Determinants of facility delivery after implementation of safer mother programme in Nepal: a prospective cohort study

BMC Pregnancy and Childbirth

Andy H Lee²  Colin W Binns²  Rajendra Karkee¹ 

[1] School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal;School of Public Health, Curtin University, Perth, WA, Australia

关键词: Nepal;    Maternal health services;    Childbirth;    Facility delivery;    Factors;    Determinants;   

Others  :  1137840
DOI  :  10.1186/1471-2393-13-193

 received in 2013-04-03, accepted in 2013-10-16,  发布年份 2013

【 摘 要 】

Background

There are several barriers for pregnant women to deliver in a health care facility. This prospective cohort study investigated factors affecting facility delivery and reasons for unplanned place of delivery after implementation of the safer mother programme in Nepal.

Methods

Baseline interviews using a validated questionnaire were conducted on a sample of 700 pregnant women representative of the Kaski district in central Nepal. Follow-up interviews of the cohort were then conducted within 45 days postpartum. Stepwise logistic regression analysis was performed to determine factors associated with the facility delivery outcome.

Results

Of the 644 pregnant women whose delivery location had been identified, 547 (85%) gave birth in a health care facility. Women were more likely to deliver in a health facility if they were educated especially with higher secondary or above qualification (adjusted odds ratio (OR) 12.39, 95% confidence interval (CI) 5.09 to 30.17), attended 4 or more antenatal care visits (OR 2.15, 95% CI 1.25 to 3.69), and lived within 30 minutes to the facility (OR 11.61, 95% CI 5.77 to 24.04). For the 97 women who delivered at home, 72 (74.2%) were unplanned, mainly due to quick precipitation of labour making it impossible to reach a health facility.

Conclusions

It appeared that facility delivery occurs more frequent among educated women and those who live nearby, even though maternity services are now freely available in Nepal. Because of the difficult terrain and transportation problem in rural areas, interventions that make maternity service physically accessible during antenatal period are needed to increase the utilisation of health facility for child birth.

【 授权许可】

   
2013 Karkee et al.; licensee BioMed Central Ltd.

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