Abstract:
With a lack of human resources, such as skilled birth attendants in developing
countries, institutional births must be increased as part of a global strategy to reduce
maternal and newborn mortality rates.
This study aimed to identify and describe factors associated with non-institutional
births in the Shiselweni region of Swaziland in an attempt to provide recommendations
to increase institutional births, ultimately reducing maternal and neonatal mortality
rates.
A quantitative, descriptive and cross-sectional design was employed. Multiple-stage
sampling was done, and data were collected from 157 respondents between 14 to 49
years of age, who experienced a non-institutional birth in the year 2019, by means of
questionnaires.
The Statistical Package for Social Sciences (SPSS) version 23 was used to analyse
data. The findings revealed that level of education, being single, unemployed, residing
in rural areas, unplanned pregnancies, inadequate antenatal care (ANC) visits, a lack
of money for transport and hospital fees, and the unavailability of transport were
factors mentioned by respondents as influencing non-institutional births.
The challenges reported were vaginal tears, postpartum haemorrhage, stillbirths, urine
incontinence, and retained placenta. The non-institutional births were all conducted by unskilled birth attendants using unsterile equipment as the woman lacked emergency
delivery kits.
It is recommended that transport services for women in labour should be free,
infrastructure should be improved, human resources should be adequate, men should
be involved in maternal health matters, and women need to be empowered.
Motivating institutional births and providing support for women by a skilled birth
attendant, such as a midwife or doctor, can contribute to the country reaching the
Sustainable Development Goals.
