Determinants of Home Deliveries by Pregnant Mothers in Lumbo Chabbobboma Zone of Gwembe District in Zambia

Background: Home deliveries is still high globally at 42% WHO 2022, due to high home deliveries, maternal death is also high at 43% globally. In sub-Sahara region home deliveries still high. Giving birth at health facilities in most of sub-Saharan African countries Zambia inclusive is still a challenge whereby more than 51% of first-time mothers give birth at home and this gives a risk of high maternal and perinatal deaths. Therefore Reducing number of home deliveries is important to improve maternal and perinatal health issues. In this study, the aim was to investigate the determinants of home deliveries by pregnant mothers in the Luumbo zone of Gwembe district, Zambia. Purpose: Access to skilled care and facilities with capacity to provide emergency and newborn care is critical to reduce maternal death. In Zambia 42% of women still deliveries from home, suggesting a persistent challenge for women to seek, reach, and receive quality maternity care. This study aimed investigate the determinants of home deliveries by pregnant mothers in Luumbo zone of Gwembe district, Zambia. Methods: The study was conducted among postnatal mothers who came for postnatal care at 6 weeks in Luumbo Chabbobboma clinic in Gwembe district southern province of Zambia. This was a descriptive cross-sectional study where a Simple random sampling technique was used to select 105 women of childbearing age who attended postnatal and had a recent delivery. Data were collected using a researcher-administered structured questionnaire to identify determinants of home deliveries in Luumbo Chabbobboma zone. Data analysis was done using SPSS computer software version 27.0. Both descriptive and inferential (chi-square test) analyses were performed and statistical significance was taken at α ≤ 0.05. Results: The results show that 46 (43.8%) respondents were in the age bracket 20 - 29 years. Of the 105 respondents included in the study, 24 (22.9%) of them delivered from home. The results show that high maternal age (p = 0.03), occupation (p = 0.024), distance to the facility (p = 0.014), means of transportation (p = 0.023), multiparity (p = 0.01), timing and number of ANC visits (p Conclusion: From this population. The major reason why women still deliver at home was long distance to the nearest facility. To reduce maternal and perinatal mortality access to health facilities by pregnant women needs to be improved. There should also be active engagement of the traditional and religious institutions in the area.

Benefits of and Barriers to Male Involvement in Maternal Health Care in Ibanda District, Southwestern, Uganda

Background: Male involvement in reproductive health care has been shown to have positive outcomes on the maternal and newborn’s health as they provide resources and make crucial decisions. However, male involvement in reproductive/maternal health care in Uganda is still low. The objective of this study was to explore community perspectives on benefits and barriers to men’s involvement in maternity care in southwestern Uganda. Methods: The study was a cross-sectional, exploratory study, in Ibanda district, southwestern Uganda Data collection was collected in May 2020, using qualitative methods, narrative interviews and analyzed using a content-based approach. The sampling was done purposively and 18 narrative interviews were conducted. Results: Eighteen (18) narrative interviews were conducted at households of the participants. The identified benefits of male’s involvement in reproductive care services included family wellbeing and health, health care services utilization, health care worker motivation and community improvement and development. The barriers that emerged included individual and behavioral factors like ignorance/knowledge, responsibility, excessive alcohol consumption, laziness and lack of money. Family and extended family factors included trust and cooperation by the couple, fidelity issues, domestic violence and family perceptions. The environment, cultural and gender factors like misperceptions of male involvement, the cultural beliefs about the role of men in reproductive issues and the gender norms. The health care services factors included timing of the services the attitude of the health workers and the availability and access to the health services. Conclusions: The benefits of male involvement in maternal health care include family wellbeing and health, health care services utilization, health worker motivation and community improvement and prosperity. The barriers to male involvement in antenatal, delivery and postnatal care include individual and behavioral, family and extended family, environmental, cultural and gender and health care services factors. Therefore interventions to improve male involvement should focus on the individual, family, cultural, gender and health care services factors.