Factors that influence the choice of place of delivery among women in selected rural and urban areas in Iloilo

Abstract

Maternal complication or deaths can be avoided and prevented with effective health care like identification of different risks that can affect the mother’s health, as well as providing counseling which prepares women for giving birth, care during and after delivery, and place to give birth. Henceforth, this study was conducted to identify the different factors that influence the choice of place of delivery among women in selected rural and urban areas in Iloilo. This quantitative study utilized the PRECEDE model of Green and Kreuter. This is a model which is usually used to successfully implement community-based health promotion programs and projects. The PRECEDE model can hypothetically explain the variables and the analyses that were undertaken in the study. According to the model, there are potential factors affecting health problems or the choice of place of delivery among mothers in the community. The choice of place of delivery may be determined by the following factors: predisposing factors (age, civil status, educational attainment, employment status, monthly family income, and parity and gravidity of the respondents), enabling factors (access to birthing facility and access to information), and reinforcing factors (support from significant others during delivery). In this study, these predisposing, enabling, and reinforcing factors are the independent variables which influenced the choice of place of delivery among mothers which is the dependent variable. The data were gathered using a questionnaire from 371 (171 from Janiuay for the rural) and (150 from Lapaz for the urban) women who gave birth from June 2017 to June 2018. The data were analyzed using SPSS. Descriptive statistics (frequency tables) and inferential statistics (Phi and Cramer’s v) were used. The findings revealed that of all predisposing factors, employment status and monthly family income found to have a significant relationship with the respondent’s choice of delivery. And for the enabling factors, means of transportation and access to information from the internet like videos also found to have a significant influence to the choice of place of delivery. The identified factors were the basis to fully understand the different factors that influenced the choice of place of delivery and from that factors proper assessment and intervention can be done to promote quality health care during delivery. The department of health can facilitate trainings and seminars that can provide proper information dissemination and skills enhancement to health care providers. Also, the department may facilitate the putting up of lying-in clinics and birthing facilities in communities, especially those in the hard-to reach barangays and ensure that mothers can safely deliver their babies. It should encourage and provide assistance by making sure that the means and ways of reaching the nearest birthing facility is not difficult. Providing free transportation and free prenatal checkup can be an example. The policy makers should provide support and formulate enabling policies that will ensure the implementation and adoption of the recommended place of delivery by the Department of Health. No home birth policy should be strictly implemented. Free facility based delivery to those who falls in the poor sector of the community can be a big help to avoid home delivery. And lastly, for the future researchers, data gaps remain on knowledge, attitudes, and practices which determine the way mother chooses their place of delivery.