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5.0 DISCUSSION. CHAPTER FIVE The discussions in this chapter are based on research findings and literature review with its relationship to objectives of this study. An overall 208 (52%) of respondents had there confinement at home while health unit delivery was 192 (48%) of the respondents. This implies that more than a half of pregnant mothers deliver at home settings where they can be subjected to high health risks. Similar findings were observed by Tanzania Demographic Health Survey (1996), which described health facility delivery being 47% and home delivery being 50%. Further more WHO estimates in developing countries deliveries in health units is only 40% while 54% of all deliveries are out side health units (WHO 1997) It was found that women with deliveries of (1 – 4) majority of them had their confinement in health units 139 (34.75%), while women with 5 deliveries and above who constituted 89 (22.25%) had their confinement at home. This indicated that grand maltiparous women who are already at risk do subject themselves to further dangers during delivery by delivering outside health units. Study findings on distance show that there is an influence on place of delivery as women living far from the health units did deliver at home. The Focus group discussion with 8 villages showed negative perception on quality of obstetric care that is there were inadequate skilled health workers, shortage of equipments, supplies and negative attitude of health workers to clients. This could be due to poor distribution of skilled health workers, shortage of equipments, supplies and non employment. 26
Social Economic/Cultural factors are some of the reasons given for not delivering in health units among others; all 8(100%) focus group discussions said that high costs of hospital delivery was a major hindrance for mothers to have delivery in health units. The high costs was contributed to, by traveling costs to health units, purchasing delivery equipments, drugs and high referral costs. More than half 218 (54.5%) of the interviewed women, had low knowledge on maternal risks during pregnancy, labour and delivery. A small minority 30 (7.5%) were knowledgeable on maternal risks. This implies that any risk woman could develop any of the mentioned risks and fell to seek/get medical help as early as possible simply because they are unaware of the consequences of the symptoms they are experiencing. In this way, they subject themselves to serious life threatening dangers during labour and delivery unknowingly. A nice example of a similar situation is given by Chiwuzie et al (1995) who reported in a study done in Ekpoma Nigeria that the community was knowledgeable about hemorrhage in pregnancy and delivery, however because of the inability to recognize early warning signs they continued with traditional treatment even when clear evidence of danger existed. In summary, the study findings taking into account the studied variables do not differ very much from findings by other researchers. Such findings like inadequate action by medical personnel, distance and deliveries ranging to 40% have been reported by WHO which does not differ very much from 48% found in this study and that of Tanzania Demographic Health Survey (1996) where delivery in health facilities was 47% . However the noted difference was in home deliveries regarding the prime gravid and grandmultiparous. This study found out that it was the grandmultiparous who used to deliver at home and not both the prime gravid and grandmultiparous as found by Godffrey et al (1996).But negative perception of the quality of obstetric care was found in all other studies as in this study. 27
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 and 14: Globally Safe Mother Hood Initiativ
Page 15 and 16: and delivery in Health units for pr
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: Focus group discussion with health
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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