Abstract:

Aim: The aim of this article is to identify the risk factors associated with pregnant women from the catchment population not delivering at the facility

Objectives: To reduce number of home deliveries

· To strengthen utilization of maternity services by catchment population

· To sustainably improve the health status of their populations to achieve national and global health targets.

Literature review: According to WHO 2014, Lesotho has a very high maternal and neonatal death rate being 487 deaths/ 100000 and 74 deaths/1000 respectively. This maybe attributed in part to the high rate of home deliveries. The report indicated that home deliveries accounts for 40% of all births in Lesotho and rates are even higher in the rural areas. The latest WHO (2016) report Annex A, global coverage of skilled attendance at birth was estimated to have reached 73% in 2013. However, despite steady improvement globally and within regions, millions of births were not assisted by a midwife, a doctor or a trained nurse. More than 40% of births in the WHO African Region and WHO South-East Asia Region were not attended by skilled health personnel.

2014 Lesotho Demographic Health Survey shows that 8 in 10 deliveries (78%) are assisted by a skilled provider, for the most part, a nurse/midwife (61%). Unskilled persons, such as traditional healers, village health workers, and relatives/friends, assist in 21%; 1% of births receive no assistance. Skilled providers assist at nearly 100% of deliveries in health facilities, but only 7% of deliveries that take place elsewhere. Indicators related to maternal health care have improved as depicted by Lesotho Demographic Health Survey (LDHS) 2014 showing that: “Seventy-seven percent (77%) of live births in the 5 years before the survey took place in a health facility, while 23% were delivered at home. Most institutional deliveries took place at public sector health facilities (70%).

Seboche Hospital catchment area was not an exception to this as it came to the facility observation that few number of local people deliver in the facility hence why the focus of the project was to increase facility based deliveries with local pregnant women. 2016 National projected catchment population for Seboche Hospital for expected deliveries is 431. Monthly the facility is expected to deliver +-36 pregnant mothers.

Keywords: Underutilisation of Maternity Services, Maternal health, Midwives, contributing factors, Interventions, community involvement, Nurse patient relationship, Nurses’ attitude, women empowerment.

References:

[1]. Lesotho Demographic Health Survey 2014

[2]. BMC Pregnancy childbirth 2013. Published online 2013 february 28

[3]. data.unicef.org.> statistics by topic> maternal health updated in June 2016

[4]. SiaLubanje C, Massar K, Hamer DH, Ruiter 2015