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    Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study

    193676_98436_Determinants_of_Facility_Delivery_After_Implementation_of_Safer_Mother.pdf (159.1Kb)
    Access Status
    Open access
    Authors
    Karkee, R.
    Binns, Colin
    Lee, Andy
    Date
    2013
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Karkee, Rajendra and Binns, Colin W. and Lee, Andy H. 2013. Determinants of facility delivery after implementation of safer mother programme in Nepal: A prospective cohort study. BMC Pregnancy and Childbirth. 13 (193): pp. 1-7.
    Source Title
    BMC Pregnancy and Childbirth
    DOI
    10.1186/1471-2393-13-193
    ISSN
    1471-2393
    Remarks

    This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0/. Please refer to the licence to obtain terms for any further reuse or distribution of this work.

    Copyright © 2013 Rajendra Karkee, Colin Binns and Andy Lee

    URI
    http://hdl.handle.net/20.500.11937/28537
    Collection
    • Curtin Research Publications
    Abstract

    Background: There are several barriers for pregnant women to deliver in a health care facility. This prospective cohort study investigated factors affecting facility delivery and reasons for unplanned place of delivery after implementation of the safer mother programme in Nepal. Methods: Baseline interviews using a validated questionnaire were conducted on a sample of 700 pregnant women representative of the Kaski district in central Nepal. Follow-up interviews of the cohort were then conducted within 45 days postpartum. Stepwise logistic regression analysis was performed to determine factors associated with the facility delivery outcome. Results: Of the 644 pregnant women whose delivery location had been identified, 547 (85%) gave birth in a health care facility. Women were more likely to deliver in a health facility if they were educated especially with higher secondary or above qualification (adjusted odds ratio (OR) 12.39, 95% confidence interval (CI) 5.09 to 30.17), attended 4 or more antenatal care visits (OR 2.15, 95% CI 1.25 to 3.69), and lived within 30 minutes to the facility (OR 11.61, 95% CI 5.77 to 24.04). For the 97 women who delivered at home, 72 (74.2%) were unplanned, mainly due to quick precipitation of labour making it impossible to reach a health facility. Conclusions: It appeared that facility delivery occurs more frequent among educated women and those who live nearby, even though maternity services are now freely available in Nepal. Because of the difficult terrain and transportation problem in rural areas, interventions that make maternity service physically accessible during antenatal period are needed to increase the utilisation of health facility for child birth.

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