Factors influencing the utilization of institutional delivery services by Chepang women in Chitwan district of Nepal
Journal Title: International Journal of Public Health Asia Pacific (IJPHAP) - Year 2023, Vol 2, Issue 2
Abstract
Background: Nepal has not yet achieved less than 70 maternal deaths per 100,000 live births of the SDG. To reduce the maternal death rates, a safe motherhood program has been implemented across Nepal to provide pregnant women with free delivery care in a healthcare facility, as well as transportation incentives promoting institutional delivery. Being a marginalized group of people residing in hilly slope areas, the Chepang population is deprived of significance usage of healthcare services. Objective: This study aimed to assess the incidence of delivery complications, and to investigate the factors associated with the utilization of institutional delivery of the Chepang women in the Chitwan district. Methods: A cross-sectional study was conducted in Rapti, Kalika and Ichchhakamana municipalities with a proportional random sample of 557 mothers. A face-to-face interview using a structured questionnaire was performed to collect the data. Using stepwise logistic regression analysis, the data were analyzed. Results: The results show that the incidence of delivery complications among those who utilized an institutional delivery was lower than the non-institutional delivery respondents. The literate parents were strongly associated with the increased usage of an institutional delivery (OR=12.08, 95%CI=6.32-23.06), and (OR=5.45, 95%CI=2.82-10.51) for literate mothers and literate spouses, respectively. Other significant factors were older ages at delivery of mothers as compared to younger ages mothers (OR= 3.28, 95%CI=1.83-5.90 for ages 20-29 year.; OR=3.75, 95%CI=1.80-7.83 for ages ≥30 year.), and engagement in business and services occupation of mothers (OR=2.01, 95%CI=1.01-4.01). The associations were observed for vehicle transportation to the delivery facility (OR =1.99, 95% CI =1.28-3.11) and travel time ≤30 minutes to the delivery facility (OR=2.80, 95%CI=1.58-4.96). Conclusions: The results revealed a lower incidence of delivery complications among those who utilized the institutional delivery. The analysis also demonstrated that age, education, income, and convenient access to an institutional delivery facility for mothers were associated with the utilization of institutional delivery of Chepang women. The findings could benefit health professionals in developing a health intervention to increase institutional delivery services for marginalized Chepang women.
Authors and Affiliations
Sakriya Shrestha, Chetnath Bhusal, Nitaya Vajanapoom
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