Factors associated with home deliveries in a low income rural setting-observations from Nchelenge district, Zambia

Objectives: To determine the proportion of and factors associated with home deliveries in Nchelenge district, Zambia. Design: A population-based cross sectional study survey using simple random sampling was carried out among women (n=499) who attended immunization posts that were randomly selected. Binary multivariate logistic regression was used to determine factors associated with home deliveries. Main outcome measure: Percentage of deliveries reported to have occurred at home. Results: Overall (n=499), the prevalence of home deliveries was 43%, 95% CI (38.62, 47.48). Women who had four years of schooling or less, were 63% (AOR=1.63, 95% CI [1.06, 2.51]) more likely to deliver at home than a health facility compared to those who had at least five years of schooling. Women who lived within a radius of 5 kilometers to the nearest health facility providing maternal health and delivery services were 39% (AOR=0.61, 95% CI [0.41, 0.90]) less likely to deliver at home compared to those who lived more than 5 km away. Aspects of traditional beliefs, personal experiences of mothers and the perspectives of community members were among possible reasons cited for this outcome. Response rate was 96% (< 5% refused). Conclusion: The association of home deliveries with access to health care suggests a need for structural response coupled with ethnographic studies to explore linked aspects of traditional beliefs, personal experiences of mothers and the perspectives of community members.