Factors associated with home deliveries in Thamplakamam, Trincomalee: a case control study

Abstract

OBJECTIVES: To identify the risk factors for home deliveries in Thampalakamam, Trincomalee. Methodology: This is a community based case control study. Cases were home deHveries that occurred during the period from Jan 1, 2000 to Dec 31, 2002 in Thampalakamam Divisional Director of Health Services (DDHS) area. Controls were institutional deliveries among women residing in Thampalakamam DDHS area during the same period. A total of 139 cases and 260 controls were selected for this study. Interviewer administered structured questionnaire was used to collect information. RESULTS: Majority of the home deliveries were Muslims (86.3%). The following factors were found to have strong association with home deliveries: low (< grade 5) maternal education (OR= 2.4, 95%CI 1.6- 3.7), no clinic visit compared with at least one clinic visit (OR =6.5, 95% CI4.1- 10.4), no home visit by the public health midwife compared with at least one visit (OR=7.5, 95%CI 4,7- 12.0), multi parity (OR=3.9, £5%CI 2.4- 6.6), maternal age >34years (OR=3.1, 95% CI 1.7- 5.7), and low (<500Rs) per capita income (OR=3.8, 95%CI 2.3- 6.3). Lack of transport (35.5%), premature delivery (20.3%), no one to accompany to hospital (11.6%), civil unrest (10.9%). and fear of hospital (10.9%) were mentioned as reasons for home deliveries by the mother. CONCLUSION: Poor standard of living including low educational level and deficiencies in the health care delivery system are strongly associated with home deliveries in Thampalakamam. Improvement of living condition and strengthening maternal and child health services can reduce the number of home deliveries in this area.