An Assessment Of The Health Implication Of Home Delivery Among Pregnant Women

The study was designed to determine the effect of home delivery among pregnant women of ofuoma. Obstetric complications and maternal deaths can be prevented through safe delivery process. Facility based delivery significantly reduces maternal mortality by increasing women’s access to skilled personnel attendance. However, in ofuoma community ughelli north local government area delta state, most deliveries take place without skilled attendants and outside health facilities. Utilization of facility-based delivery is affected by socio-cultural norms and several other factors including cost, long distance, accessibility and availability of quality services. This study examined country-level variations of the self-reported causes of not choosing to deliver at a health facility.

ABBREVIATIONS AND MEANING

AIDS: Acquired Immune Deficiency Syndrome

ANC: Antenatal Care

CI: Confidence Interval

HD: Home Delivery

HF: Health Facility

HIV: Human Immunodeficiency Virus

HSDP: Health Survey Demographic Program

ID: Institutional Delivery

KM: Kilo Meter

MCH: Maternal Child Health

OR: Odd Ratio

TBA: Traditional Birth Attendant

TTBA: Trained Traditional Birth Attendant

WHO: World Health Organization

TABLE OF CONTENTS

COVER PAGE

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWELDGEMENT

ABSTRACT

GLOSSARY

CHAPTER ONE

1.0      INTRODUCTION

1.1      BACKGROUND OF THE PROJECT

• • STATEMENT OF PROBLEM

• • AIM AND OBJECTIVE OF THE STUDY

• • SIGNIFICANCE OF THE STUDY

• • SCOPE OF THE STUDY

• • RESEARCH QUESTIONS

• • LIMITATION OF THE STUDY

• • DEFINITION OF TERMS

CHAPTER TWO

LITERATURE REVIEW

• • REVIEW OF THE STUDY

• • OVERVIEW OF MATERNAL DEATH

• • CAUSES OF MATERNAL DEATH REVIEWED

• • PREVENTION OF MATERNAL DEATH REVIEWED

• • OVERVIEW OF PRENATAL CARE

CHAPTER THREE

3.0      RESEARCH METHODOLOGY

• • INTRODUCTION

• • RESEACH DESIGN

• • POPULATION OF THE STUDY

• • SAMPLE AND SAMPLING TECHNIQUE

• • DATA COLLECTION PROCEDURE

• • VALIDATION OF INSTRUMENTS AND RELIABILITY

CHAPTER FOUR

4.0      RESULT ANALYSIS

4.1      SOCIO-DEMOGRAPHIC CHARACTERISTICS

4.2     OBSTETRIC CHARACTERISTICS

4.3     KNOWLEDGE ON CHOICE OF PLACE OF DELIVERY

4.4     CHOICE OF PLACE OF DELIVERY

4.5     REASON FOR HOME DELIVERY

4.6     ASSOCIATION BETWEEN DEPENDENT AND INDEPENDENT VARIABLES

4.7     DISCUSSION

CHAPTER FIVE

• • CONCLUSION AND RECOMMENDATION

• • REFERENCES

CHAPTER ONE

• • INTRODUCTION

Maternal mortality rate is a key indicator of health status of a population. In 2013, the World Health Organization defined maternal mortality as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy (uterine or extra uterine) from any cause related to or made worse by the pregnancy or its management [1]. Achieving good maternal health requires quality reproductive health services and a series of well-timed interventions to ensure a women’s safe passage to motherhood. Failure to provide these services results in hundreds of thousands of needless deaths each year. Every year, nearly half a million women and girls needlessly die as a result of complications during pregnancy or childbirth, and 99% occur in developing countries [2]. In developing countries many women do not have access to skilled personnel during child birth. This lack of skilled attendance is another factor responsible for high maternal and infant mortality [3]. Health facilities can provide proper medical attention and hygienic conditions during delivery and can reduce the risk of complication and infection [4]. Health facility delivery among pregnant mothers can be increased through antenatal clinic (ANC) attendance by providing reproductive health education and services. The aim of the study is to determine the effect of home delivery among pregnant women in Ofuoma community in Ughelli North Local Government Area, Delta State Nigeria.

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 preferring to deliver at home in Nigeria.

Worldwide, 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].

1.2                                 STATEMENT OF THE PROBLEM

I observed that home delivery is very common in ofuoma community ughelli north local government area delta state 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 ofuoma community ughelli north local government area delta state.

1.3                                          AIM AND OBJECTIVES

The aim of the study is to determine the effect of home delivery among pregnant women in ofuoma community ughelli north local government area through the following objectives:

1. 1. To identify the reason and adverse outcomes of home deliveries in women.

1. 1. To identify the possible measures that will reduce home delivery among pregnant women in ofuoma.

1. 1. To understand the effect of home delivery.

1. 1. To identify the causes of home delivery among pregnant women.

1. 1. 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 ofuoma community ughelli north local government area delta state.

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 [3].

1.5                                          SCOPE OF THE STUDY

The scope of this study is limited to women of child bearing age and pregnant women of ofuoma community ughelli north local government area delta state, which will show the effect of home delivery.

1.6                                          RESEARCH QUESTIONS

1. 1. What is home delivery?

1. 1. What are the causes of home delivery?

1. 1. What are the effects of home delivery?

1. 1. What are the importance of delivering at the presence of a medical personnel?

1. 1. 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. 1. Financial difficulties

1. 1. Lack of time

1.8                              DEFINATION OF TERMS

1. 1. Maternal mortality:death rate of women as a result of complication.

1. 1. TBAs: Traditional Birth Attendant

1. 1. Post partum haemorage:is the loss of more than 500ml – 1000ml of blood within         the first 24hours following child birth.

1. 1. Bleeding:is the loss of blood from the body as a result of injury.

1. 1. Puerperal sepsis:is a condition that occurs after child birth as a result of infection.