Assessment of factors Influencing a Pregnant Woman's Choice of Place of Delivery in Chipembe: A Phenomenological Study

Abstract

The health of a mother contributes greatly to the health of the unborn child. All decisions a pregnant woman makes affect the unborn baby. About 2.4 million neonatal deaths were recorded in 2019 and 293 maternal deaths recorded in 2017 world over. It was estimated that 56% of maternal deaths were from Sub-Saharan Africa. In Chipembe community, pregnant women do not have the privileges that women who live in cities and big towns enjoy. The bad roads, poor modes of transport, lack of formal jobs, limited business opportunities, illiteracy, lack of formal private health care providers, lack of exposure etc. are few of the many barriers that hinder them from accessing care. These obviously affect their health seeking behaviour. Place of delivery is an important contributing factor to a safe delivery. Therefore, a pregnant woman must choose a place of delivery that will guarantee a safe delivery. This study sought to investigate factors which influenced pregnant women’s choice of place of delivery in Chipembe community. This was qualitative study approach, using a Phenomenological study design and data collection tools were a questionnaire, theme table and phone recorder. The sampling method employed the principle of saturation. The data were analysed using thematic analysis method. The most patronised place of delivery in Chipembe Community among the participants was Chipembe Mission Rural Health Centre. Factors that influenced participants’ choice of place of delivery included: the first-time-mother and multiparous-mother policy, which forced participants in the category to deliver from the Nyimba District Hospital or any other similar level Hospital or higher; Distance to the nearest health centre; HIV Positive status; Anaemia; Financial/Economic status; History of abortion; No delivery room in the local health centre; staff attitude; illiteracy; Having a friend who is a health worker; Gifts/incentives; Fear of complications; and many more. The study findings fit into the Three-Delay Model of health seeking behaviour by pregnant women. Factors such as lack of knowledge about their right to choose, illiteracy, parity etc. are typical examples of the first delay. The Second-Delay includes distance to the Health Centre, poor roads, and financial/economic status. The Third-Delay includes staff attitude, practitioner’s skill and others.

Keywords: Place of delivery; pregnant women; Chipembe