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Witter, S., Armar-Klemesu, M. and Dieng, T. (2008) National Fee Exemption Schemes for Deliverie: Comparing the Recent Experiences of Ghana and Senegal. In: Richard, F., Witter, S. and De Brouwere, V., Eds., Reducing the Financial Barriers to Access to Obstetric Care, Studies in Health Services Organisation and Policy series, ITG Press, Antwerp.

has been cited by the following article:

• TITLE: Study of the Factors Associated with Home Delivery in a Situation of Free Care in Senegal

  AUTHORS: Adama Faye, Anta Tal-Dia, Daouda Faye

  KEYWORDS: Home Delivery, Free Care, Health Facility, Senegal

  JOURNAL NAME: Open Journal of Epidemiology, Vol.7 No.4, October 25, 2017

  ABSTRACT: Introduction: Home delivery is still a health problem in Kolda (Senegal). The aim of this work is to study the factors associated with the place of delivery in a situation of free care delivery. Method: A descriptive and analytical cross-sectional study was carried out. Sampling was in two-stage clusters. The study focused on women who gave birth in the last 12months. The data were collected during an individual interview at home. The collection focused on knowledge, attitudes and practices about delivery. Logistic regression was used to explore the determinants of childbirth at the level of health facility. Results: The average age was 25.4 ± 6.5 years. Among the interviewed women, education was reported in 35% of the women and 55% of women estimate that the closest health facility is within 5 km to their home. The time to get to the nearest health facility is less than 15 minutes for 39% of the interviewed women. The prevalence of home delivery was 43.5%. Home delivery was related to the remoteness of the health facility (2.43 [1.75 - 3.37]) but also to incomplete antenatal care (2.52 [1.59 - 4.00]). Support groups highlighted difficulties of access to health facilities because of remoteness. Interviews revealed a lack of involvement of husbands in seeking care for women. Cultural barriers are still there. Conclusions: Despite the gratuity of delivery, the remoteness of health structures and socio-cultural factors are still barriers to access to care for pregnant women. These aspects must be taken into account in health policies. Multi-lateral interventions should be implemented to provide solutions for this health problem.