(PHCII) - MMH/MMS

Socioeconomic/cultural factors have significant influences on a place where delivery is to
take place. WHO describes that poverty is clearly a high risk factor. It is also known that
poor women are less likely to have formal education than wealthy women, and are less
likely to be in good health and to seek or receive medical care (Maine WHO 1986). Some
studies done in Bachok district Malaysia and elsewhere noted that, child birth at home is
perceived as a natural family event in which relatives support and comfort the mother
while child birth in hospital on the other hand is an event from which families are to
some extent excluded. Furthermore hospital delivery is not popular among rural mothers
who are strongly influenced by tradition (Ahmad et al -WHO 1995).
Whereas Bolam et al in a study on factors affecting home delivery in the Kathmandu
valley Nepal health unit delivery was 81% and home delivery was 19%. In univariate
analysis comparing home and institutional deliveries, maternal education, parity and
poverty were associated with place of delivery. It has been noted that poor education and
multiparity rather than poverty per se increase the risk of a home delivery in
Kathmandu(Bolam et al 1998).
Mathew et al (1995) in survey to establish knowledge of TBAs in Nigeria on handling
deliveries they noted that, many of the birth attendants were illiterate and only a few had
been trained by a health professional. Majority did not recognize potentially serious
complications occurring in the mother as a cause of concern.
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