A study to determine factors contributing to low utilization of health institutions for deliveries by pregnant mothers in chadiza district.

Abstract

Low utilization of health institutions for delivery by pregnant women in Chadiza District has become a major concern to Chadiza District Health Team (DHMT) despite efforts by the District Health Management Team with the support of collaborating partners to encourage women to deliver in health institutions. Institutional deliveries ranged between 8% to 19% from 2000 to 2004 below 40% which is the national target for rural districts. Home deliveries may predispose a women to a lot of complications or risks which may lead to loss of life of the mother or baby or maternal complications or disabilities like obstetric fistula, and such women are often abandoned or divorced by husbands and ostracized by their family and community and thus frequently live without support. Hence the study was aimed at determining the factors contributing to low utilization of health institutions for deliveries by pregnant women in Chadiza District.A descriptive study design with both quantitative and qualitative dimension was used. The target population under study were women of childbearing age who had their last delivery either at home or in a health facility in Chadiza District. Data was collected during the months of August to September, 2005. A sample size of fifty two (52) respondents, 26 for each rural health centre and 13 of respondents had their deliveries in health facility while 13 had their last deliveries outside the health facility (home, relative's place, TBA's place). The study also revealed that 46% of the respondents had low knowledge on categories of at risk expectant mothers who are supposed to deliver in a moderate health facility and dangers of home deliveries. Forty six percent (46%) of the respondents had attained primary education and only 17% had secondary education). Most (38%) of the respondents who had institutional deliveries were not satisfied with care given by the nurses, midwives and other health workers. It was further revealed that 79% of the respondents did not have access to health services due to distance to the health institution, lack of transport, unaffordable fees, poor staff attitude. Majority (61%) of the respondents said that cultural practices, beliefs and taboos related to pregnancy and delivery were practiced in the community.