Prevalence and determinants of home delivery among pregnant women in Somaliland: Insights from SLDHS 2020 data  <span class="so-article-trans-title" dir="auto"> Translated title: Factores determinantes del parto a domicilio entre las mujeres embarazadas de Somalilandia: datos de SLDHS 2020 </span>

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objective

This cross-sectional study aimed to identify the determinants of home deliveries among women in Somaliland, with the objective of informing targeted interventions to improve maternal and child health outcomes.

Design

A cross-sectional study design was employed, utilizing data from a nationally representative sample of 3250 women in Somaliland. A multivariate logistic regression analysis was conducted to examine the factors influencing the likelihood of home delivery.

Site

The study was conducted in Somaliland, a region where home delivery remains prevalent.

Participants

The study included 3250 women of reproductive age in Somaliland who had given birth.

Interventions

No specific interventions were administered as part of this study. The focus was on understanding the factors associated with home deliveries.

Main measurements

Sociodemographic, economic, and regional factors were examined as potential determinants of home deliveries. Education levels of women and their husbands, maternal age at first marriage and first birth, and household wealth were among the main measurements analyzed.

Results

The analysis revealed that higher education levels were associated with a decreased likelihood of home delivery. Women with secondary (OR: 0.42, 95% CI: 0.32–0.55) or higher (OR: 0.21, 95% CI: 0.12–0.37) education were less likely to deliver at home than those with no education. Similarly, women whose husbands had a secondary (OR: 0.55, 95% CI: 0.41–0.73) or higher (OR: 0.43, 95% CI: 0.28–0.66) education were less likely to deliver at home. Increased maternal age at first marriage (OR: 1.04, 95% CI: 1.02–1.06) and first birth (OR: 1.03, 95% CI: 1.01–1.05) were significant predictors of home delivery. Lower household wealth was also associated with a higher likelihood of home delivery. Significant regional variations were observed, with certain regions showing higher rates of home deliveries compared to others.

Conclusions

The findings highlight the importance of targeted interventions to address sociodemographic and regional disparities in the utilization of institutional delivery services in Somaliland. Strategies should focus on improving access to and quality of maternal healthcare services, empowering women's decision-making, and engaging men to address gender norms within households.

Translated abstract

Objetivo

Este estudio transversal se propuso identificar los factores determinantes de los partos en el hogar entre las mujeres de Somalilandia, con el objetivo de informar de las intervenciones dirigidas a mejorar los resultados de salud materna e infantil.

Diseño

Se empleó un diseño de estudio transversal, utilizando datos de una muestra nacional representativa de 3.250 mujeres en Somalilandia. Se realizó un análisis de regresión logística multivariante para examinar los factores que influyen en la probabilidad de dar a luz en casa.

Emplazamiento

El estudio se llevó a cabo en Somalilandia, una región donde el parto en casa sigue siendo frecuente.

Participantes

El estudio incluyó a 3.250 mujeres en edad reproductiva de Somalilandia que habían dado a luz.

Intervenciones

No se administraron intervenciones específicas como parte de este estudio. La atención se centró en comprender los factores asociados a los partos domiciliarios.

Mediciones principales

Se examinaron factores sociodemográficos, económicos y regionales como posibles determinantes de los partos en el hogar. Los niveles de educación de las mujeres y sus maridos, la edad materna en el momento del primer matrimonio y el primer parto y la riqueza del hogar fueron algunas de las principales medidas analizadas.

Resultados

El análisis reveló que un mayor nivel educativo se asociaba con una menor probabilidad de parto en casa. Las mujeres con estudios secundarios (OR: 0,42; IC 95%: 0,32-0,55) o superiores (OR: 0,21; IC 95%: 0,12-0,37) tenían menos probabilidades de dar a luz en casa que las que no tenían estudios. Del mismo modo, las mujeres cuyos maridos tenían estudios secundarios (OR: 0,55; IC 95%: 0,41-0,73) o superiores (OR: 0,43; IC 95%: 0,28-0,66) tenían menos probabilidades de dar a luz en casa. Una mayor edad materna en el primer matrimonio (OR: 1,04; IC 95%: 1,02-1,06) y en el primer parto (OR: 1,03; IC 95%: 1,01-1,05) fueron predictores significativos de parto en casa. Una menor riqueza familiar también se asoció con una mayor probabilidad de parto en casa. Se observaron variaciones regionales significativas y algunas regiones mostraron tasas más elevadas de partos en casa que otras.

Conclusiones

Los hallazgos destacan la importancia de las intervenciones específicas para abordar las disparidades sociodemográficas y regionales en la utilización de los servicios de parto institucional en Somalilandia. Las estrategias deben centrarse en mejorar el acceso y la calidad de los servicios de atención sanitaria materna, potenciar la toma de decisiones de las mujeres e implicar a los hombres para abordar las normas de género en los hogares.

Related collections

Most cited references 13

Record: found
Abstract: found
Article: found

Is Open Access

The association of neighbourhood and individual social capital with consistent self-rated health: a longitudinal study in Brazilian pregnant and postpartum women

Gabriela Lamarca, Maria Leal, Aubrey Sheiham … (2013)

Background Social conditions, social relationships and neighbourhood environment, the components of social capital, are important determinants of health. The objective of this study was to investigate the association of neighbourhood and individual social capital with consistent self-rated health in women between the first trimester of pregnancy and six months postpartum. Methods A multilevel cohort study in 34 neighbourhoods was performed on 685 Brazilian women recruited at antenatal units in two cities in the State of Rio de Janeiro, Brazil. Self-rated health (SRH) was assessed in the 1st trimester of pregnancy (baseline) and six months after childbirth (follow-up). The participants were divided into two groups: 1. Good SRH – good SRH at baseline and follow-up, and, 2. Poor SRH – poor SRH at baseline and follow-up. Exploratory variables collected at baseline included neighbourhood social capital (neighbourhood-level variable), individual social capital (social support and social networks), demographic and socioeconomic characteristics, health-related behaviours and self-reported diseases. A hierarchical binomial multilevel analysis was performed to test the association between neighbourhood and individual social capital and SRH, adjusted for covariates. Results The Good SRH group reported higher scores of social support and social networks than the Poor SRH group. Although low neighbourhood social capital was associated with poor SRH in crude analysis, the association was not significant when individual socio-demographic variables were included in the model. In the final model, women reporting poor SRH both at baseline and follow-up had lower levels of social support (positive social interaction) [OR 0.82 (95% CI: 0.73-0.90)] and a lower likelihood of friendship social networks [OR 0.61 (95% CI: 0.37-0.99)] than the Good SRH group. The characteristics that remained associated with poor SRH were low level of schooling, Black and Brown ethnicity, more children, urinary infection and water plumbing outside the house. Conclusions Low individual social capital during pregnancy, considered here as social support and social network, was independently associated with poor SRH in women whereas neighbourhood social capital did not affect women’s SRH during pregnancy and the months thereafter. From pregnancy and up to six months postpartum, the effect of individual social capital explained better the consistency of SRH over time than neighbourhood social capital.

0 comments Cited 229 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: found

Is Open Access

Determinants of use of maternal health services in Nigeria - looking beyond individual and household factors

Stella Babalola, Adesegun Olayiwola Fatusi, Mireille Van Poppel (2009)

Background Utilization of maternal health services is associated with improved maternal and neonatal health outcomes. Considering global and national interests in the Millennium Development Goal and Nigeria's high level of maternal mortality, understanding the factors affecting maternal health use is crucial. Studies on the use of maternal care services have largely overlooked community and other contextual factors. This study examined the determinants of maternal services utilization in Nigeria, with a focus on individual, household, community and state-level factors. Methods Data from the 2005 National HIV/AIDS and Reproductive Health Survey - an interviewer-administered nationally representative survey - were analyzed to identify individual, household and community factors that were significantly associated with utilization of maternal care services among 2148 women who had a baby during the five years preceding the survey. In view of the nested nature of the data, we used multilevel analytic methods and assessed state-level random effects. Results Approximately three-fifths (60.3%) of the mothers used antenatal services at least once during their most recent pregnancy, while 43.5% had skilled attendants at delivery and 41.2% received postnatal care. There are commonalities and differences in the predictors of the three indicators of maternal health service utilization. Education is the only individual-level variable that is consistently a significant predictor of service utilization, while socio-economic level is a consistent significant predictor at the household level. At the community level, urban residence and community media saturation are consistently strong predictors. In contrast, some factors are significant in predicting one or more of the indicators of use but not for all. These inconsistent predictors include some individual level variables (the woman's age at the birth of the last child, ethnicity, the notion of ideal family size, and approval of family planning), a community-level variable (prevalence of the small family norm in the community), and a state-level variable (ratio of PHC to the population). Conclusion Factors influencing maternal health services utilization operate at various levels - individual, household, community and state. Depending on the indicator of maternal health services, the relevant determinants vary. Effective interventions to promote maternal health service utilization should target the underlying individual, household, community and policy-level factors. The interventions should reflect the relative roles of the various underlying factors.

0 comments Cited 114 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: found

Is Open Access

Factors affecting home delivery among women living in remote areas of rural Zambia: a cross-sectional, mixed-methods analysis

Nancy A. Scott, Elizabeth G. Henry, Jeanette L. Kaiser … (2018)

Purpose Access to skilled care and facilities with capacity to provide emergency obstetric and newborn care is critical to reducing maternal mortality. In rural areas of Zambia, 42% of women deliver at home, suggesting persistent challenges for women in seeking, reaching, and receiving quality maternity care. This study assessed the determinants of home delivery among remote women in rural Zambia. Methods A household survey was administered to a random selection of recently delivered women living 10 km or more from their catchment area health facility in 40 sites. A subset of respondents completed an in-depth interview. Multiple regression and content analysis were used to analyze the data. Results The final sample included 2,381 women, of which 240 also completed an interview. Households were a median of 12.8 km (interquartile range 10.9, 16.2) from their catchment area health facility. Although 1% of respondents intended to deliver at home, 15.3% of respondents actually delivered at home and 3.2% delivered en route to a facility. Respondents cited shorter than expected labor, limited availability and high costs of transport, distance, and costs of required supplies as reasons for not delivering at a health facility. After adjusting for confounders, women with a first pregnancy (adjusted OR [aOR]: 0.1, 95% CI: 0.1, 0.2) and who stayed at a maternity waiting home (MWH) while awaiting delivery were associated with reduced odds of home delivery (aOR 0.1, 95% CI: 0.1, 0.2). Being over 35 (aOR 1.3, 95% CI: 0.9, 1.9), never married (aOR 2.1, 95% CI: 1.2, 3.7), not completing the recommended four or more antenatal visits (aOR 2.0, 95% CI: 1.5, 2.5), and not living in districts exposed to a large-scale maternal health program (aOR 3.2, 95% CI: 2.3, 4.5) were significant predictors of home delivery. After adjusting for confounders, living nearer to the facility (9.5–10 km) was not associated with reduced odds of home delivery, though the CIs suggest a trend toward significance (aOR 0.7, 95% CI: 0.4, 1.1). Conclusion Findings highlight persistent challenges facing women living in remote areas when it comes to realizing their intentions regarding delivery location. Interventions to reduce home deliveries should potentially target not only those residing farthest away, but multigravida women, those who attend fewer antenatal visits, and those who do not utilize MWHs.

0 comments Cited 41 times – based on 0 reviews      Review now

All references

Author and article information

Contributors

Yahye Hassan Muse

Journal

Journal ID (nlm-ta): Aten Primaria

Journal ID (iso-abbrev): Aten Primaria

Title: Atencion Primaria

Publisher: Elsevier

ISSN (Print): 0212-6567

ISSN (Electronic): 1578-1275

Publication date PMC-release: 16 September 2024

Publication date (Print): February 2025

Publication date (Electronic): 16 September 2024

Volume: 57

Issue: 2

Electronic Location Identifier: 103082

Affiliations

[a ]Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama, Somalia

[b ]School of Graduate Studies, University of Hargeisa, Hargeisa, Somalia

Author notes

[* ]Corresponding author. Yahye.Hassan@ 123456uoh.edu.so yahye.hassan@ 123456amoud.edu.so

Article

Publisher Item ID: S0212-6567(24)00224-5 Publisher ID: 103082

DOI: 10.1016/j.aprim.2024.103082

PMC ID: 11420480

PubMed ID: 39288728

SO-VID: ab471a26-ec18-43b3-a5a5-f1acf4121539

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Prevalence and determinants of home delivery among pregnant women in Somaliland: Insights from SLDHS 2020 data Translated title: Factores determinantes del parto a domicilio entre las mujeres embarazadas de Somalilandia: datos de SLDHS 2020

Read this article at

Abstract

Objective

Design

Site

Participants

Interventions

Main measurements

Results

Conclusions

Translated abstract

Related collections

Serotonin and BEYOND

Most cited references 13

The association of neighbourhood and individual social capital with consistent self-rated health: a longitudinal study in Brazilian pregnant and postpartum women

Determinants of use of maternal health services in Nigeria - looking beyond individual and household factors

Factors affecting home delivery among women living in remote areas of rural Zambia: a cross-sectional, mixed-methods analysis

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 7

Cited by 3

Most referenced authors 716