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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 3
and delivery in Health units for pregnant mothers. Most of this Health education sessions are based to mothers who come to seek for health care in these clinic, however it has not been effective to solve the problem. This necessitated the need for conducting this study so as to find out the reasons for low deliveries in Health units. The information resulting from the research will be used to plan appropriate interventions towards improving safe motherhood services in the district. It will also be used to advise the non-governmental organization and CHMT members in Kigoma district towards proper formulation of strategies and effective Health education messages to help solve the problem of low deliveries in Health units in the district. 1.3. THE PURPOSE OF THE STUDY The purpose of this study was to determine the magnitude and factors contributing to low deliveries in Health units in Kigoma Rural District. 1.4. RATIONALE OF THE STUDY The need for this study comes from the fact that despite a high antenatal attendances of pregnant women (94%) and health education interventions through MCH clinics employed to motivate mothers on the importance of delivering in health units, health facility deliveries, in Kigoma district are still low being 35.7%. (District Annual health report, 2000). Also there is no study that has been done in the district to find out the magnitude and determinants of the problem and recommend for appropriate measures to address the problem.. The consequences of un-assisted delivery by skilled personnel is devastating and threatening the life of both mother and the child, therefore this document intend to highlight on some effective measures which could be used to address the problem of low heath unit deliveries. 4
Page 1 and 2: PRIMARY HEALTH CARE INSTITUTE - IRI
Page 3 and 4: DEDICATION I dedicate this work to
Page 5 and 6: TABLE OF CONTENTS SUBJECT PAGE Decl
Page 7 and 8: LIST OF TABLES Table 1: Distributio
Page 9 and 10: ABREVIATIONS ANC - Ante-Natal Care
Page 11 and 12: ABSTRACT Health unit delivery is a
Page 13: Globally Safe Mother Hood Initiativ
Page 17 and 18: 2.0. LITRATURE REVIEW CHAPTER TWO S
Page 19 and 20: Several other studies have been don
Page 21 and 22: 3.0. RESEARCH METHODOLOGY 3.1. STUD
Page 23 and 24: 3.4. STUDY POPULATION The populatio
Page 25 and 26: The processed data was analyzed man
Page 27 and 28: 4.0. RESEARCH FINDINGS CHAPTER FOUR
Page 29 and 30: Table 5: Distribution of respondent
Page 31 and 32: Table 8: Distribution of Respondent
Page 33 and 34: The table above shows that women wh
Page 35 and 36: Table 14: Reasons given by mothers
Page 37 and 38: Introduction FOCUS GROUP DISCUSSION
Page 39 and 40: Focus group discussion with health
Page 41 and 42: Social Economic/Cultural factors ar
Page 43 and 44: HEALTH EDUCATION MODEL 5.3.THEORETI
Page 45 and 46: To reduce the complications that ap
Page 47 and 48: People will only perform a given be
Page 49 and 50: BIBLIOGRAPHY Ahmad Z. et al (1998).
Page 51 and 52: Ladfors L. et al (2001). A populati
Page 53 and 54: Walraven et al (2000) Maternal mort
Page 55 and 56: 8. How long does it take you to rea
Page 57 and 58: ANNEX 2 FOCUS GROUP DISCUSSION FOR
Page 59 and 60: ANNEX 2: QUESTIONS FOR FOCUS GROUP
Page 61: ANNEX 5: PERMISSION LETTER 47

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