Factors influencing choice of delivery sites in Rakai district of Uganda

• Published in: Social science & medicine (1982) Vol. 50; no. 2; pp. 203 - 213
• Main Authors: Amooti-Kaguna, B, Nuwaha, F
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 2000; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adolescent; Adult; Attitudes; Behavior; Biological and medical sciences; Childbirth; Choice; Choice Behavior; Cultural Characteristics; Culture; Delivery sites; Delivery, Obstetric - classification; Delivery, Obstetric - psychology; Delivery. Postpartum. Lactation; Factors; Female; Gynecology. Andrology. Obstetrics; Health care; Home Childbirth; Humans; Interviews; Male; Maternal, fetal and perinatal monitoring; Medical sciences; Middle Aged; Miscellaneous; Morbidity; Pregnancy; Pregnancy Complications; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rakai; Samples; Self-efficacy; Social influence; Socioeconomic Factors; TBAs; TBAs Attitudes Social-influence Self-efficacy Delivery sites; Tropical medicine; Uganda; Women; Uganda; Africa; Attitudes; Social-influence; Delivery sites; TBAs; Self-efficacy; Human; Evaluation; Choice; Folk midwife; Attitude; Hospital environment; Pregnancy; At home; Delivery; Woman; Social aspect; Comparative study; Public health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(99)00275-0

In order to understand factors influencing choice of delivery sites in Rakai district of south-western Uganda, eight focus group discussions based on the Attitudes–Social influence–Self efficacy model were held with 32 women and 32 men. Semi-structured interviews were also held with 211 women from 21 random cluster samples who had a delivery in the previous 12 months (from 2 June 1997). Forty four percent of the sample delivered at home, 17% at traditional birth attendant’s (TBA) place, 32% at public health units, and 7% at private clinics. Among the factors influencing choice of delivery site were: access to maternity services; social influence from the spouse, other relatives, TBAs and health workers; self-efficacy; habit (previous experience) and the concept of normal versus abnormal pregnancy. Attitudinal beliefs towards various delivery sites were well understood and articulated. Attendance of ante-natal care may discourage delivery in health units if the mothers are told that the pregnancy is normal. In order to make delivery safer, there is need to improve access to maternity services, train TBAs and equip them with delivery kits, change mother’s self-efficacy beliefs, and involve spouses in education about safe delivery.