Abstract
In developing countries, most deliveries take place without a skilled birth attendance. This lack of skilled birthattendance could be considered as one of the major factors contributing to maternal and neonatal morbidity and mortality. The use of facility-based delivery system helps to reduce various complications during childbirth, which may be affected by social and cultural norms among several other factors. This study was to assess the proportion of pregnant women delivering at home and the role of socioeconomic and demographic factors affecting the choice of place of delivery among pregnant women attending antenatal, postnatal and Immunization clinic at Rano General Hospital, Kano. This is a cross sectional study carried out between September 2018 to November 2018 among 310 pregnant women who had at least delivered once and are attending antenatal care, post-natal or immunization clinic at the General hospital in Rano local government area of Kano state within the study period. Data was collected using interviewer administered questionnaire which was interpreted to those participants who cannot understand English language. Data obtained was entered into excel spread sheet 2018 and subsequently analyzed using SPSS 2016 version 20. Multivariateregression methods were used for measuring the associations between socio-demographic variables and place of delivery. About 310 questionnaires were distributed of which 100% retrieval rate was achieved. A total of 281 (90.6%) received antenatal services at least once during their previous pregnancy among which 183 (59.03%) of them had home delivery. The respondents were between the ages of 18-37 years with the mean age of 24.9 ± 5.1 years. Minimum age of the respondents was 18 years, while the maximum age was 37 years. The main reasons for home delivery were, previous delivery was at home and complication free, short interval between onset of labor and delivery and also husband and mother in-law's decision. This study has shown that there is still high rate of home delivery among antenatal clinic attendees. This home delivery is usually preferred to hospital delivery by their husbands and mother in-laws as they consider it to be safe and more convenient. There is therefore need to educate women on early signs of labor and address the importance of health care delivery to prevent complications which may increase the maternal mortality rate.
Highlights
In developing countries, in sub-Saharan Africa, many women do not have the good fortune to be attended by skilled personnel during childbirth, which could be considered as one of the major factors leading to maternal and neonatal morbidity and mortality.[1]
A study based on 48 Demographic and Health Survey (DHS) found that world-wide about half of the birth occurred at home, in South and South-East Asia women from poor household had higher levels of home delivery compared to women in Sub-Saharan Africa
This is lower than 74.1 % and 70% who opted out of the process of ANC and delivered at home in the study by Abubakar et al, 9 and Idris et al, 8 but is higher compared with study by Kasaye et al, 10 who found only 25% of the respondents had home delivery, Egharevba et al.,[4] Envulada et al, 1and Dhakal et al, 3 found only 15%, 40% and 41.9% delivered with TBA or at home respectively
Summary
In sub-Saharan Africa, many women do not have the good fortune to be attended by skilled personnel during childbirth, which could be considered as one of the major factors leading to maternal and neonatal morbidity and mortality.[1]. 6 The World Health Organization (WHO) recommends delivery by a skilled birth attendant (SBA) in reducing deaths among pregnant women and neonates.[5] The proportion of skilled health professionals available at the time of delivery is one of the indicators for monitoring progress towards the Millennium Development Goal of improving maternal health.[4] In Sub-Saharan Africa, uptake of skilled delivery services in healthcare facilities is low compared to other parts of the world. 4 Nigeria Demographic and Health survey indicates that in 2018 only 56% of rural women received skilled antenatal care and only 29% were delivered by skilled birth attendant compared to 66% of urban women. The aim of this study is to assess the proportion of home delivery and factors preventing pregnant women from utilizing the hospital or other healthcare facilities as their place of choice for delivery even after accessing ANC service. To determine the socio-economic, demographic, cultural and obstetrics factors such as
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