Comparison Of Factors Associated With Utilization And Non-Utilization Of Child Delivery Services Among Multiparous And Grandmultiparous Women At Oshakati Intermediate Hospital And Nearby Heal

Abstract

Attendance at antenatal clinic during pregnancy and delivery in health facilities by skilled birth attendants have been shown to reduce the incidence of maternal and neonatal morbidity and mortality. Despite efforts by the Namibian government through the Ministry of Health and Social Services to promote delivery at health facilities by pregnant women, many women still deliver at home resulting in high maternal and neonatal mortality and morbidity in the country. Factors that influence pregnant women to choose either home or health facility as the preferred place of delivery have not been fully explored in Namibia.

The main objectives of this study therefore were to describe the socio-demographic profile of the women attending maternal services and compare the factors associated with choice of home or health facility as the preferred place of delivery by the pregnant women. The study was a cross sectional study conducted among 142 multiparous and grand-multiparous women who were conveniently sampled while attending postnatal care services at Oshakati Hospital, Ongwediva Health Centre and Ou Nick Health centre in Oshana Region.

The findings revealed that 71 (50%) of the women delivered in the health facilities and 71 (50%) delivered at home. The ages of the participants ranged from 17-45 years with a mean age of 30.6 years, with the majority (48%) being those aged 20-29 years. The study revealed that women who delivered at home tended to be younger (mean age 28.13 years) while those who delivered in the health facilities were older (mean age 33.15 years). Those who delivered at home were often single (67.6%) compared with those who delivered in the health facilities (54.9%), and unemployed (81.7% against 35.2%) compared with those who delivered in the health facilities. About 77.5% of those who delivered at the health facilities had secondary or tertiary education compared with 45% of those who delivered at home. Also only 32.4% of those who delivered at home attended the recommended four or more ANC sessions during the course of the pregnancy compared with 86% of those who delivered in the health facilities. Approximately 75% of those who delivered at home lived more than five kilometers from the nearest health facility compared with 33.8% of those who delivered at health facilities.

The main recommendations that emanates from this study include the need to intensify health education and empower women with information about choice of health facility for safe delivery. Improving access to health facilities through construction of more health facilities in the rural areas and making use of the health extension workers to attend to pregnant women in the local communities will go a long way in reducing maternal and neonatal morbidity and mortality in Namibia. Further research is needed to understand the role of the partners and the communities in supporting women to deliver in the health facilities as well as how provision of kind incentives can encourage more women to make use of health facilities for delivery.