Factors Affecting the Place of Delivery among Mothers Residing in Jhorahat VDC, Morang, Nepal.
Prativa Dhakal, Mangala Shrestha, Dharanidhar Baral and 1 others
PMID 29344531WHAT IT FOUND
In 93 mothers in rural Nepal, 41.9% delivered at home.
Institutional delivery was more common among educated mothers, those with higher income, nearer facilities, first births, four or more antenatal visits, planned facility birth, or previous facility birth.
Key findings
01Institutional delivery was associated with maternal education, upper caste, spouse education, spouse occupation, per capita income, distance to the health institution, primiparity, four or more antenatal visits, and planned institutional delivery.
02Among 39 mothers who delivered at home, 26 said home delivery was easy and convenient, 48.7% cited previous home deliveries, 25.6% cited continuity of care at home, and 20.5% cited precipitated labour.
03Focus group discussions with decision makers and community health volunteers described home births as attended by traditional birth attendants, and volunteers reported visiting after home birth to apply chlorhexidine to the newborn's umbilicus and give health education.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Data were collected from only one village development committee in Morang District. This limits generalisability. The reported KR21 coefficient was 2.72, and the authors state the questionnaire reliability was low. The study was observational and mixed-method. It reports associations and experiences, not causes or tested effects of interventions. Mothers who were unwilling to participate and deliveries on the way to hospital were excluded. The focus groups included only 12 decision makers and eight FCHVs.
The easy way to misread this
Do not read the associations with education, income, distance, antenatal visits, or previous place of delivery as proof that changing these factors will increase institutional delivery. The study is from one rural village, the questionnaire reliability was low, and no intervention was tested.