Association between social support and place of delivery: a cross-sectional study in Kericho, Western Kenya

Background: An estimated 358,000 maternal deaths still occur worldwide each year. The place of delivery is of great significance to the reduction of maternal mortality. Moreover, socio-economic factors, cultural traits, and local customs are associated with health-seeking behavior. This study aimed to explore determinants of association between social support and place of delivery. Methods: This cross-sectional study was conducted from September to November 2011 at Sosiot Health Center, Kericho West District, Kenya. Participants were 303 mothers who brought their babies to the health center for immunization within their first year of life. Women underwent a structured interview using a questionnaire on demographic characteristics and their experiences of delivery including place of delivery and social support. Results: The proportion of deliveries at health facilities was significantly higher in unmarried than married women (93% and 78%, respectively; P = 0.008). Unmarried women whose mothers supported them in housework and whose sisters helped them fetch water were more likely to deliver at health facilities (P = 0.002 and 0.042, respectively) than those without this support. However, married women whose husbands supported them in farming and whose neighbors helped them fetch water were less likely to deliver at health facilities (P = 0.003 and 0.021, respectively) than those without this support. Married women who were advised to deliver at a health facility by their mother-in-law or health staff were more likely to deliver at health facilities (P = 0.015 and 0.022, respectively) than those who did not receive this advice. Multivariate analysis revealed that married women were more likely to deliver at health facilities if they were highly educated (odds ratio [OR] = 2.5); had financial capability (OR = 4.3); had medical insurance (OR = 4.2); were primiparous (OR = 3.5); did not have the support of sisters-in-law for fetching water (OR = 2.2); or were advised to deliver at a health facility by family or neighbors (OR = 2.5).Conclusions: Promotion of delivery at health facilities requires approaches that consider women\u27s social situation, since factors influencing place of delivery differ for married and unmarried women

Exclusive Breast Feeding Practice in Zambia

Background: Exclusive Breast Feeding (EBF), the best feeding practice for infants aged from birth to six (6) months has faced challenges of adherence, exposes infants to infections such as diarrhoea, despite information on its importance being given to mothers. The main objective of this study was to establish levels of EBF practice among breast feeding mothers who had infants aged from birth to six months, factors influencing the practices and support required for mothers in Luangwa district.Methods: A descriptive cross section study design was used and a total sample of 171 breast feeding mothers with infants aged from birth to six months were selected using systematic sampling method. The study was conducted in five randomly selected health facilities. The respondents were interviewed using a pretested semi-structured interview schedule and five focus group discussions each group with seven participants, were conducted using a focus group discussion guide at study sites. Quantitative data was analysed using SPSS computer software package and Fishers Exact test was used to test the association between the dependent and independent variables. Qualitative data from the focus group discussions was analysed using content analysis with the help of qualitative research computer software Nvivo.Results: The prevalence of exclusive breast feeding practice was at 61%. The factors that were found to be statistically significant to exclusive breast feeding were age of infant and support breast feeding mothers received. The others factors were found not to be statistically significant to exclusive breast feeding and these were educational level of the mother, knowledge on benefits of breast feeding and support from spouse.The study revealed that mothers found it difficult to practice Exclusive Breast Feeding because of the amount of work at home and spouses found it difficult to help with house chores because culturally it was a woman's work.Conclusion: Though exclusive breast feeding practice had improved in the district, there was still need to strengthen the practice in the district through education of spouses, family and the community on infant feeding for them to support breast feeding mothers. With the support, mothers will have time to exclusively breast feed their infants