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  • Title: Obstetrics service utilisation by the community in Lebowa, northern Transvaal.
    Author: Uyirwoth GP, Itsweng MD, Mpai S, Nchabeleng E, Nkoane H.
    Journal: East Afr Med J; 1996 Feb; 73(2):91-4. PubMed ID: 8756046.
    Abstract:
    A cross sectional cluster survey was done in all health wards of Lebowa in May 1992. The study was based on a recall of antenatal, intrapartum and postnatal experience during the last pregnancy of 2940 mothers. Only mothers who delivered within 12 months before the date of interview were included. Antenatal coverage was high at 93.5%, the proportion of health facility deliveries was 74.6% while 26.3% of all births occurred at home. Inaccessibility of maternity services, lack of money, negative staff attitudes and lack of privacy were the common reasons given for preference of home delivery. Mothers who delivered at home were more likely to be of higher parity and unbooked than their counterparts who delivered in a health facility. Postnatal coverage was 50.7% with a 25.4% rate of utilisation of a method of childspacing. The proportion of births attended to by trained personnel needs to be increased. A cross-sectional survey was conducted of 1992 of 2940 mothers who delivered during the 12 month period prior to the survey in all 14 health wards in Lebowa, northern Transvaal, South Africa. The survey sought to determine patterns of obstetric services utilization. Mean parity of respondents from the wards ranged from 2.8 to 3.5. Antenatal coverage was high (93.5% overall, range 8.0-98.6%). 74.6% of deliveries occurred in a health facility, while 26.3% were home births (range 0-44.3%). The health wards with a higher proportion of home deliveries tended to be rural. Traditional birth attendants were present at 34.8% of home births. Reasons for home delivery included lack of access to health services (19%), lack of money to pay for services (15.2%), negative staff attitudes (9.8%), and precipitate labor (7.2%). Mothers who delivered at home were more likely than their counterparts who gave birth in a health facility to be of higher parity. Postnatal coverage was 50.7%, and 25.4% of mothers were using a reliable method of child spacing at the time of the survey. Overall, these findings reveal a pattern of selective use of obstetric services. Primary health care administrators are urged to review obstacles to health facility deliveries, including negative staff attitudes, and to deploy trained midwives to rural areas in order to prevent birth complications and maternal mortality.
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