Factors associated with home delivery and outcomes: a case study of homesteads in Kapoeta North County, South Sudan

Abstract

Background: Delivering infants in homesteads is still considered the norm in many parts of the world. However, the practice is fraught with health risks for both pregnant women and newborns. Kapoeta North County in the eastern part of South Sudan is known to have high levels of maternal and infant deaths with an estimated 97.8% of women delivering outside health facilities. This study investigated demographic, socio-economic, and health system factors associated with home deliveries in Kapoeta North County, South Sudan. Methods: A cross-sectional analytical research design was used. A sample of 400 women of reproductive age who had delivered in the past six months were interviewed. Cluster, stratified and simple random sampling were used to identify the study areas and to select study respondents. Quantitative and qualitative techniques of data collection were employed.Results: Homestead delivery was found to be high, 272 (68%) women of reproductive age delivered at home. Being educated (OR=9.93, 95% CI: 2.56-38.47), distance to the health facility (OR=10.87, 95% CI: 0.04-0.20), gender of the birth attendant (OR=2.61, 95% CI: 1.25-5.45) and availability of the amenities (OR=1.83, 95% CI: 0.86-3.90) were significantly associated with home delivery. Conclusions: The study concluded that homestead delivery at Kapoeta North County of South Sudan is high at 68%. There is a need for expansion of the health infrastructure, financial empowerment of the vulnerable women, and improved awareness through social media about the consequences of delivering at home.