries seems to influence choice of place of delivery since almost one quarter of the women delivering at home said they did so because it is cheaper. More than half the women interviewed would actually prefer not to be charged at all for deliveries. Traditional birth attendants were found to be non-active.Constraints of the study included small sample size and a questionnaire that failed to elicit certain information.According to the findings, it is recommended that;1.Health education be improved.2.The problem of non-functional traditional birth attendants should be resolved.3.Charging for deliveries should stop, or other feasible measures should be put in place to protect the less privileged. 4. A bigger study, going into more detail, is required to determine adequately the outcome of home births in comparison to health facility deliveries.