An Assessment On The Effect Of Home Delivery Among Pregnant Women

Medical and Health Science Project and Seminar Material

An Assessment On The Effect Of Home Delivery Among Pregnant Women


Abstract


The study was designed to determine the effect of home delivery among pregnant women of Sabon Gari Kaduna South Local Government Area Kaduna State. The project is divided into 5 chapters in other to make easy understanding, chapter 1 scope and delimitation, aim and objectives, limitation and defination of terms of the study. Chapter 2 focused on literature review of the study from different authors, which the topics is divided into sub-topic, they include: effect of home delivery, causes of home delivery, which are poverty, lack of clinics, ignorance, lack of personnels, distance also tried to find the risk factor associated with home delivery which are complication like haemorrage, retained placenta, obstructed labour, maternal mortality infection etc. chapter 3 deals with the methodology used in the research project they are research design, population of the study which is about 6050 people, the sample study is 100 people, the sampling, the data collection used in this work is questionnaire which are distributed top different people, the instrument used for data analysis is simple table chart with percentage.

The next chapter discuss on the presentation of findings of data collected from the respondents and the last chapter deals with summary of findings, conclusion, recommendation and references, which shows that home delivery can reduce through creating, provision of adequate clinics and personnel. 27% believes is adequate medical personnels and 37% said health education, the majority of the respondent belief it is an adequate clinics that will reduce home delivery followed by health education and adequate personnels, from table 13, it shows that 50% of the respondent have only on health centre in their area while 30% have 2 and 19% have 3 above, therefore majority of the respondent have only 1 clinic in there area.


Table of Contents


Preliminary Page(s)

  • Title page
  • Certification page
  • Dedication
  • Acknowledgement
  • Abstract
  • Table of content

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the problem
  • 1.3 Aim and objectives
  • 1.4 Research questions
  • 1.5 Significance of the study
  • 1.6 Scope of the study
  • 1.7 Limitation of the study
  • 1.8 Definition of terms

Chapter Two:

Literature Review

  • 2.1 Introduction
  • 2.2 Decision Making Process
  • 2.3 Factors That Influence Decision Making
  • 2.4 Demographic Factors and Choice of Place of Delivery
  • 2.5 Socio cultural Factors and Choice of Place of Delivery
  • 2.6 Economic Factors and Choice of Place of Delivery
  • 2.7 Antenatal Clinic Attendance and Choice of Place of Delivery
  • 2.8 Theoretical Framework

Chapter Three:

Research Methodology

  • 3.1 Research design
  • 3.2 Sources of Data
  • 3.3 Population of the study
  • 3.4 Sample size determination
  • 3.5 Instrumentation
  • 3.6 Reliability
  • 3.7 Validity
  • 3.8 Method of Data Collection
  • 3.9 Method of data processing and analysis
  • 3.10 Ethical consideration

Chapter Four:

Results and Recommendations

  • 4.1 Results
  • 4.2 Discussion

Chapter Five:

Conclusion and Recommendations

  • 5.2 Conclusion
  • 5.2 Recommendations
  • References

Chapter One


Introduction

1.1 Background of the Study

Home delivering is a common traditional belief that child birth is a natural process which does not require any medical attention and should be conducted at home by the family who is a well known and trusted figure for the family, is easily available and is not very expensive.

Home deliveries by traditional birth attendant are a cultural norm in Nigeria. This is true both for rural areas as well as urban slums. This attitude coupled with poverty, illiteracy and ignorance regarding complication of delivery is responsible for the majority of women preffering to deliver at home in Nigeria.

World wide, an estimated 529,000 maternal deaths occur every year almost all of them in developing countries e.g. Nigeria, Chad, … is an inverse relationship between the proportion of deliveries assisted by a skilled attendant and the maternal mortality ratio in these countries.

According to WHO, immediate and effective professional care at the time of delivery can make the difference between life and death for both women and their new born. Furthermore, this care should be available close to where people live, but at the same time safe with a skilled professional able to act immediately when unpredictable complications occurs TBAs (whether trained or not) have not been included among the skilled birth attendants by the WHO. Since their training has not shown any reduction in maternal mortality. However, it has been suggested that TBAs could perform the role of the skilled attendants where required with some training. As they may be the only source of care for some women. In addition they may also serve to provide emotional support and health education to pregnant women at the local level.

According to the latest Nigeria Demographic and Health Survey (DNHs) 2007, the maternal mortality ratio of Nigeria is 276/100,000 live births and the three major killers are post partum hemorrhage, puerperal sepsis and eclampsia. This survey, the largest household survey ever conducted in Nigeria also showed that 65% of deliveries are conducted at home. Traditional birth attendants assisted almost 79% of home deliveries followed by relatives or friends in 11%. According to this survey, the most frequent reason (stated by 57% of women) for not delivering in a facility was the belief that it was not necessary. The next most common reason (stated by 38% of women) was that the cost is too much.


1.2 Statement of the Problem

I observed that home delivery is very common in Sabon Gari Kaduna South Local Government, in most cases of the delivery, a complication usually arise which include a high risk of neonatal or bleeding and fatal malposition which may lead to the dead of the baby or the mother. Also sometimes it happens that the women may have a serious problem or the baby in which the person near her will not observe anything about it unless through medical personnel (doctors, nurse, midwives).

This study is meant to find out the effect of home delivery among pregnant women in Sabon Gari Kaduna South Local Government.


1.3 Aim and Objectives

The aim of the study is to determine the effect of home delivery among pregnant women in Sabon Gari Kaduna South Local Government Area through the following objectives:

  1. To identify the reason and adverse outcomes of home deliveries in women.
  2. To identify the possible measures that will reduce home delivery among pregnant women in Sabon Gari.
  3. To understand the effect of home delivery.
  4. To identify the causes of home delivery among pregnant women.
  5. To make recommendation according to findings.

1.4 Significance of the Study

The significance of the study is to create awareness among pregnant women especially those of child bearing age within Sabon Gari Kaduna South Local Government.

Also to help people to know the importance of health care facility delivery in order to prevent complication that may arise at home such as post partum haemorage, maternal mortality.


1.5 Scope of the Study

The scope of this study is limited to women of child bearing age and pregnant women of Sabon Gari Kaduna South Local Government Area, which will show the effect of home delivery.


1.6 Research Questions

  1. What is home delivery?
  2. What are the causes of home delivery?
  3. What are the effects of home delivery?
  4. What are the importance of delivering at the presence of a medical personnel?
  5. What are the possible measures that will reduce home delivery?

1.7 Limitation of the Study

In the research project, I experience a lot of limitation which are:

  1. Financial difficulties
  2. Lack of time

1.8 Definition of Terms

1. Maternal Mortality:

Death rate of women as a result of complication.

2. TBAs:

Traditional Birth Attendant

3. Post Partum Haemorage:

Is the loss of more than 500ml – 1000ml of blood within the first 24hours following child birth.

4. Bleeding:

Is the loss of blood from the body as a result of injury.

5. Puerperal Sepsis:

Is a condition that occurs after child birth as a result of infection.


Chapter Five


Summary, Conclusions and Recommendation

5.1 Summary

With regard to factors that influence home deliveries, the application of herbs for facilitating labour seemed to be leading, such that out of 111 mothers who delivered at home 93% applied the herbs. Additionally, findings show that low income of people, bad condition of roads, long distance to health facilities, and shortage of skilled staff, supplies and equipments, lack of women’s decision making power, lack of timing and transport to health facilities influenced home deliveries in the study area.

As for the impact of home deliveries, 8% of the respondents reported that their relatives died of maternal problems, of which, from home deliveries were 11% while from health facilities were 3%. Concerning infant mortality, 5% of mothers who delivered at home said that they lost their children within 28 days after birth whereas 3% of mothers who delivered at health facilities reported to have lost their children within 28 days. Home deliveries therefore led to more infant and maternal mortality compared to health facility deliveries.


5.2 Conclusion

Based on the findings, it can be concluded that except for respondents’ level of education, all other variables i.e., demographic, economic, geographic, socio-cultural factors and environment of health facilities influenced home deliveries. Level of education did not influence home deliveries in the study area presumably because majority of the respondents were standard seven leavers. Comparing between a standard seven leaver with someone without any type of formal education does not make much difference. Additionally, home deliveries had impact on maternal and infant mortality as they caused more deaths to mothers and infants compared to health facility deliveries.


5.3 Recommendations

Since Rural Development Policy 2007-2013 focuses on improving quality of life in rural areas and encouraging diversification of rural economy (Maeda and Bagachwa, 2007); the following might help to reverse the trend of home deliveries not only in the study area but also in other rural areas.

Firstly, since 98% of mothers who delivered at home reported to use herbs for facilitating labour, more awareness against those norms is needed so that all women deliver at health facilities in minimizing the dangers associated with home deliveries. Secondly, based on findings 87 % of mothers who delivered at home said that health facilities in the study area encounter shortage of skilled birth attendants, and 79% reported that facilities experience inadequate delivery equipment and supplies which made women to deliver at home. So there is a need for health facilities to be equipped with human resources and delivery materials in rural areas so as to reduce risks related to home deliveries. Thirdly, given that field data pointed out that 87% of mothers who delivered at home said that they delivered at home because of low income they earn, there is a call for community empowerment on entrepreneurship and resource mobilisation in order to raise people’s income so that they eventually afford delivery costs at health facilities. Fourthly, because of long distance to health facilities 88% of respondents reported to deliver at home, and 91% said to have given birth at home due to lack of transport, this calls for improvement of infrastructures (roads, water ways) and transportation systems in rural areas in order to enable women access delivery services in health facilities. Fifthly, there is a need of implementing existing Health Policy of 2000 which, among other things stresses the need of bringing adequate health care services near people in rural areas (instituting dispensaries in every 5 kilometres, a health centre in every 10 kilometres, a area hospital in each area, and improving referral system from community level to national level).


An Assessment On The Effect Of Home Delivery Among Pregnant Women


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