Factors associated with utilization of labour and delivery health services by women in Lusaka district facilities

Abstract

ABSTRACT This study focused on women’s utilization of labour and delivery health services in Lusaka urban district health facilities. Utilization of labour and delivery health services can ensure that women are attended to by skilled personnel and link them to referral system in case of any complications. However, delivering in health facilities is still challenging in Sub-Saharan region including Zambia, despite the importance of institutional deliveries in preventing maternal and neonatal morbidity and mortality. The aim of this study was to determine factors that are associated with utilization of Labor and delivery health services by women in Lusaka district health facilities. This cross sectional study was carried out using both qualitative and quantitative approach to collect data from three hundred and seventy three postnatal women (15-45years) who had given birth six(6) months and below prior data collection. Stratified random sampling was used to select six (6) study sites, systematic sampling was used to select three hundred and forty three (343) respondents for quantitative data while purposive sampling was used to select thirty (30) respondents for qualitative data respectively. Three Focus Group Discussions (FGDs) were conducted in three health centers namely Kanyama, Chawama and George health facilities. Interview schedules and FGDs guide were used to collect data. Data from interview schedules were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 22.0 for windows and presented using frequency tables, pie charts, and histogram and cross tabulations. The Chi-square test was used to test the association among variables and multivariate logistic regression analysis was carried out to predict the outcome. Statistical significance was set at 0.05 and strength of statistical association was assessed by odds ratio (OR) with 95% confidence interval. Content analysis was used to analyse data from the Focus Group Discussions and the most use full information that merged from the discussion was selected and used to illustrate the main points. The results showed utilization levels were at 89% while non-utilization stood at 11%. After multivariate logistic regression, maternal education (Odds=3.5, CI, 1.046-11.861, P-value=0.042), Antenatal care visits (Odds=9.8, CI, 1.248-76.769, P-value=0.030) and transport affordability (Odds=4.7, CI-1.707-12.975, P-value=0.003) were factors which were significantly associated with utilization of labour and delivery health services in Lusaka district health facilities. In this study, utilization of labour and delivery health services was optimal while non-utilization stood at 11%. Therefore, the study recommends that there is need for Ministry of Education to support women’s education beyond primary education and the health providers to continuously sensitize women on importance of early antenatal care booking and complete the four recommended visits because during antenatal care, women are given information on birth preparedness and on benefits of utilising labour and delivery health services. For further research, there is need to conduct a community based study on home deliveries so that more information from women who don’t register home births is obtained. Key words: Utilization, Labour, Delivery, Health facilities, Women.