Factors contributing to the high number of home deliveries in Mufulira Urban

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Shipili, Pascalis
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The research contained in this document was done in order to determine the factors contributing to a high number of home deliveries in Mufulira urban. The identified factors were subjected to tests in order to establish whether the association observed was significant or not.Maternal health is the complete physical, social and psychological well-being of a woman of reproductive age. Addressing maternal health encompasses social and cultural factors, as well as addressing health system and health policy. Indicators used to measure maternal health include skilled attendance at birth, contraceptive prevalence rates and most importantly maternal mortality and morbidity. Improving maternal health is one of the eight millennium development goals, and great efforts have been put forth to achieve that goal.A case control study comprising 340 women aged between 15-45 years who had delivered at home within the past three months as cases (164) and those who did so in health facilities as controls (176). The sample was randomly selected from two residential areas which were conveniently selected due to the high number of home deliveries.Data were collected by use of questionnaires, focus group discussion and review of records. Data analysis was done with computer software SPSS and EPl info. The analysed data were presented in frequency tables, cross tabulations and bar graphs. Both multivariate and bivariate analyses were done on variables whose association with the place of delivery was found to be significant.This study revealed that low education level of women contributes to the increase in home deliveries (A significant association was observed between level of education and place of delivery, P<0.001). This is due to the fact that women of low education are not able to easily understand certain maternal conditions and the need to seek health care. Distance to the nearest health facility was also observed to contribute to pregnant mothers delivering in their homes (P=0.003). In addition, a significant association was observed between husband's employment status and place of delivery (P<0,OOI), Women married to men who are working have a higher chance of seeking health care because they can afford user fees, transport costs and layette. The study further revealed a significant association between the number of antenatal visits attended by a mother and the place of delivery. The lower the number of antenatal visits, the more likely that the mother will deliver from her home(P=0.031, Fisher's Test).This study concluded by coming up with several policy change recommendations which would enhance pregnant mothers' access to maternal health services. It was recommended that the health centres should be operating beyond 1600 hours so that those who might go in labour after 1600 hours could still be assisted by a skilled health worker. In addition, staffing levels needed to be improved to ensure quality maternal health care. There was need to source transport for the health centres to enhance the referral of patients from one health facility to another. Other recommendations included the rehabilitation of the health infrastructure and also the training of traditional birth attendants needs to be strengthened further as these cadres are playing major roles in the provision of maternal health services in the community in which they live.
Maternal health services--Zambia