The factors affecting the practice of delivery among the pregnant women who received antenatal care during their pregnancy in Bhutan

Name: Zangmo, Dechen

LCSH: Pregnant women -- Bhutan

LCSH: Prenatal care -- Bhutan

LCSH: Maternal health services -- Bhutan

LCSH: Delivery (Obstetrics) -- Bhutan

MeSH: Delivery

Abstract: This study explored the factors affecting the place of delivery and the presence of trained birth attendants during delivery by women who received prenatal care during their pregnancy. It focused on the age and education level of mothers, their socio-economic status, the distance from health centers, the mode of transportation used to travel to the health centers and their place of residence. Secondary quantitative data from the Bhutan Living Standard Survey, 2003, was used for analysis. The results revealed a large gap in the utilization of maternal care services with more than two fifths of women delivering at home and nearly a quarter of births being delivered without trained birth attendants . Women with education above primary education are 4.2 times and 4.5 times more likely to deliver in health institutions and to have trained birth attendants respectively. Women who have to walk more than 15 minutes are 58 percent less likely to deliver in the health centers and 53 percent less likely to be attended at birth by trained personnel. Women who travel on foot compared to vehicles are 36 percent less likely to deliver in the health institutions and 61 percent less likely to be attended at birth. However, the insignificant relationship between the socio-economic indicators and the service utilization is attributed to the free medical services provided by the Royal Government of Bhutan. The women who are residing in the rural areas are significantly 35 percent less likely to deliver in the health centers and 68 percent of them are less likely to be attended at birth compared to their counterparts. Thus, the policy makers should be made aware of the birth institutionalization challenge and focus on prioritizing the education of women to a level above the primary level, and establishing health services in proportion to the scattered settlements. The fact that large proportion of women who use prenatal care does not deliver in health institutions raises questions into the quality of services provided during ANC visits. Thus, a qualitative research will serve to find the other causes of differentials in service utilization like quality of care, social norms and beliefs regarding pregnancy and childbirth. The establishment of maternity waiting homes, further encouragement of health workers in assisting births in rural areas and training of family members as birth attendants along with the review of quality of care provided during ANC visits are recommended.

Mahidol University

Address: NAKHON PATHOM

Email: liwww@mahidol.ac.th

Name: Aphichat Chamratrithirong

Role: Thesis Advisors

Created: 2006

Modified: 2020-04-22

Issued: 2010-06-04

วิทยานิพนธ์/Thesis

application/pdf

ISBN: 9740475698

CallNumber: TH Z29f 2006

eng

Spatial: Bhutan

DegreeName: Master of Arts

Level: Master's Degree

Descipline: Population and Reproductive Health Research

Grantor: Mahidol University

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