Study of the Factors Associated with Home Delivery in a Situation of Free Care in Senegal

Abstract

Introduction: Home delivery is still a health problem in Kolda (Senegal). The aim of this work is to study the factors associated with the place of delivery in a situation of free care delivery. Method: A descriptive and analytical cross-sectional study was carried out. Sampling was in two-stage clusters. The study focused on women who gave birth in the last 12months. The data were collected during an individual interview at home. The collection focused on knowledge, attitudes and practices about delivery. Logistic regression was used to explore the determinants of childbirth at the level of health facility. Results: The average age was 25.4 ± 6.5 years. Among the interviewed women, education was reported in 35% of the women and 55% of women estimate that the closest health facility is within 5 km to their home. The time to get to the nearest health facility is less than 15 minutes for 39% of the interviewed women. The prevalence of home delivery was 43.5%. Home delivery was related to the remoteness of the health facility (2.43 [1.75 -3.37]) but also to incomplete antenatal care (2.52 [1.59 -4.00]). Support groups highlighted difficulties of access to health facilities because of remoteness. Interviews revealed a lack of involvement of husbands in seeking care for women. Cultural barriers are still there. Conclusions: Despite the gratuity of delivery, the remoteness of health structures and socio-cultural factors are still barriers to access to care for pregnant women. These aspects must be taken into account in health policies. Multi-lateral interventions should be implemented to provide solutions for this health problem.

Childbirth at home and associated factors in Ethiopia: a systematic review and meta-analysis

“…Studies from Kathmandu, Nepal, and Malawi showed a strong connection between no/fewer than four ANC visits and home delivery [ 28 , 98 ]. Additionally, this finding is consistent with studies conducted in Eretria [ 99 ], Bhutan [ 100 ], and Senegal [ 69 ]. The possible reason might be women who had no/few ANC follow-up might be less aware of birth preparedness and complication readiness plan, danger signs of pregnancy, when to visit health facilities, and the danger of giving childbirth at home which increases the probability of home childbirth.…”

“…The result is in line with a study extracted from the 2016 Ethiopia Demographic and Health Survey accounting for 67.2% of mothers giving birth at home [ 90 ]. However, the result is higher than the study in Nepal [ 91 ] 41.9%, Senegal [ 69 ] 43.5%, and Guinea-Bissau [ 92 ] 61.2%, quite possibly due to difference in the availability of transportation, distance from the health facility, health literacy, wealth index, access to media like listening to radio/watching TV, mothers’ level of education, and knowledge of birth preparedness and complication readiness plan. As per the authors’ knowledge, this is the first systematic review and meta-analysis in Ethiopia to estimate the pooled prevalence and determinants of home childbirth.…”

“…We excluded 2 case-control studies on the prevalence estimation (Fantu A.at al (2018) [ 69 ] and Resom T.et al (2014) [ 68 ]). The overall prevalence of home childbirth is presented with a forest plot (Fig.…”