Factors influencing mother’s choice of place of delivery in Soroti District, Uganda
Akinyo, Anne Rita
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This study on factors that influence mother’s choice of place of delivery intends to establish reasons why mothers decide to deliver in the different sites. The main objective of the study was to understand factors influencing choice of place of delivery in Soroti. A total of 320 mothers with babies less than three years old were sampled. A logistic model regression was fitted to establish the association between the independent variables and place of delivery. Of the 87.5% of the expectant mothers who had planned to deliver in health unit, less than a half (42.2%) deliver from the health units. Yet only 3.3 % of the home deliveries were attended to by a health worker. Place of residence had a strong influence on place of delivery. A majority of the rural residents delivered at home (90.6%). Four in ten of the respondents reported that the reason for delivering at home was because of labor onset which was sudden and quick. In FGDs, a majority of the respondents reported that labour started at night when it was difficult to access the health units due to lack of transport and security reasons. Mother’s age at first pregnancy had influence on mother’s place of delivery. The results revealed that the majority of the mothers who had their first pregnancy at 12-14 years delivered at home (71.4%) as compared to those who were 25-29 years (17.6%). Parity was seen to have a strong influence on place of delivery (P = 0.000). The majority of mothers with higher birth order delivered at home (78.2%). Educational attainment of these women was low. Educational level of a mother is a very important factor in accessing utilization of health unit during birth. Of the women who delivered from health unit, a majority (78.3%) had post secondary education. Home deliveries were common among women with primary level education (70.3%). the P value was 0.000. It was further established that the majority of the women attended ANC. But attendance of most mothers started in the second trimester (58.1%). During ANC, little was talked about the danger signs of pregnancy hence level of knowledge was quite low. About nine in ten of the women who did not attend antenatal care, delivered at home. At multivariate level of analysis, independent variables that showed a strong influence on place of delivery were residence (β = -2.132), length labour (β = -2.254), health unit charge (β = -1.522), ANC attendance (β = 2.799), distance to health unit (β = -1.232), occupation ( β = 1.640 ) and education attainment ( β = 0.213). The recommendations made were as follows; Girls should be encouraged to finish their education so as to delay the age of conceiving and marriage. Parents, schools, local authorities need to enforce age at marriage and girl child should be kept in school. During antenatal visits mother should be educated about the danger signs of pregnancy and risk of delivering at home. Also health workers need to encourage mothers to have health unit deliveries. Health workers should encourage husbands to attend these visits with their wives. They should provide financial and moral support throughout the pregnancy and during delivery. Since transport was found to be the biggest challenge to most of the mothers during time of delivery, ambulances provided in Health Center III should always be on stand by with enough fuel for emergency cases. Government should improve on the facilities in the health units in the rural areas. Therefore, findings highlight that "choice" is not an inert concept influenced only by women’s preferences. The perception of choice varied among women and was influenced by several factors.