1. Home Delivery or Hospital Delivery
Preference on
Home Delivery or Hospital Delivery
among the mothers of the rural community of
Faridpur, Bangladesh
Presenting Author: Tonmoy Biswas
Co-Authors:
Nowjum Noor Qunjo
Debjyoti Das
Niloy Das
Suja Hossain
Boniface Hasdak
Sudipto Ray
Thank you. I am Tonmoy Biswas from Faridpur medical College, Bangladesh. I am here to present a study that is about preference on home delivery or Hospital delivery among the mothers of rural community of Faridpur Bangladesh. Here is shown the name of the authors. And the presenting author is Tonmoy Biswas myself.

2. Introduction
The delivery which occurs in home without adequate hygiene and treatment facilities under the birth attendant (trained or untrained) is called home delivery
Home delivery is the delivery where adequate hygiene
& treatment facilities are not maintained.

3. The delivery which occurs in hospitals or health institutions with adequate hygiene & treatment facilities under the trained birth attendants is called hospital or institutional delivery
Every year more than half a million (5,29,000) women in the world die from causes related to pregnancy & childbirth
On the other hand the deliveries in hospital maintain adequate hygiene, treatment under trained birth attendants.
Every year about half a million women in the world die during pregnancy & child birth.

4. The number of pregnant women is around 3.8 million in Bangladesh
Currently women die every year due to causes related pregnancy & child birth
Untrained TBA and relatives at home attend most of the deliveries in rural Bangladesh
Currently in Bangladesh about women die every year due to causes related to pregnancy & childbirth as the birth attendants are not trained

5. Home Delivery or Hospital Delivery
Preference on
Home Delivery or Hospital Delivery
among the mothers of the rural community of Faridpur, Bangladesh
Now lets enter into our research study

6. Research Questions:
What is the preference on Home Delivery or Hospital Delivery among the mothers of the rural community in Bangladesh?
What are the dominating factors or causes to influence their preference?
We started our study based on two questions
What is preference on Home delivery or Hospital Delivery among the others of the rural community in Bangladesh?
And what are the dominating factors to influence their preferences?

7. Rationale:
Though early marriage & early pregnancy is common for girls in Bangladesh, they don’t seek any checkup by physicians at the time of delivery
The traditional birth attendant conduct most of the deliveries.
Due to poor knowledge & skill of the dai (TBA) many women have to face complications & disabilities in their future
Here is the rationale
Women in the rural area don’t seek any check up physicians at the time of delivery. Untrained village mid-wives conduct most of the deliveries that causes complications as a result

8. The present study is unique in concerned area
The present study is unique in concerned area. It is expected that the study will be able to throw light on preference for place of delivery in the rural areas.
The study will be able to add new knowledge in the discipline of obstetrics, gynecology & pediatrics.
The health care providers particularly the health planners & managers will get information reagarding delivery practice in rural area of Bangladesh.
This study will throw light on rural delivery practices and will able to add new knowledge in the discipline of gynecology, obstetrics & pediatrics field

9. General Objectives: Specific Objectives:
To determine the preference on home or hospital delivery among the mother of the rural area of Bangladesh
Specific Objectives:
To detect the socio-economic status of the mothers.
To find out the preference of delivery among the literate & illiterate people.
To detect the range of age for first time pregnancy.
To detect the factors which influence to make the preference
To find out the people who influence to decide the place of delivery
Our general objectives was to determine the preference on home or hospital delivery among the mother of the rural area of Bangladesh
And specifically we wanted to-
Detect the socio-economic status of the mothers
To find out the link between their education & their preference
To detect the range of age for the first time pregnancy
And to find out the people who influence to decide the place of delivery

10. Methodology: Study Type: Cross sectional
Study area: Modhukhali Upazilla, Faridpur, Bangladesh
Study Time: 6 April 2013 to 23 April 2013
Study population: Mothers of middle & young age
Sample size: 170
Sampling technique: Purposive sampling & convenient sampling
Data collection type: Face to face interview
Research instruments: Semi-structured questionnaire
DATA Analysis: SPSS version 18.0
Here is our methodology
Study type was cross sectional
Study area modhukhali upazila, Faridpur Bnagladesh
Study time was from 6 april 2013 to 23 april 2013
We selected mothers of the middle & young age for our study
170 people was interviewed
Data collection type was face to face interview
by semi structured questionnnaire
Data analysis was done by SPSS (Stattistical package for the social sciences) version 18

11. Picture: Upazilla Health Complex, Madhukhali, Faridpur (Study Area)
-With Map
It is the picture of a part of the concerned area with the map

12. It’s time for results now…..

13. Frequency of distribution of Respondents by age:
Age Groups in years
Frequency
Number
Percentage
16-19 13 7%
20-24 31
18.2%
25-29 68
40%
30-34 24
14.1%
35-39 20
11.7%
40 & above 14 8%
Total
170
100%
Most of the respondents of our study were between 25 to 29 years of age

14. Frequency of distribution of Respondents by religion:
Number
Percentage
Islam
144
84.7%
Hindu 26
15.2%
Total
170
100%
Frequency of distribution of households according to type of family:
Most the people were muslim in the study area. And ratio of nuclear families & joint families was nearly same
Type of family
Frequency
Number
Percentage
Nuclear 87
51.1%
Joint/Extended 83
48.8%
Total
170
100%

15. Frequency of distribution of Respondents by educational status:
We can see that most of the respondents were educated up to secondary level & the number of illiterate people comes after that

16. Frequency of distribution of Respondents by socio-economic status:
Here is shown the economic status of the families where 54% were lower middle class

17. Frequency of distribution of Respondents by time of first pregnancy:
Age of the 1st Pregnancy
Frequency
Number
Percentage
16 to 20 years
110
64.7%
20 to 25 years 42
24.7%
25 to 30 years 14 8%
Above 30 years 4 2%
Most of the respondents had their first baby when they were between 16 to 20 years
16 to 20 years

18. Frequency of distribution of Respondents having children of different ages:
No Children & their age
Frequency
Number
Percentage
1 child below 5 years 47
27.6%
2 children below 5 years 73
42.9%
1 child above 5 years 12 7%
2 children above 5 years 31
18.2%
Others 7 4%
Total
170
100%
Here is shown that about 43% mothers of our study had

19. Frequency of distribution of Respondents by place of delivery of last child:
We can see that more than 100 among the 170 respondents delivered their last child at home. Relatively few mothers delivered their last baby at hospitals

20. Frequency of distribution of Respondents by type of the birth attendants:
In most cases the concerned people had unskilled women during the time of their last delivery. Secondly they approached to a graduate doctor

21. Frequency of distribution of Respondents by preference of Hospital Delivery or Home Delivery:%
Home Delivery
131
77.06%
Hospital Delivery 39
22.94%
Total
170
100%
It is the main result of our study that reflects 77% people with preference for home delivery. And only 23% mother prefer hospital for their delivery

22. Preference of Hospital Delivery or Home Delivery in rural areas:
Here the large green area shows the home delivery preferences
77.06%

23. Frequency of distribution of Respondents by preference of Hospital Delivery or Home Delivery relating to their educational status:
Education
Preference
Total
Home Delivery
Hospital Delivery N %
Illiterate 35
87% 5
13% 40
Below SSC & informal 44
85% 9
15% 53
SSC 42
75% 14
25% 56
HSC or above 10
47% 11
53% 21
131 39
170
Now lets see the factors causing these kind of preferences we found that 87% illiterate people preferred home delivery
Where most educated people preferred hospital delivery

24. Frequency of distribution of Respondents by persons influencing their preferences :
48.2%
Now the people who influence their preferences
Their own family members influence mainly to select the delivery places
Influence of close neighbors was also high
TBA & friends also have some less influences…..

25. Frequency of factors influencing Home Delivery:
After people these are the factors affecting their decision about home delivery…..
We can see that blue area showing 42% people prefer home delivery for homely confortable environment
And 26% get fear from hospitals

26. Frequency of factors influencing Hospital Delivery:
And those people who prefer hospital delivery showed main causes as safety & well care in hospitals

27. Conclusion:
Among the mothers of the rural community of Bangladesh. The Study revealed –
High Preference on Home Delivery than Hospital Delivery
Low educated & illiterate people show more preference on home delivery
Senior Family members play important role in making decision about the place of the delivery
Home environment & fear about hospital is the key factor in making preference on Home Delivery.
At last. From the result we conclude that…..
In that rural community.
High preference on home delivery than hospital delivery
Low educated & illiterate people show more preference on home delivery
Senior Family members play important role in making decision about the place of the delivery
Home environment & fear about hospital is the key factor in making preference on Home Delivery.

28. Recommendations:
Mass education program should be strengthened with special emphasis on Female education
Measures should be taken to train more birth attendants at the rural areas
Govt. & the NGOs should take steps to make senior family members understand the importance of safe delivery as they highly influence in making the preferences
We may recommend that
Mass education program should be strengthened with special emphasis on Female education
Measures should be taken to train more birth attendants at the rural areas
Govt. & the NGOs should take steps to make senior family members understand the importance of safe delivery as they highly influence in making the preferences

29. Fear & shyness about hospital delivery can be removed by counseling.
Awareness about safe delivery can be aroused by school teachers, health workers, volunteers and common public media.
Fear & shyness about hospital delivery can be removed by counseling.
It is needed to recruit more female doctors in the health centers of rural areas.
Awareness about safe delivery can be aroused by school teachers, health workers, volunteers and common public media.

30. References 1. Maternal mortality & global fact book WHO 1991 6-10.
2. Safe motherhood from advocacy to Action, issue 7, Nov 1991
3. Statistical pocket book of Bangladesh 2006 (BBS)
4. Park Text book of Preventive & Social medicine 10th edition
5. Rashid, Khabir, Hayder’s Text book of Community medicine & Public Health, 4th edition, Dhaka
These are the references…..

31. THANK YOU
Thank you everyone!