Study on factors influencing the choice of delivery among mothers at Hiran Regional Hospital in Beletwein- Hiran- Somalia

Background of study the government has formulated policies to ensure women have access to skilled birth attendants at delivery but home delivery and subsequent maternal mortality remain disturbingly high. The national maternal mortality rate for Kenya was 441 deaths per 100,000 live births in 2005 (KEMRI/CDC, 2005) but fluctuations in the trend were observed as the national maternal mortality rate rose to 530 deaths per 100,000 live births in 2008 then dropped to 490 deaths per 100,000 live births in 2009 (USAID, 2009; UNICEF, 2010). In addition, there are variations in maternal mortality across regions; in Busia District of Western Kenya, maternal mortality is estimated to be 680 per 100,000 live births (AMREF, 2011), in Korogocho and Viwandani slum areas in Nairobi the MMR was reported to be 706 maternal deaths per 100,000 live births (Ziraba et al. 2009), and in North Eastern Province of Kenya where Garissa District is located MMR stands at 1000 deaths per 100,000 live births (USAID, 2009; MOH, 2009). The reasons for these variations are mainly attributable to variations in income, education level, availability/accessibility and use of maternity services in the respective regions (GoK, 2009). Globally, Home delivery is common across communities in the world however; it is associated with high incidence of maternal and perinatal mortality (WHO, 2009). Half a million women die each year from causes related to pregnancy and childbirth; 99% of these are in the developing countries (UNICEF, 2008). For example, in Uganda, less than 40% of deliveries take place in a health facility; TBAs handle 15%, relatives 35% and 12% are unassisted (MOH & Population Council, 2004). Differences for these variations can be attributed to (i) socio-cultural factors, (ii) perceived benefit/need of skilled attendance, (iii) economic accessibility and (iv) physical accessibility (Sabine & Campbell, 2009. About 83% of women from North Eastern
Province give birth at home (KDHS, 2009). Home deliveries contribute immensely to high rate of infant and maternal mortality, tears (Vesico-Vaginal Fistula, Recto-Vaginal Fistula), sepsis, post-partum hemorrhage and fetal asphyxia (MOH, 2009). Similarly, Garissa District health indicators are of concern, they are the lowest nationally; MMR in the District is 1000/100,000 live births compared to 441/100,000 nationally, infant mortality rate (IMR) is 63/1000 compared to 52/1000 nationally, maternal and child immunization coverage is 57% compared to 90% nationally (KDHS, 2009; USAID, 2009; MOH, 2009). Home delivery related morbidity due to anemia, obstructed labor, obstetric fistula and hemorrhage accounts for the high number of hospital admissions in Garissa District (MOH, 2006). The KDHS, 2009 reported higher levels of antenatal use (69.5%) and low levels of hospital delivery (17%) in Garissa District though the report did not specify the number of ANC visits made per woman; hence this research investigated the cause of this disparity. In addition, women’s perception of the accessibility, cost and quality of hospital services they received was assessed. The extensive level of gender inequality, maternal age, education, economic coupled with service-related factors associated with choice of place of child delivery was investigated. These together with identification of the existing opportunities for community involvement in reproductive health will help to address many maternal health challenges in Kenya. It is anticipated that the findings from this study will be used to develop recommendations for interventions aimed at increasing women’s utilization of health services for delivery. Therefore, this study is going to find out Factors influencing to choose of delivery among mothers at Hiran Regional Hospital in Beletwein- Hiran-Somalia. Research Design a descriptive case study approach was used in order to determine and report
about the Study on factors influencing to choose of delivery among mothers at Hiran Regional Hospital in Beletwein-Hiran- Somalia. Finding the According to Respondents Age the majority of the respondents 75 (75%) were between 23-35 years, 15(15%) were above 36 years old, while remaining 10(10%) were between 18-22. According to Respondents Marital Status the majority of respondents 60(60%) were married, while only 40(40%) were divorced. According to Respondents Marital Status the majority of respondents 80(80%) were illiteracy, 10(10%) were primary, 5(5%) were secondary, 5(10%) were universal level.