Determinants of choice of place of delivery among women in reproductive age (15-49) in Uganda
Abstract
Background: Reducing maternal and neonatal mortality remains a formidable challenge in Uganda, especially for achieving the country’s Sustainable Development Goals (SDGs) by 2030. One of the challenges is increasing delivery at healthcare facilities to ensure safe and healthy births. Factors contributing to the choice of the place of childbirth have not been adequately investigated in Uganda, while more than 40% of deliveries occur outside of healthcare facilities. The utilization of untrained/unskilled birth attendants has been cited as a determinant contributing to the high maternal and neonatal mortalities in low-resource countries, including Uganda. This study aimed to identify determinants of the choice of the place of child delivery among parous women of reproductive age in Uganda.
Method: The study involved quantitative analysis of Uganda Demographic and Health Survey (UDHS) data of 2016. A total of weighted sample of 13,693 parous women aged 15–49 were included in our analyses. I examined the association between choice of place of childbirth and independent variables using binary logistic regression analysis. The results are presented using odds ratio (OR), with their respective confidence intervals (CIs). Statistical significance was set at p < 0.05.
Results: A total of 6,057(44.2%) parous women had outside facility childbirth. The determinants for choice of place of child delivery (CPCD) were: woman’s age, parity, wealth index, woman’s education, geographical region and partner’s/husband drinks alcohol. The odds of CPCD among parous women in reproductive age were higher among women with over four (>4) childbirth [OR: 1.621; CI: 1.381-1.904] in reference to women with 1-4 childbirth, women with secondary+ level of education [OR: 2.012; CI:1.600-2.529] in reference to no formal education, staying in Northern geographical region [OR:1.837; CI:1.432-2.357]. Likewise, odds were low among parous in the age group of 40-44 and 45-49 years [OR: 0.063; CI: 0.423-0.094], [OR: 0.017; CI: 0.011-0.028] in reference to 15-19 age group.
Conclusion: The findings could inform policies and interventions in Uganda on the crucial issue of increasing the choice of place of child delivery (CPCD) among parous women. Strategies to augment the accessibility and availability of healthcare services, and financial support that targets mothers from impoverished households to utilize health services will be beneficial. Health education targeting mothers and their partners with no education is vital to enhance their awareness about the importance of skilled birth attendance at birth