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INVESTIGATING THE FACTORS INFLUENCING THE CHOICE BETWEEN TRADITIONAL AND MODERN CHILDBIRTH PRACTICES IN WARRI, DELTA STATE

5,000.00

ABSTRACT

Maternal mortality remains a major public health challenge in Nigeria, where a substantial proportion of women still deliver outside health facilities under the care of unskilled attendants. The choice between traditional and modern childbirth practices is a critical determinant of maternal and newborn outcomes. This study investigated the factors influencing the choice between traditional and modern childbirth practices among women of childbearing age in Warri, Delta State. A descriptive cross-sectional design was adopted. Using Taro Yamane’s formula, a sample of 110 women who had experienced at least one childbirth was drawn by simple random sampling from women attending maternal and child health services in selected health facilities in Warri. Data were collected with a validated self-structured questionnaire (test-retest reliability index r = 0.81) and analysed using frequencies and simple percentages, presented in tables and charts. Findings showed that 56.4% of respondents delivered their last baby in a health facility while 43.6% utilised traditional options (traditional birth attendants, home or faith-based delivery). Socio-cultural factors influencing choice included family and spousal influence (70.9%), fear of caesarean section (65.5%) and the belief that traditional birth attendants understand cultural practices better (60.0%). Socio-economic factors included the high cost of hospital delivery (72.7%) and the cheaper, flexible payment system of traditional birth attendants (76.4%). Health system factors included long waiting time (63.6%), negative attitude of health workers (56.4%) and the perceived compassionate care of traditional birth attendants (74.5%). The study concluded that the choice of childbirth practice in Warri is shaped by interacting socio-cultural, socio-economic and health system factors, and recommended community-based maternal health education, reduction of financial barriers to facility delivery and improvement in the quality and friendliness of skilled birth services. (NOTE: Findings are based on illustrative simulated data to be replaced with field data.)

Keywords: Childbirth practices, Traditional birth attendants, Skilled birth attendance, Maternal health, Warri.

TABLE OF CONTENTS

CHAPTER ONE: INTRODUCTION……………………………………………………………………………. 1

1.1 Background of the Study……………………………………………………………………………………. 1

1.2 Statement of the Problem……………………………………………………………………………………. 3

1.3 Objectives of the Study………………………………………………………………………………………. 4

1.4 Research Questions……………………………………………………………………………………………. 4

1.5 Significance of the Study……………………………………………………………………………………. 5

1.6 Scope of the Study…………………………………………………………………………………………….. 5

1.7 Operational Definition of Terms…………………………………………………………………………. 6

CHAPTER TWO: LITERATURE REVIEW…………………………………………………………………. 8

2.1 Conceptual Review……………………………………………………………………………………………. 8

2.1.1 Concept of Childbirth Practices…………………………………………………………………….. 8

2.1.2 Traditional Childbirth Practices and Traditional Birth Attendants…………………….. 8

2.1.3 Modern Childbirth Practices and Skilled Birth Attendance………………………………. 9

2.1.4 Factors Influencing the Choice of Childbirth Practice……………………………………. 10

2.1.5 Implications of the Choice of Childbirth Practice for Maternal and Newborn Health     11

2.2 Theoretical Review………………………………………………………………………………………….. 12

2.2.1 Andersen’s Behavioural Model of Health Services Use…………………………………. 12

2.2.2 Application of the Model to the Present Study………………………………………………. 12

2.3 Empirical Review……………………………………………………………………………………………. 13

2.4 Summary of Literature Review and Research Gap………………………………………………. 16

CHAPTER THREE: RESEARCH METHODOLOGY…………………………………………………. 17

3.1 Research Design……………………………………………………………………………………………… 17

3.2 Research Setting……………………………………………………………………………………………… 17

3.3 Target Population…………………………………………………………………………………………….. 18

3.4 Sample Size Determination………………………………………………………………………………. 18

3.5 Sampling Technique………………………………………………………………………………………… 19

3.6 Instrument for Data Collection………………………………………………………………………….. 19

3.7 Validity of the Instrument…………………………………………………………………………………. 20

3.8 Reliability of the Instrument……………………………………………………………………………… 20

3.9 Method of Data Collection……………………………………………………………………………….. 20

3.10 Method of Data Analysis………………………………………………………………………………… 21

3.11 Ethical Considerations……………………………………………………………………………………. 21

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS………………………………….. 22

4.1 Socio-Demographic Data of Respondents…………………………………………………………… 22

4.2 Answering the Research Questions……………………………………………………………………. 25

Research Question 1: What is the prevalent choice of childbirth practice (traditional or modern) among women of childbearing age in Warri, Delta State?…………………………………………………. 25

Research Question 2: What are the socio-cultural factors influencing the choice between traditional and modern childbirth practices?……………………………………………………………………………….. 26

Research Question 3: What are the socio-economic factors influencing the choice between traditional and modern childbirth practices?…………………………………………………………………………. 26

Research Question 4: What are the health system-related factors influencing the choice between traditional and modern childbirth practices?…………………………………………………………. 27

4.3 Summary of Findings………………………………………………………………………………………. 28

CHAPTER FIVE: DISCUSSION OF FINDINGS, SUMMARY, CONCLUSION AND RECOMMENDATIONS…………………………………………………………………………………………… 29

5.1 Discussion of Findings…………………………………………………………………………………….. 29

5.1.1 Prevalent Choice of Childbirth Practice……………………………………………………….. 29

5.1.2 Socio-Cultural Factors Influencing the Choice of Childbirth Practice………………. 30

5.1.3 Socio-Economic Factors Influencing the Choice of Childbirth Practice…………… 30

5.1.4 Health System-Related Factors Influencing the Choice of Childbirth Practice….. 31

5.2 Implications of the Study for Nursing………………………………………………………………… 32

5.3 Limitations of the Study…………………………………………………………………………………… 32

5.4 Contributions to Knowledge……………………………………………………………………………… 32

5.5 Summary………………………………………………………………………………………………………… 33

5.6 Conclusion……………………………………………………………………………………………………… 34

5.7 Recommendations……………………………………………………………………………………………. 34

5.8 Suggestions for Further Studies…………………………………………………………………………. 35

REFERENCES………………………………………………………………………………………………………… 37

APPENDIX I: LETTER OF INTRODUCTION AND INFORMED CONSENT……………… 40

APPENDIX II: QUESTIONNAIRE……………………………………………………………………………. 41

 

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