Online Program

Determinants of institutional delivery among women in rural Haiti

Wednesday, November 6, 2013 : 12:30 p.m. - 12:50 p.m.

Marie Seraphin, MPH, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Catherine Striley, PhD, MSW, MPE, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Ismael Teta, PhD, UNICEF, Port-au-Prince, Haiti
Mohamed Ayoya, MD, PhD, UNICEF, Port-au-Prince, Haiti
In Haiti, 26% of deliveries are attended by a trained health professional. One in 93 Haitian women dies from child-birth complications. Historically this high rate of death has been attributed to delays in: 1) seeking care for obstetric emergencies, 2) reaching the closest health center and 3) receiving appropriate care on arrival. To evaluate the factors that increase institutional delivery in a specific rural area, Fond des Blancs, Haiti, we analyzed Maternal Child Health data from a household-based survey using a multi-stage sampling methodology. Among the sample of 650 women who had had a child in the five years preceding the survey, 49% had delivered at a heath facility (SE=2.1), higher than the national average. Multivariate analysis showed that mothers from this area were more likely to give birth in a hospital if they were young (15-24 years old) (OR=1.67, CI: 2.51 – 6.60), graduated from high school (OR=3.83, CI: 2.40 – 6.13), lived close to a hospital (OR=2.46, CI: 1.78 – 3.39), had four or more prenatal sessions (OR=10.71, CI: 4.42 – 25.96), transportation (OR=1.94, CI: 1.38 – 2.73) and risk signs during pregnancy (OR=1.68, CI: 1.11 – 2.53). This analysis shows that seeking care due to high risks, and distance from the hospital/access to transportation, in addition to the mother's age and education level, affect whether a woman gives birth at home or in a hospital. Uniquely, we show that the modifiable factor of prenatal care receipt can increase hospital delivery even in a rural district of Haiti.

Learning Areas:

Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Describe the prevalence of maternal health services uptake for women of childbearing age in a isolated rural Haitian town

Keyword(s): Access and Services, Maternal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the design of the survey and collection of the data presented and have experience in Monitoring and Evaluation of MCH programs. I have also completed the analysis and drafted this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.