Determinants of the utilisation of delivery services by pregnant women in Rwanda
Date
2011-03-10
Authors
Umurungi, Serubibi Yvonne
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Abstract
Objective:
To identify determinants for the utilisation of delivery services by pregnant women
in Rwanda, considering individual and demographic, socioeconomic and health
service factors.
Design:
A secondary data analysis of the third (2005) Rwandan Demographic Health Survey
(RDHS III) was conducted. Women who had at least one live birth during the fiveyear
period prior to the survey were included in the analysis. Bivariate and
multivariate analyses were undertaken.
Results:
A total of 5235 participants fulfilled the study eligibility criteria and were included
in the analysis. Although more than 90% of participants attended an antenatal
service, only 30% delivered at a health facility. The predictors of a home delivery
were higher parity (OR=5.01, 95% CI: 4.11-6.31 for parity of 6 or more), place of
residence (OR=1.86, 95% CI: 1.55-2.23 for rural women), lower household wealth
(OR=4.37, 95% CI: 3.43-5.56 for the poorest quintile), lower education level
(OR=3.61, 95% CI: 2.73-4.76 for no education), none or one antenatal care visit
(OR=3.62, 95% CI: 2.76-4.74 for one antenatal care visit) and the lack of antenatal
counselling about pregnancy complications (OR=1.83, 95% CI:1.40-2.40).
Conclusion
Utilisation of maternal health services, particularly health facility delivery services,
remains low in Rwanda. The promotion of at least four standard antenatal care
visits, as well as efforts targeting specific risk groups, such as higher parity, rural
and less educated women living in poorer households are critical if the country
wishes to reduce maternal and neonatal mortality and morbidity.
Description
MSc (Med), Child Health Community Paediatrics, Faculty of Health Sciences, University of the Witwatersrand
Keywords
maternal health services, usage, delivery, birth, Rwanda