Determinants of Home Delivery among Women Aged 15-24 Years in Tanzania

Florence F Kimario; Charles Festo; Josephine Shabani; Mwifadhi Mrisho

doi:10.21106/ijma.361

Determinants of Home Delivery among Women Aged 15-24 Years in Tanzania

Int J MCH AIDS. 2020;9(2):191-199. doi: 10.21106/ijma.361. Epub 2020 Apr 23.

Authors

Florence F Kimario^{1

2}, Charles Festo³, Josephine Shabani³, Mwifadhi Mrisho³

Affiliations

¹ Nelson Mandela African Institute of Science and Technology in Collaboration with Ifakara Health Institute. P.O. Box 447, Arusha, Tanzania.
² Kilimanjaro Christian Medical Centre, (KCMC), P.O. BOX 3010, Moshi, Tanzania.
³ Ifakara Health Institute, Department of Health System and Impact Evaluation and Policy, P.O. Box 78373 Dar es Salaam, Tanzania.

Abstract

Background: The United Nation's Sustainable Development Goal number 3 aims at reducing the maternal mortality rate by less than 70/100,000 live births globally and 216/100,000 live births in developing regions by 2030. Despite several interventions in Tanzania, maternal mortality has increased from 454/100,000 live births in 2010 to 556/100,000 live births in 2015. Home delivery and maternal young age contribute to maternal deaths. Reducing home deliveries among women aged 15-24 years may likely decrease the prevalence of maternal deaths in Tanzania. This study investigated the determinants of home delivery among women aged 15- 24 years in rural and mainland districts of Tanzania.

Methods: This study uses a mixed-methods approach using data collected as part of the evaluation of government and UNICEF interventions in 13 districts of Tanzania mainland from October and November 2011. Results from the secondary analysis were supplemented by qualitative data collected between February and April 2019 from four rural districts: Bagamoyo, Tandahimba, Magu, and Moshi.

Results: A total of 409 adolescents and young women who delivered one year before the quantitative data collection were included in the final analysis. A quarter of them gave birth at home. Having at least four antenatal care (ANC) visits (OR=0.23, 95% CI: 0.12-0.41, p<0.01), planning place of delivery (OR=0.22, 95% CI: 0.14-0.36 p<0.01), and knowledge of the danger signs during pregnancy (OR=0.36, 95% CI: 0.22-0.57, p<0.01) were significantly associated with the place of delivery.

Conclusion and global health implications: Maternal level of education, number of ANC visits attended, planned place of delivery, and knowledge of danger signs during pregnancy were the determinants of the choice of place of delivery among women aged 15-24 years in Tanzania. Understanding these risk factors is important in designing programs and interventions to reduce maternal deaths from women of this age group which contributes about 18% of all maternal deaths in Tanzania.

Keywords: Adolescents; Home delivery; Sub-Saharan Africa; Tanzania; Young women.