Delivery Practices and Associated Factors among Mothers Seeking Child Welfare Services in Selected Health Facilities in Nyandarua South District, Kenya

Abstract

BackgroundA measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG) 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care.MethodsA hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice.ResultsAmong the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170) were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170) of the deliveries while in 11.7% (137/1170) of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have <3 years of education (Adjusted Odds ratio [AOR] 19.2, 95% confidence interval [CI] 1.7 - 212.8) and with more than three deliveries in a life time (AOR 3.8, 95% CI 2.3 - 6.4). Mothers with perceived similarity in delivery attendance among skilled and unskilled delivery attendants were associated with unsafe delivery practice (AOR 1.9, 95% CI 1.1 - 3.4). Mother's with lower knowledge score on safe delivery (%) were more likely to have unskilled delivery attendance (AOR 36.5, 95% CI 4.3 - 309.3).ConclusionAmong the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.

Awareness and Health Care Practice of Mothers’ About Obstetric Danger Signs at Haramaya District, Eastern Ethiopia

“…This very low and even incomparable with other African countries: 99.8% in Ghana [20], 97% in Kinshasa [31] and 57.2% in Kenya [32]. Giving birth at health institution was associated with increased likelihood of good awareness on obstetric danger signs.…”

A quantitative study on the determinants of utilization of skilled birth attendance, Bamba division, Kilifi

“…The possible reason was that the older women were more experienced in giving birth and perceived skilled care as unnecessary, this was also revealed in other studies. 10,17,19,20,23,24,26,27,28 Lower parity women were more likely to deliver in the health facilities under skilled care compared to those who had three and more children. The possible reasons; women who were giving birth for the first time might be younger and have better understanding about the benefits of delivering in the health facility, less experienced in the birthing process thus fears about the possibility of a difficult labour may motivate them to seek skilled delivery care.…”

“…This result was comparable to other studies. 10,20,31 In addition, mosquito net use among women was found to be a positive factor to the use of skilled attendance at birth. The possible reason for the finding is that women who had and were using a mosquito net were more knowledgeable on the importance of preventing themselves from contracting malaria and were also aware of the benefits of seeking skilled care during delivery.…”

“…The low SBA results are also similar to other studies done in other countries such as Ethiopia and Tanzania and also comparable to studies done in other parts of the country such as Western Kenya and Nyandarua South District. [16][17][18][19][20] More women should be encouraged to seek care in the health facilities since unskilled birth attendants are more preferred in the locality. These estimates are low when compared to the WHO estimates and KDHS survey.…”

Choice of place of Delivery amongst Women in a Rural Community in northeastern Nigeria

“…In Nigeria, like many other developing countries, unskilled birth attendants attend to deliveries at home [13] and most of these deliveries take place in questionable hygienic conditions. Unskilled attendance at delivery puts both the mother and the newborn at risk of delivery related complications [5,14,15] . The 2008 Nigeria Demographic and Health Survey (NDHS) reported that of all home deliveries, one in five pregnant women delivered alone with no one present [16] .…”