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

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 in...

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Main Authors: Karkee, R., Binns, Colin, Lee, Andy
Format: Journal Article
Published: BioMed Central Ltd 2013
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/28537
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author Karkee, R.
Binns, Colin
Lee, Andy
author_facet Karkee, R.
Binns, Colin
Lee, Andy
author_sort Karkee, R.
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-285372017-09-13T15:19:09Z Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study Karkee, R. Binns, Colin Lee, Andy facility delivery maternal health services childbirth factors determinants Nepal 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. 2013 Journal Article http://hdl.handle.net/20.500.11937/28537 10.1186/1471-2393-13-193 BioMed Central Ltd fulltext
spellingShingle facility delivery
maternal health services
childbirth
factors
determinants
Nepal
Karkee, R.
Binns, Colin
Lee, Andy
Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study
title Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study
title_full Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study
title_fullStr Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study
title_full_unstemmed Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study
title_short Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study
title_sort determinants of facility delivery after implementation of safer mother programme in nepal: a prospective cohort study
topic facility delivery
maternal health services
childbirth
factors
determinants
Nepal
url http://hdl.handle.net/20.500.11937/28537