(PHCII) - MMH/MMS

Reproductive and Child Health services by developing the National Package of Essential
RCH interventions called Focused Antenatal Care (MOH 2002).
The goal for Focused Antenatal Care is to provide timely and appropriate Care to women
during pregnancy to reduce the Maternal Morbidity and Mortality as well as achieving a
good outcome for the baby (MOH 2002).
1.2. STATEMENT OF THE PROBLEM
The problem of low deliveries in health facilities exist in all the districts in Kigoma
region, which is less than 40%, thus Kigoma rural district is not an exception. According
to District Annual health report (2000). Kigoma district has 35.7% of women delivered in
health units, while the Antenatal coverage was 94%.
Determinants leading to low deliveries in health units in Kigoma rural district is not
known. However empirical research has shown that the following factors contribute to
the problem and these include cultural traditions, mothers being unfamiliar with hospital
environment, uncomfortable about being examined by male physician, worried about
cost, being unhappy with separation from their families (WHO 1998 and Dehne K. L. et a
1995).
However Rooney (1992) also reported that health unit delivery is only for those with risk
factors e.g. Prim-parity, height less than 150 cms and a history of serious complications
in a previous delivery.
The deliveries outside Health units subjects a woman into complications such as tears,
retained placenta, ruptured uterus, postpartum haemorrhage and puepheral sepsis. It
often happens to some women who agree to enter Health unit only when birth
complications have advanced and tends to increase the incidence of maternal mortality
(Ahmed 1998 and Mathew et al 1995).
In Kigoma district in order to alleviate the problem of low deliveries in Health units,
health education is provided in all MCH clinics with emphasis on Antenatal care visits
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