Factors Affecting the Place of Delivery among Mothers Residing in Jhorahat VDC, Morang, Nepal

Abstract

Background: In Nepal, the maternal mortality ratio is 281 per thousand live births, among which 40% mortality occurs during home delivery. Home delivery increases the risk of maternal and neonatal mortality and morbidity due to the birth not assisted by skilled attendant. This study was carried out to determine the factors affecting the place of delivery among the mothers residing in Jhorahat VDC, Morang district, Nepal. Methods: A mixed method study using interviews based on semi-structured questionnaire (n=93) among mothers and two focus group discussion among decision makers of the house and female community health volunteers was conducted between November to December 2012. For quantitative data, Chi-square test and Fischer's Exact test were used to examine the association between the selected variables and place of delivery. Results: More than half (58.1%) of the mothers had institutional delivery and 41.9% of them had home delivery. The most common reason for home delivery was easy and convenient environment (66.7%) and that for institutional delivery was safety (77.8%). There was a significant association between caste, education of mothers, education of spouse, occupation of spouse, per capita income, time to reach the nearest health center, parity, previous place of delivery, number of antenatal visit, knowledge about place of delivery, planned place of delivery, and place of delivery. Conclusion: Maternal health services, such as prenatal care, skilled assistance during delivery and post-natal care, along with adequately equipped health institutions, play a major role in the reduction of maternal morbidity and mortality. Concerted efforts should be made both at community and government levels to increase institutional delivery.