| Summary: | 碩士 === 國立臺北護理健康大學 === 護理研究所 === 105 === Background: In recent years, much attention have shifted to improving maternal and child health services as a result of the Millennium Developing Goals which was geared to reducing maternal and child mortality. Despite these attention and shift, the Gambia still battles with high maternal mortality. Evidence that emerged from a series of studies has shown that one of the fundamental pillars to reduce this menace is skilled birth attendant/institutional delivery. However, institutional delivery is relatively low in rural Gambia.
Purpose: The purpose of the study is to explore factors influencing institutional delivery in rural Gambia.
Method: A descriptive and cross sectional design with convenient sampling was used to find out the factors influencing institutional delivery. Data collection was held in the reproductive and child health (RCH) clinics of both Kerewan and Kuntaur Health Centres after permission to collect data was approved by IRB. The questionnaire modified from Bhattacharyya, Srivastava, Roy, & Avan’s (2016) study was administered to obtain as much as needed data. Totally, two hundred and sixty four participants were recruited in the study. The collected data was analyzed using the statistical package for social sciences (SPSS) version 20.0. The descriptive and inference statistics were used to examine the relationships among study variables and explore factors influencing institutional delivery.
Results: The mean age of the participants was 26.70±5.84. The mean family income for the women who participated in the study was 34.66 USD (1527 GMD) ±29.94 USD (1318.85 GMD). One hundred and sixteen participants (43.9%) women experienced previous delivery at home while one hundred and forty eight (56.1%) had an institutional delivery. There were 72 (27.3%) women visited the antenatal clinic for routine care less than four times while 192 (72.7%) visited four or more times. Women who had previous delivery at home (M=27.71, SD=5.73) were significantly older (t= 2.52, p<.05) than those who had previous delivery in the institution or hospital (M=25.91, SD=5.82). In addition, both ethnicity (χ² = 9.319, p<.05) and the number of delivery (χ²= 18.66, p<.005) were significantly associated with the previous choice of place to delivery. Several variables were significant predictors of institutional delivery in the future such as women’s age, employment status and adequate information about birth preparedness.
Implications: Findings from this study can help health professionals and policy makers to design strategies and develop policies toward improvement of service utilization, developing relevant community interventions focusing on adequate information about birth preparedness aimed at increasing institutional delivery. In addition, the results of this study may provide the midwives and the health professionals the opportunity to intensify the health education or promotion to facilitate more and more institutional delivery in the country. Once women’s awareness are increased and health care services are more accessible, the subsequent increase in institutional delivery would be expected and thereby a step closer to curtailing the maternal mortality and child mortality in Gambia.
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