Reproductive Health and Wellness
The Use of Facilities for Labor and Delivery: the Views of Women in Rural Uganda
The aim of the paper is to explore factors
associated with home or hospital delivery
in rural Uganda. Qualitative interviews
with recently-delivered women in rural
Uganda and statistical analysis of data from
the 2011 Ugandan Demographic and Health
Survey (DHS) to assess the association
between socio-demographic and cultural
factors and delivery location in multivariable
regression models. In the DHS, 61.7%
(of 4907) women had a facility-based delivery
(FBD); in adjusted analyses, FBD was
associated with an urban setting [adjusted
odds ratio (aOR) 3.38, 95% confidence
interval (CI) 2.66 to 4.28)], the upper
wealth quintile (aOR: 3.69, 95%CI 2.79 to
3.87) and with secondary education (aOR:
3.07, 95%CI 2.37 to 3.96). In interviews
women quoted costs and distance as barriers
to FBD. Other factors reported in interviews
to be associated with FBD included
family influence, perceived necessity of
care (weak women needed FBD), and the
reputation of the facility (women bypassed
local facilities to deliver at better hospitals).
Choosing a FBD is a complex decision and education around the benefits of FBD
should be combined with interventions
designed to remove barriers to FBD.
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