REVIEW OF RELATED LITERATURE Chapter 2

 

                        FACTORS AFFECTING COMPLIANCE AND NON-COMPLIANCE TO

 FACILITY-BASED DELIVERY IN BARANGAY MAGDAUP,

MUNICIPALITY OF IPIL

CHAPTER II

Chapter 1   Chapter 2

REVIEW OF RELATED LITERATURE

Literature

Factors Affecting Compliance to Facility-Based Delivery

Maternal mortality remains a major global public health concern more than twenty years after the International Safe Mother Initiative was launched. Each year 358,000 women die worldwide from pregnancy – related causes, nearly all in Asia and Sub-Saharan Africa, and many women die from obstetric complications (WHO 2010).

Several studies have been conducted worldwide on the factors affecting delivery in health facilities and following was observed, the issue of risk and vulnerability, such as lack of money, lack of transport, sudden onset of labor, short labor, staff attitudes, lack of privacy, geographical location, perception of poor quality of health services, tradition, cultures and the process of decision-making power within the household where perceived as key determinants of the place of delivery (Mrisho  et al 2007; Magoma  2010;Zulfiqur et al, 2009).

Although many efforts have been done to reduced maternal death worldwide, more than half millions of women die each year as the result of childbirth and complications of pregnancy particularly Sub-Saharan Africa and Asia (WHO report 2005).

            There are several reasons behind the low use of professional services. In the study of Amooti – Kaguna & Nuwaha (2006)  in Uganda, a number of country- specific studies have identified potential barriers to access which can lead to home delivery, either unattended or with traditional birth attendants (TBAs) in the home

The most common barriers include; distance from the health facility, transportation problems, costs of services, including stigma, fear, inability for women to travel alone, or to be seen by male doctors (Amooti- Kaguna & Nuwaha,2006).

Another study reveals that involving family members, such as their husband, or other community members, in the decision-making process is important for women when seeking facility-based delivery services (Shimazaki etal.,2013).

 With respect to marital status, there is a strong belief that women in unions are more likely to access maternal health care services during their first trimester compared to those who are not. This is because of the likelihood that married women are more likely to be supported by their spouses, and are more likely to have disposable income required to access maternal health services and are less to be autonomous (Ochako et al.2011).

Health provider behavior and attitudes are also determinant factor for a choice of place of delivery for pregnant mother, some of the health workers are very rude, using abusive language and refuse to assist patients, and these attitudes prevent the Women to deliver in health facilities however positive attitudes of health workers attract women to deliver in health facilities. For example in a study conducted by Mrisho, one women during focused group discussion said when I went to the health facility(X) for delivery, I was impressed by the midwife who cared for me so much. She was so human, polite and sympathetic. (Mrisho et al 2008). This encourages the women to deliver in health facilities. Improves skills and knowledge among health providers and increase access of health services in rural areas and will increase access to pregnant mother to deliver in facility delivery.

Unreliable transport is also a barrier to access skilled delivery in rural areas, failure to plan in advance for transport cause higher number of women to deliver in their homes even if they had planned to deliver in health facilities (Mrisho et al 2007, Magoma M 2010).

 Economic stability has also been identified as important in influencing maternal health care service utilization behavior of women. For example, a study in more than 50 countries showed that on average more than 80% of births were attended for the richest women compared with only 34% of the poorest women (Gill, Pande & Malhotra 2007). In Ethiopia, Dagne (2010) also found on her study a statistically significant association between household wealth and assistance during delivery with women in the rich and richest wealth groups more likely to have professional assistance during birth ( Dagna,2010).

In the Philippines, according to the 2008 National Demographic and Health Survey (NDHS), the proportion of deliveries in a health facility among all births is 44.2% (NSO,2009). In comparison with the previous surveys, the proportion went up from 34% in 1998 and 37.9% in 2003 (NSO,2006). Regional estimates are also available. The region with the highest of health facility deliveries is the National Capital Region (NCR) with 69.3% while the region with the lowest is the Autonomous Region of Muslim (ARMM) with 14.7%.

In the country, the preliminary results of the 2013 National Demographic and Health Survey (NDHS) of the National Statistical Office (NSO) indicate some improvement in delivery care. In particular, the findings unveil an increase in facility-based deliveries and in births delivered by health professionals (NDHS,2013).

On the other hand, a recent study in Pasig City found that 94% of women in the richest quintile delivered with a skilled birth attendant, compared with 25% in the poorest; and 84% of women in richest quintile had facility-based delivery, compared with 13% of the poorest. (Pasig City &Washington: The World Bank, 2011).

 In the Philippines, the study of Rogan (2013) identifies a number of variables including urbanity, parity, age of the women, and status as significant and independent predictors for the use of prenatal care services. According to her, women in urban areas are 0.88 times more likely to avail prenatal care services that their rural country part. Regarding parity, the study revealed that there is little difference in the likelihood of use of prenatal services among women. The oddsof having prenatal care decreases as the number of children increases. On the other hand, women who are 15-19 years old are twice as likely to access maternal care as the 45 to 49 years old women. (Rogan,2013).

Therefore we expect women with more children to have lower levels of use of maternal health care services because of the constraints of time and money. Also, greater use of maternal health care services for first births may be attributed to higher risk of complications (Majokoet al.2004).

THESIS ON FACTORS AFFECTING COMPLIANCE FACILITY-BASED DELIVERY

Location: Philippines

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