Home Delivery or Hospital Delivery Preference on Home Delivery or Hospital Delivery among the mothers of the rural community of Faridpur, Bangladesh Presenting Author: Tonmoy Biswas Co-Authors: Nowjum Noor Qunjo Debjyoti Das Niloy Das Suja Hossain Boniface Hasdak Sudipto Ray Thank you. I am Tonmoy Biswas from Faridpur medical College, Bangladesh. I am here to present a study that is about preference on home delivery or Hospital delivery among the mothers of rural community of Faridpur Bangladesh. Here is shown the name of the authors. And the presenting author is Tonmoy Biswas myself.

Introduction The delivery which occurs in home without adequate hygiene and treatment facilities under the birth attendant (trained or untrained) is called home delivery Home delivery is the delivery where adequate hygiene & treatment facilities are not maintained.

The delivery which occurs in hospitals or health institutions with adequate hygiene & treatment facilities under the trained birth attendants is called hospital or institutional delivery Every year more than half a million (5,29,000) women in the world die from causes related to pregnancy & childbirth On the other hand the deliveries in hospital maintain adequate hygiene, treatment under trained birth attendants. Every year about half a million women in the world die during pregnancy & child birth.

The number of pregnant women is around 3.8 million in Bangladesh Currently 21000 women die every year due to causes related pregnancy & child birth Untrained TBA and relatives at home attend most of the deliveries in rural Bangladesh Currently in Bangladesh about 21000 women die every year due to causes related to pregnancy & childbirth as the birth attendants are not trained

Home Delivery or Hospital Delivery Preference on Home Delivery or Hospital Delivery among the mothers of the rural community of Faridpur, Bangladesh Now lets enter into our research study

Research Questions: What is the preference on Home Delivery or Hospital Delivery among the mothers of the rural community in Bangladesh? What are the dominating factors or causes to influence their preference? We started our study based on two questions What is preference on Home delivery or Hospital Delivery among the others of the rural community in Bangladesh? And what are the dominating factors to influence their preferences?

Rationale: Though early marriage & early pregnancy is common for girls in Bangladesh, they don’t seek any checkup by physicians at the time of delivery The traditional birth attendant conduct most of the deliveries. Due to poor knowledge & skill of the dai (TBA) many women have to face complications & disabilities in their future Here is the rationale Women in the rural area don’t seek any check up physicians at the time of delivery. Untrained village mid-wives conduct most of the deliveries that causes complications as a result

The present study is unique in concerned area The present study is unique in concerned area. It is expected that the study will be able to throw light on preference for place of delivery in the rural areas. The study will be able to add new knowledge in the discipline of obstetrics, gynecology & pediatrics. The health care providers particularly the health planners & managers will get information reagarding delivery practice in rural area of Bangladesh. This study will throw light on rural delivery practices and will able to add new knowledge in the discipline of gynecology, obstetrics & pediatrics field

General Objectives: Specific Objectives: To determine the preference on home or hospital delivery among the mother of the rural area of Bangladesh Specific Objectives: To detect the socio-economic status of the mothers. To find out the preference of delivery among the literate & illiterate people. To detect the range of age for first time pregnancy. To detect the factors which influence to make the preference To find out the people who influence to decide the place of delivery Our general objectives was to determine the preference on home or hospital delivery among the mother of the rural area of Bangladesh And specifically we wanted to- Detect the socio-economic status of the mothers To find out the link between their education & their preference To detect the range of age for the first time pregnancy And to find out the people who influence to decide the place of delivery

Methodology: Study Type: Cross sectional Study area: Modhukhali Upazilla, Faridpur, Bangladesh Study Time: 6 April 2013 to 23 April 2013 Study population: Mothers of middle & young age Sample size: 170 Sampling technique: Purposive sampling & convenient sampling Data collection type: Face to face interview Research instruments: Semi-structured questionnaire DATA Analysis: SPSS version 18.0 Here is our methodology Study type was cross sectional Study area modhukhali upazila, Faridpur Bnagladesh Study time was from 6 april 2013 to 23 april 2013 We selected mothers of the middle & young age for our study 170 people was interviewed Data collection type was face to face interview by semi structured questionnnaire Data analysis was done by SPSS (Stattistical package for the social sciences) version 18

Picture: Upazilla Health Complex, Madhukhali, Faridpur (Study Area) -With Map It is the picture of a part of the concerned area with the map

It’s time for results now…..

Frequency of distribution of Respondents by age: Age Groups in years Frequency Number Percentage 16-19 13 7% 20-24 31 18.2% 25-29 68 40% 30-34 24 14.1% 35-39 20 11.7% 40 & above 14 8% Total 170 100% Most of the respondents of our study were between 25 to 29 years of age

Frequency of distribution of Respondents by religion: Number Percentage Islam 144 84.7% Hindu 26 15.2% Total 170 100% Frequency of distribution of households according to type of family: Most the people were muslim in the study area. And ratio of nuclear families & joint families was nearly same Type of family Frequency Number Percentage Nuclear 87 51.1% Joint/Extended 83 48.8% Total 170 100%

Frequency of distribution of Respondents by educational status: We can see that most of the respondents were educated up to secondary level & the number of illiterate people comes after that

Frequency of distribution of Respondents by socio-economic status: Here is shown the economic status of the families where 54% were lower middle class

Frequency of distribution of Respondents by time of first pregnancy: Age of the 1st Pregnancy Frequency Number Percentage 16 to 20 years 110 64.7% 20 to 25 years 42 24.7% 25 to 30 years 14 8% Above 30 years 4 2% Most of the respondents had their first baby when they were between 16 to 20 years 16 to 20 years

Frequency of distribution of Respondents having children of different ages: No Children & their age Frequency Number Percentage 1 child below 5 years 47 27.6% 2 children below 5 years 73 42.9% 1 child above 5 years 12 7% 2 children above 5 years 31 18.2% Others 7 4% Total 170 100% Here is shown that about 43% mothers of our study had

Frequency of distribution of Respondents by place of delivery of last child: We can see that more than 100 among the 170 respondents delivered their last child at home. Relatively few mothers delivered their last baby at hospitals

Frequency of distribution of Respondents by type of the birth attendants: In most cases the concerned people had unskilled women during the time of their last delivery. Secondly they approached to a graduate doctor

Frequency of distribution of Respondents by preference of Hospital Delivery or Home Delivery: % Home Delivery 131 77.06% Hospital Delivery 39 22.94% Total 170 100% It is the main result of our study that reflects 77% people with preference for home delivery. And only 23% mother prefer hospital for their delivery

Preference of Hospital Delivery or Home Delivery in rural areas: Here the large green area shows the home delivery preferences 77.06%

Frequency of distribution of Respondents by preference of Hospital Delivery or Home Delivery relating to their educational status: Education Preference Total Home Delivery Hospital Delivery N % Illiterate 35 87% 5 13% 40 Below SSC & informal 44 85% 9 15% 53 SSC 42 75% 14 25% 56 HSC or above 10 47% 11 53% 21 131 39 170 Now lets see the factors causing these kind of preferences we found that 87% illiterate people preferred home delivery Where most educated people preferred hospital delivery

Frequency of distribution of Respondents by persons influencing their preferences : 48.2% Now the people who influence their preferences Their own family members influence mainly to select the delivery places Influence of close neighbors was also high TBA & friends also have some less influences…..

Frequency of factors influencing Home Delivery: After people these are the factors affecting their decision about home delivery….. We can see that blue area showing 42% people prefer home delivery for homely confortable environment And 26% get fear from hospitals

Frequency of factors influencing Hospital Delivery: And those people who prefer hospital delivery showed main causes as safety & well care in hospitals

Conclusion: Among the mothers of the rural community of Bangladesh. The Study revealed – High Preference on Home Delivery than Hospital Delivery Low educated & illiterate people show more preference on home delivery Senior Family members play important role in making decision about the place of the delivery Home environment & fear about hospital is the key factor in making preference on Home Delivery. At last. From the result we conclude that….. In that rural community. High preference on home delivery than hospital delivery Low educated & illiterate people show more preference on home delivery Senior Family members play important role in making decision about the place of the delivery Home environment & fear about hospital is the key factor in making preference on Home Delivery.

Recommendations: Mass education program should be strengthened with special emphasis on Female education Measures should be taken to train more birth attendants at the rural areas Govt. & the NGOs should take steps to make senior family members understand the importance of safe delivery as they highly influence in making the preferences We may recommend that Mass education program should be strengthened with special emphasis on Female education Measures should be taken to train more birth attendants at the rural areas Govt. & the NGOs should take steps to make senior family members understand the importance of safe delivery as they highly influence in making the preferences

Fear & shyness about hospital delivery can be removed by counseling. Awareness about safe delivery can be aroused by school teachers, health workers, volunteers and common public media. Fear & shyness about hospital delivery can be removed by counseling. It is needed to recruit more female doctors in the health centers of rural areas. Awareness about safe delivery can be aroused by school teachers, health workers, volunteers and common public media.

References 1. Maternal mortality & global fact book WHO 1991 6-10. 2. Safe motherhood from advocacy to Action, issue 7, Nov 1991 3. Statistical pocket book of Bangladesh 2006 (BBS) 4. Park Text book of Preventive & Social medicine 10th edition 5. Rashid, Khabir, Hayder’s Text book of Community medicine & Public Health, 4th edition, Dhaka These are the references…..

THANK YOU Thank you everyone!