Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

Abstract

Background Many childbearing women in sub-Saharan African countries like Guinea still face challenges accessing and utilizing health facility delivery services and opt to deliver at home. This study examined the non-utilization of health facility delivery and its associated factors among childbearing women in Guinea. Methods Data from the 2018 Guinea Demographic and Health Survey was used in this study. Data of 5406 childbearing women were analysed using STATA version 14.2 by employing a multilevel logistic regression approach. The results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results More than three-quarters (47.6%) of childbearing women in Guinea did not deliver at health facilities. Women who had no formal education (aOR = 1.52, 95% CI = 1.09–2.12), those whose partners had no formal education (aOR = 1.25, 95% CI =1.01–1.56), those whose pregnancies were unintended (aOR = 1.40, 95% CI =1.13–1.74) and those who were Muslims (aOR = 2.87, 95% CI =1.17–7.08) were more likely to deliver at home. Furthermore, women with parity four or more (aOR = 1.78, 95% CI =1.34–2.37), those who listened to radio less than once a week (aOR = 5.05, 95% CI =1.83–13.89), those who never watched television (aOR = 1.46, 95% CI =1.12–1.91), those with poorest wealth quintile (aOR = 4.29, 95% CI =2.79–6.60), women in female-headed households (aOR = 1.38, 95% CI =1.08–1.78) and rural dwellers (aOR = 3.86, 95% CI =2.66–5.60) were more likely to deliver at home. Conclusion This study has identified low socio-economic status, inadequate exposure to media, having an unplanned pregnancy and religious disparities as key predictors of home delivery among childbearing women in Guinea. The findings call for the need to enhance advocacy and educational strategies like focus group discussions, peer teaching, mentor-mentee programmes at both national and community levels for women to encourage health facility delivery. There is also the need to improve maternal healthcare services utilization policies to promote access to health facility delivery by reducing costs and making health facilities available in communities.

Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data

“…Consistent with previous studies [23,28,39,40] our nding suggests that women who exposed to media were 20% lower chances of home delivery in compared with women without media exposure. Media promotion of institutional delivery and danger of home delivery may in uence mothers to develop positive behavior towards delivering in a health facility.…”

“…Women living rural area had as higher odds of home delivery, which is similar to ndings in previous studies [23,28,31,37]. Rural residents in Sub Saharan countries have poor access to health care facilities.…”

“…Educated women had less likelihood of home deliver as compared to uneducated women. The result was in line with the individual studies conducted in rural Ethiopia [26][27][28], Zimbabwe [29], Nigeria [30], Ghana [31,32], Guinea [23] and Nepal [33]. The reason for this might be due the fact that when mothers are educated it is more is likely to enhance female self-determination, positive attitude, and nancial freedom [34,35].…”

“…On other hand, low social acceptance of unmarried status in that there is still social stigmatism surrounding illegitimate births in many countries. Hence unmarried women may be intrinsically different from married women who may be less empowered, self-isolated or lack of motivation to access the health service [23][24][25]. All these factors might be increasing the likelihood of home delivery among currently unmarried mothers.…”

What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

“…However, many childbearing women in LMICs, especially countries in sub-Saharan Africa (SSA), still face challenges in accessing and utilizing maternal healthcare services, including delivery services, and opt to deliver at home [ 11 , 12 ]. Evidence suggests that home births among women in SSA pose high risks to the health of the mother and the child during the period after delivery [ 13 – 15 ]. Some of these risks include desertion of colostrum provision and breastfeeding practices, neglect of immunisations and nutrition supplementation for mother and child, and lack of postnatal care check-up for the child and mother [ 16 – 18 ].…”