Prevalence and correlates of home delivery amongst HIV-infected women attending care at a rural public health facility in Coastal Kenya
Document Type
Article
Department
Institute for Human Development
Abstract
Abstract: Background Home delivery, referring to pregnant women giving birth in the absence of a skilled birth attendant, is a significant contributor to maternal mortality, and is encouragingly reported to be on a decline in the general population in resource limited settings. However, much less is known about home delivery amongst HIV-infected women in sub-Saharan Africa (sSA). We described the prevalence and correlates of home delivery among HIV-infected women attending care at a rural public health facility in Kilifi, Coastal Kenya.
Methods A cross-sectional design using mixed methods was used. Quantitative data were collected using interviewer-administered questionnaires from HIV-infected women with a recent pregnancy (within 5 years, n = 425), whilst qualitative data were collected using focused group discussions (FGD, n = 5). Data were analysed using logistic regression and a thematic framework approach respectively.
Results Overall, 108 (25.4%, [95% CI: 21.3–29.8]) participants delivered at home. Correlates of home delivery included lack of formal education (aOR 12.4 [95% CI: 3.4–46.0], p<0.001), history of a previous home delivery (2.7 [95% CI:1.2–6.0], p = 0.019) and being on highly active antiretroviral therapy (HAART, 0.4 [95% CI:0.2–0.8], p = 0.006).Despite a strong endorsement against home delivery, major thematic challenges included consumer-associated barriers, health care provider associated barriers and structural barriers.
Conclusion A quarter of HIV-infected women delivered at home, which is comparable to estimates reported from the general population in this rural setting, and much lower than estimates from other sSA settings. A tailored package of care targeting women with no formal education and with a history of a previous home delivery, coupled with interventions towards scaling up HAART and improving the quality of maternal care in HIV-infected women may positively contribute to a decline in home delivery and subsequent maternal mortality in this setting.
Publication (Name of Journal)
PLoS One
Recommended Citation
Chea, S.,
Mwangi, T.,
Ndirangu, K.,
Abdullahi, O.,
Munywoki, P.,
Abubakar, A.,
Hassan, A.
(2018). Prevalence and correlates of home delivery amongst HIV-infected women attending care at a rural public health facility in Coastal Kenya. PLoS One, 13(3), 1-14.
Available at:
https://ecommons.aku.edu/eastafrica_ihd/70
Comments
This work was published before the author joined Aga Khan University.