Social cultural factors influencing home deliveries in Tanzania: a case study of Bagamoyo district in Coast region.

The purpose of this study was to explore socio-cultural factors which influence home deliveries in Tanzania with particular reference to Bagamoyo district. The study was based on two notions: That maternal mortality ratios in Tanzania are alarmingly high that efforts to explain causes of maternal deaths have concentrated on the immediate causes with little emphasis on the underlying factors which put women at risk of dying from child birth. Such an explanation may limit interventions aimed at preventing the problem of maternal mortality. The study sought to establish the social characteristics of women who deliver in health institutions and those who deliver at home, the factors which influence their choice of place of delivery, their views on home and institutional deliveries and their knowledge on risks involved in home deliveries. The study was guided by the health belief model and it used a descriptive, comparative and cross sectional design. A sample of convenience was used. Data was collected through interviews using questionnaire and focus group discussions. Interviews were conducted to women in reproductive age and who had delivered within two previous months. Focus group discussions were held with traditional birth attendants men, women who have passed reproductive age, women in reproductive age and the health workers. Findings from this study indicate that majority (61.6%) of women in the study area deliver at home, and that over 1/2 of those who deliver at home are attended by TBAs. Reasons for home deliveries are multiple, and involve the social cultural status of women which do not give them control over decision about where they should deliver. Other socio factors such as marital status, and occupation of partner had significant influence. Educated women tend to deliver in health institutions when compared to uneducated women. The study demonstrated further that community's perception about quality of care influence choice of place of delivery. Lack of facilities cost sharing and preference of TBAs are viewed as factors which inhibit the community from utilizing health facilities for delivery. The findings of this study will assist health planners in developing appropriate strategies of improving access and quality of maternal health, and developing acceptable community based delivery services.