Factors Influencing The Place Of Delivery Among Pregnant Mothers In Ishaka Municipality Bushenyi District

Abstract

Since 2000 to-date, there have been several health sector reforms in Uganda. These include abolition of user fees in Public Health facilities and increasing subsidies from Government to Private not for Profit health facilities. These reforms have led to increased utilization of health services as evidenced by numerous studies and reports. However, utilization of maternity services has remained low. Bushenyi is one of the districts that have achieved the national target of 40% deliveries conducted by skilled health workers. Despite being known by pregnant women that visiting a trained health personnel with midwifery skills during childbirth significantly decreases both maternal morbidity and mortality, there is still low utilization of skilled attendance for childbirth in Ishaka municipality. The purpose of this study was to analyze and describe the factors that influence the place of delivery among pregnant women in Ishaka municipality. A sample of 358 women was interviewed using structured questionnaires. These women had either delivered at; home, TBA, private or public clinic and 83% had been delivered by skilled attendants. Choice of delivery site was influenced by factors including the attitudes of health workers, proximity of site (p =0.028), attendance of antenatal clinic at a site, availability of supplies and drugs (p=0.000), plus level of care including emergency obstetric care (p=0.038), affordability of services (p=0.014). The study concluded that skilled attendance at birth is under reported. Choice of delivery site depended on personal, community, health worker attitude, health facility and health system design. Due to low literacy rates prevailing in the district, there is need to develop reproductive health programs that lead to closer and more community engagements with the health workers in order to sensitize the community and give correct information and messages to guide women in decision making processes.