HIGH ANTENATAL ATTENDANCE, LOW SKILLED DELIVERY: ASSESSMENT OF FACTORS INFLUENCING DECLINE IN SKILLED DELIVERY IN TOLON DISTRICT IN NORTHERN REGION

Abstract

Skilled delivery has become an essential subject of discussion in recent times. Though figures on ANC indicate high attendance, skilled delivery does not match with the ANC attendance as may be the perception of health professionals. It was this impairment on the MDG5 that prompted this study in the Tolon district to assess the factors contributing to high ANC attendance and low health facility or skilled delivery. The study employed a mixed research method of adopting both quantitative and qualitative approaches to research to sample 423 women for quantitative study. Health workers and community men from 4 communities were studied qualitatively in a focus group discussion. The selection criteria were basically purposive. Both primary and secondary information was used in the study. It was found that, the district lacks far behind on the global target for maternal health care and the MDG5. This was because hidden traditional beliefs were traced to the people’s high use of the health facility for ANC (85.8%) but low use for delivery (57.1%). Husbands (74.6%) and mother in laws (20.8%) were the major influence in the decision to place of delivery and have often opted for TBAs and prayer camps. Though there was a high preference for health facility delivery (83.4%), there was a low usage among the women (57.1%). There was absolutely high knowledge of the relevance of skilled delivery (95.2%). Healthcare worker attitudes that were expected to ensure access to delivery center and service were found to have existed. There was, however, an issue of transportation to the center for skilled delivery service (29.1%). The study, therefore recommended ambulance service and intensified education targeting not only the women, but their families and community members as well. The study also suggested the conversion of TBAs into skilled birth attendants through training.