Nepal Clean Home Delivery Kit: Evaluation of the Health Impact - Path

Table 2. Type of birth attendants, by kit use and district
KIT USER
KIT NON-USER
Siraha Morang Sunsari Total Siraha Morang Sunsari Total
Trained TBA 132 121 141 394 168 113 97 378
% 96.4 91.7 93.4 93.8 96.6 89.0 94.2 93.6
Health worker 5.0 11 10 26 6 14 6 26
% 3.6 8.3 6.6 6.2 3.4 11.0 5.8 6.4
Total Trained 137 132 151 420 174 127 103 404
Untrained TBA 46 64 65 175 47 78 60 185
% 79.3 45.4 32.7 44.0 38.2 41.5 47.2 42.2
Family/neighbor 12 77 134 223 76 110 67 253
% 20.7 54.6 67.3 56.0 61.8 58.5 52.8 57.8
Total Untrained 58 141 199 398 123 188 127 438
From Tables 3 and 4 on characteristics of the households and the mothers, it is apparent
that kit users and non-users as a whole do not differ greatly. More users are literate and in
the higher socioeconomic category, but generally the differences between those with
trained and untrained attendants are greater than those between kit users and non-users. In
particular, there are some significant differences between kit users with trained and
untrained attendants. Kit users with a trained birth attendant had:
• Higher proportion of female head of household.
• More heads of household who were 50 years or older.
• Higher literacy rate for head of household and for mothers.
• Higher land ownership rate.
• Higher proportion in mid-level socioeconomic status.
• Younger mothers.
• More first pregnancies, fewer with five or more pregnancies.
• More mothers with antenatal care and with tetanus immunization.
Because of these differences and the possibility that some of them may be related to
infection outcome, it was apparent that it might not be possible to pool the two groups of
kit users during the analysis. Although there were only minor differences between the
characteristics of the two groups of kit non-users (more households headed by the fatherin-law
rather than the husband and consequently more household heads who were 50
years or older), they differed substantially in birth practices (see below). The differences
in antenatal care and tetanus toxoid (TT) were clearly related, since those with no
antenatal care were much more likely to have no TT (57.6% vs. 9.4%).
Table 3. Household characteristics, by cohort
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Nepal Delivery Kit Evaluation May 2000