Abstract
BackgroundHome birth is a common contributor to maternal and neonatal deaths particularly in low and middle-income countries (LMICs). We generally refer to home births as all births that occurred at the home setting. In Benin, home birth is phenomenal among some category of women. We therefore analysed individual and community-level factors influencing home birth in Benin.MethodsData was extracted from the 2017–2018 Benin Demographic and Health Survey females’ file. The survey used stratified sampling technique to recruit 15,928 women aged 15–49. This study was restricted to 7758 women in their reproductive age who had complete data. The outcome variable was home birth among women. A mixed effect regression analysis was performed using 18 individual and community level explanatory variables. Alpha threshold was fixed at 0.05 confidence interval (CI). All analyses were done using STATA (v14.0). The results were presented in adjusted odds ratios (AORs).ResultsWe found that 14% (n = 1099) of the respondents delivered at home. The odds of home births was high among cohabiting women compared with the married [AOR = 1.57, CI = 1.21–2.04] and women at parity 5 or more compared with those at parity 1–2 [AOR = 1.29, CI = 1.01–1.66]. The odds declined among the richest [AOR = 0.07, CI = 0.02–0.24], and those with formal education compared with those without formal education [AOR = 0.71, CI = 0.54–0.93]. Similarly, it was less probable for women whose partners had formal education relative to those whose partners had no formal education [AOR = 0.62, CI = 0.49–0.79]. The tendency of home birth was low for women who did not have problem in getting permission to seek medical care [AOR = 0.62, CI = 0.50–0.77], had access to mass media [AOR = 0.78, CI = 0.60–0.99], attained the recommended ANC visits [AOR = 0.33, CI = 0.18–0.63], belonged to a community of high literacy level [AOR = 0.24, CI = 0.14–0.41], and those from communities of high socio-economic status (SES) [AOR = 0.25, CI = 0.14–0.46].ConclusionThe significant predictors of home birth are wealth status, education, marital status, parity, partner’s education, access to mass media, getting permission to go for medical care, ANC visit, community literacy level and community SES. To achieve maternal and child health related goals including SDG 3 and 10, the government of Benin and all stakeholders must prioritise these factors in their quest to promote facility-based delivery.
Highlights
Home birth is a common contributor to maternal and neonatal deaths in low and middle-income countries (LMICs)
The significant predictors of home birth are wealth status, education, marital status, parity, partner’s education, access to mass media, getting permission to go for medical care, ANC visit, community literacy level and community socio-economic status (SES)
To achieve maternal and child health related goals including Sustainable Development Goals (SDGs) 3 and 10, the government of Benin and all stakeholders must prioritise these factors in their quest to promote facility-based delivery
Summary
Home birth is a common contributor to maternal and neonatal deaths in low and middle-income countries (LMICs). Compared to maternal deaths in high-income countries (11 per 100,000 livebirths), 462 deaths per 100,000 live births occur in low income countries such as Benin [36]. The global call for universal health coverage and skilled birth attendance has not been homogeneously achieved across regions, the higher MMR in low-income countries reflects several factors. These include inequalities in access to quality health services, distance to healthcare facilities, deep-rooted sociocultural beliefs [37] and several practices including poorhealthcare seeking behaviour and home care delivery [2, 22]
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