Abstract:
Worldwide, home deliveries persist especially in developing countries; SSA inclusive. In
Tanzania, the trend was 53% in 1991-1992; 47% in 1996; and 44% in 1999; while 47% in
2004. In Songea, home delivery trend was 44% in 2005; 40% in 2006; and 42% in 2007
though antenatal care attendance was above 95%. This trend raises concern. The study
was guided by two research questions: what determines home deliveries, and what impact
do home deliveries have on maternal and infant mortality. The study was conducted in
Songea Rural District. It adopted cross-sectional design and used structured questionnaires
to collect primary data. Secondary data were obtained from reviewed related literatures.
The study involved 200 respondents from five wards and 10 villages. The wards and
villages were purposively selected while simple random method was used in choosing
respondents. The study report is presented using descriptive statistics namely, frequencies
and percentages. The results indicate that application of herbs for facilitating labour was
leading factor by 98% of the respondents with home deliveries. Other causes were low
income of people (87%), bad condition of roads (90%), long distance to health facilities
(88%), inadequate delivery services at health facilities (89%); lack of women’s decision
making power (76%), timing problem (75%), lack of transport to health facilities (91%),
cost at health facilities (90%), and experience in previous deliveries (84%). Of the 15
maternal deaths found; 12 occurred among mothers delivering at home compared to three
that delivered at health facilities.
Moreover, home deliveries were associated with six
infant deaths compared to three in health facilities. Reversing the trend of home deliveries
requires improvement of infrastructures, empowering women to make decisions,
sensitisation against social norms which promote home deliveries, retaining skilled
personnel in rural facilities, and equipping health facilities with delivery materials
regularly.
