Determinants of home delivery among women aged 15-24 years in thirteen districts of Tanzania

Abstract

Giving birth at health facilities in most of sub-Saharan African countries is still a challenge whereby more than 51% of first-time mothers gives birth at home. In Tanzania more than 37% of women still give birth at home and among them 33% are below 20 years of age. Studies on factors for home deliveries among women of reproductive age have been done in Tanzania and the recommended interventions were kept in place. However due to the unique needs of adolescent and young mothers there is a need of having current information on determinants of home deliveries among women aged 15-24 years. The objective of this study was to determine the factors of home deliveries among women aged 15-24 years in thirteen districts of Tanzania. This was a mixed method study combining quantitative secondary data analysis and qualitative primary data analysis. In secondary analysis we analyzed data collected from October to November 2011. This involved woman aged 15-24 years who gave birth one-year prior data collection in thirteen districts of Tanzania. In qualitative methods, we analyzed data from health care providers’ key informants, and traditional birth attendants (TBA). Data were collected from February to April 2019 in Bagamoyo, Tandahimba, Magu, and Moshi Rural districts. The in-depth interviews from health care providers were based on antenatal care (ANC) delivery and postnatal care (PNC) utilization among women aged 15-24 years. Traditional Birth Attendants were asked if they still conduct home deliveries, reasons why women prefer to give birth at home and challenges they face during home delivery. A total of 409 adolescents and young women who delivered in one-year prior to data collection were included in the final analysis. A quarter of them give birth at home. Having at least four ANC visits (OR=0.23, 95% CI: 0.12-0.41, p<0.01 ref: never attended), planning place of delivery (OR=0.22, 95%CI: 0.14-0.36 P<0.01) and knowledge about the dangers signs during pregnancy (OR=0.36, 95% CI: 0.22-0.57, P<0.01) were significantly associated with the place of delivery. The study findings revealed that maternal educational, number of ANC visits, planned place of delivery and knowledge about pregnant danger signs were determinants associated with place of delivery among the women aged 15-24 years. It is important to consider these factors in programming of interventions to reduce maternal deaths.