Does Socio-demographic Factors Influence Women’s Choice of Place of Delivery in Rural Areas of Tamilnadu State in India

Rejoice Puthuchira Ravi^1, and Ravishankar Athimulam Kulasekaran²

¹Consultant, IRHD, Kottayam, Kerala, India

²Department of Population Studies, Annamalai University, Tamilnadu, India

Cite this paper

Rejoice Puthuchira Ravi and Ravishankar Athimulam Kulasekaran. Does Socio-demographic Factors Influence Women’s Choice of Place of Delivery in Rural Areas of Tamilnadu State in India. American Journal of Public Health Research. 2014; 2(3):75-80. doi: 10.12691/AJPHR-2-3-2

Abstract

Every day, approximately 1000 women die from preventable causes related to pregnancy and childbirth. Of which, 99% of all maternal deaths occur in developing countries. The aim of this study was to assess the socio-demographic factors influence women’s choice of place of delivery in rural areas of Thiruvarur district of Tamilnadu state in India. A community based cross-sectional study was conducted in 28 villages selected using multistage sampling technique for selecting 605 women in the age group of 15-24 years during July 2010-April 2011. Data analysis was by use of Statistical Package for Social Sciences version-17, with statistical significance set at p-value of 0.05. The study reveals that education, age at marriage, birth order, standard of living index and exposure to mass media appeared strong influencing factors for the choice of place of delivery among women in rural areas. The result shows that 69% of home deliveries were monitored by Traditional Birth Attendants (TBAs/Dais). Bivariate analysis indicates that all women who had completed higher secondary education were preferred the health institution for their delivery whereas 18.8% of home deliveries have been taken place among illiterates. The proportion of home deliveries (7.3%) was higher among women in households in the less standard of living index. Home deliveries were higher among women who were less exposed to mass media (7.1%) than more exposed to mass media (1.6%). Birth order was significantly influence on the place of delivery among women. First birth order deliveries were less likely to take place at home (2.5%) than second (8.2%) and third birth order deliveries (9.1%). It concludes that family tradition and poor socioeconomic condition of the family appear to be the main reasons for choosing to deliver at home. It recommends that Government should be taken a comprehensive strategy to increase the availability, accessibility and affordability of delivery care services in rural areas. Public health strategies involving traditional birth attendants will be beneficial particularly rural/remote areas where their services are highly utilized.

Keywords

home delivery, institutional delivery, scheduled castes, standard of living index, young women

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Imogie AO, Agwubike EO, Aluko K. Assessing the role of traditional birth attendants (TBAs) in health care delivery in Edo State, Nigeria. African Journal of Reproductive Health 2002; 6: 94-100.
[2]	World Health Organization (WHO), Maternal mortality, Millennium Development Goal (MDG) 5. 2013; 1.
[3]	Gabrysch S, Campbell O. Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth 2009; 9 (34).
[4]	Stephenson R, Baschieri A, Clements S, Hennink M, Madise N. Contextual influences on the use of health facilities for childbirth in Africa. American Journal of Public Health 2006; 96 (1): 84-93.
[5]	Say L, Raine R. A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context. Bull WHO. 2007; 85: 812-819.
[6]	Gabrysch S, Cousens S, Cox J, Campbell O. Distance and quality of care strongly influence choice of delivery place in rural Zambia: A study linking national data in a Geographic Information System. Journal of Epidemiology and Community Health 2011; 65: A42–A42.
[7]	Thind A, Mohani A, Banerjee K, Hagigi F. Where to deliver? Analysis of choice of delivery location from a national survey in India. BMC Public Health 2008; 8: 29.
[8]	Mills S, Bertrand JT. Use of health professionals for obstetric care in northern Ghana. Studies in Family Planning 2005; 36 (1): 45-56.
[9]	Borghi J, Ensor T, Neupane BD, Tiwari S. Financial implications of skilled attendance at delivery in Nepal. Tropical Medicine and International Health 2006; 11 (2): 228-237.
[10]	Liu M, Zhang Q, Lu M, Kwon CS, Quan H. Rural and urban disparity in health services utilization in China. Medical Care 2007; 45 (8): 767-774.
[11]	Adanu R. The challenge of meeting the Millennium Development Goal for maternal health. International Journal of Gynaecology and Obstetrics 2008; 102: 1-2.
[12]	Letamo G, Rakgoasi SD. Factors associated with the non–use of maternal health services in Botswana. Journal of Health and Population Nutrition 2003; 21: 40-47.
[13]	Gage AJ, Callixte MG. Effects of physical accessibility of maternal health services on their use in rural Haiti. Population Studies (Cambridge) 2006; 60: 271-88.
[14]	Wilson SB, Collison AHK, Richardsom S. The maternity Ghana experience. International Journal of Gynecology and Obstetrics 1997; 59 (2): S1650-S172.
[15]	Carr D. Improving the health of the world’s poorest people. Health Bulletin 2004; 3-12.
[16]	Samai O, Sengeh P. Facilitating emergency care through transportation and communication, Bo, Sierra Leone. International Journal of Gynecology and Obstetrics 1997; 59(2): S157- S164.
[17]	Census, Govt of India (Office of the Registrar General and Census Commissioner). 2001.
[18]	Ministry of Health and Family Welfare (MOHFW), Reproductive and Child Health Programme: Schemes for Implementation, Department of Family Welfare, New Delhi. 1997.
[19]	Ministry of Health (MOH). Nepal Demographic and Health Survey 2001. Kathmandu, Nepal: MOHP, New Era and ORC Macro, qsw Calverton, Maryland. 2002.
[20]	Ebrahim GJ. Cross-cultural aspects of pregnancy and breast feeding. Nutritional Sociology 1980; 39: 13-15.
[21]	Dadhich JP. The Traditional Birth Attendants- Can we do without them? Journal of Neonatology 2009: 23:3.
[22]	Levin A, McEuen M, Dymatraczenko T, Sengooba F, Mangani R, Van Dyck G. Costs of Maternal Health care Services in three Anglophone African Countries. International Journal of Health Planning and Management 2003; 18 (1): 3-22.
[23]	Stephenson R, Baschieri A, Clements S, Hennink M, Madise N. Contextual influences on the use of health facilities for childbirth in Africa. American Journal of Public Health 2006; 96: 84-93.
[24]	Tuladhar H, Dali SM, Pradhanang V. Complications of home delivery: a retrospective analysis. Journal of Nepal Medical Association 2005; 44: 87-91.
[25]	Mpembeni RNM, Killewo JZ, Leshabari MT, Massawe SN, Jahn A, Mushi D. Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy Childbirth 2007; 7: 29.
[26]	Stanton C, Blanc AK, Croft T, Choi Y. Skilled care at birth in the developing world: Progress to date and strategies for expanding coverage. Journal of Biosocial Sciences 2007; 39: 109-120.
[27]	Chakraborty N, Islam MA, Chowdhury RI, Bari W, Akhter HH. Determinants of the use of maternal health services in rural Bangladesh. Journal of Health Promotion 2003; 18: 327-37.
[28]	Navaneetham K, Dharmalingamb A. Utilization of maternal health care services in Southern India. Social Science Medicine 2002; 55: 1849-1869.
[29]	Mayhew M, Hansen PM, Peters DH, Edward A, Singh LP, Dwivedi V. Determinants of skilled birth attendance in Afghanistan: a Cross-sectional study. American Journal of Public Health 2008; 98: 1849-56.
[30]	Houweling TAJ, Ronsmans C, Campbell OMR, Kunst AE. Huge poor-rich inequalities in maternity care: an international comparative study of maternity and child care in developing countries. Bull World Health Organ 2007; 85: 745-754.
[31]	Thind A, Mohani A, Banerjee K, Hagigi F. Where to deliver? Analysis of choice of delivery location from a national survey in India. BMC Public Health 2008; 8: 29.
[32]	Celik Y, Hotchkiss DR. The socio-economic determinants of maternal health care utilization in Turkey. Social Science Medicine 2000; 50: 1797-806.
[33]	Katung PY. Socio-economic factors responsible for poor utilization of primary health care services in a rural community in Nigeria. Nigerian Journal of Medicine 2001; 10: 20-59.
[34]	Satoko Y, Sophal O, Susumu W. Determinants of skilled birth attendance in rural Cambodia. Tropical Medicine International Health 2006; 2: 238-251.