DETERMINANTS OF HOME BIRTHS AMONG WOMEN OF REPRODUCTIVE AGE AFTER ANTENATAL HOSPITAL CARE VISITS IN NAROK COUNTY, KENYA

Abstract

Purpose: The purpose of the study was to investigate the contributors associated with having a home delivery after antenatal hospital care visits in women of reproductive age in Narok South Sub-County, Kenya.
 Materials and Methods: Across-sectional survey of 323 women who delivered at home within the last two years yet attended antenatal care clinics was carried out. The survey was conducted in Narok south sub-county, and respondents were picked randomly from all the wards. Data was collected using an interviewer-administered questionnaire; exploration of variables was done using a chi-squire test. Using odd ratio with95% confidence interval with p<0.05 taken as a statistically significant association.
 Results: The One way ANOVA analysis indicated that there was a significant influence on source of income and home delivery (F=62.022, P=0.0001. All three factors (age, education, distance) had a significant positive relationship with the number of children delivered at home(r =0.574, 0.677 and 0.534 respectively). Using Pearson correlation analysis, the findings revealed that the distance to the health facility significantly influenced home delivery(r=0.53, P=0.0001).On assessing the level of knowledge associated with home delivery, many mothers were aware of bleeding and perinea tears as complications. Given opportunity majority would not deliver at home again (77.4%). Those who had no emergency backup plan were96.3% and those who stated that they would deliver at home again, had no emergency backup plan. In contrast, women who had emergency backup plans would not deliver at home again (Fishers' exact test = 3.628, P = 0.043). Awareness of the risk factors stated 95.0% were aware of the risk of placenta praevia and bleeding problems, and there was no significant difference in the number of women aware of the danger signs to those not familiar (x2 value 30000,p-value 0.224). 
 Unique contribution to theory, practice and policy: The study recommended that the County Education officers in liaison with social development officers should promote adult formal education to improve literacy levels, which will go a long way in influencing reproductive health decisions. County health management team, together with the reproductive health section should network with other relevant stakeholders to increase sensitization on utilization of hospital-based deliveries.