TY  - BOOK
AU  - Halima A Mangiri
AU  - Konje, Eveline
AU  - Matovelo, Dismaas
AU  - Aliyah Dosani
TI  - Prevalence, Factors, and Outcomes Associated With Late Presentation at Heath Facility During Labour in Sengerema District,  Mwanza Tanzania
PY  - 2019///
CY  - Mwanza, Tanzania:  
PB  - Catholic University of Health and Allied Sciences [CUHAS - Bugando]
KW  - Public Health
N2  - Abstract:

Background: Timely health facility (HF) delivery assisted by skilled health care professionals is one of the key interventions in reducing the burden of maternal and neonatal deaths. However, some pregnant women in labour may delay seeking health care services and/or delay reaching the HF during labour. Due to these delays. Pregnant women and newborns are at high risk of developing a number of maternal and fetal related complications.
Objective: The aim of this study was to determine feta-maternal outcomes and factors associated with late presentation at HF during labour among women giving birth at Sengerema district: Mwanza. 

Method: This is health facility base analytical cross-sectional study involving all pregnant women aged 15-50 years who arrived for delivery at selected HF and those delivered on way to HF in Sengerema district. Based on the cervix dilatation at the arrival. Participants were considered either early presentation when they arrived at 4-9cm cervical dilatation or late presentation when they arrived at full cervical dilation or delivered on the way to HF. Data were analyzed by STATA 3.2 

Results: The prevalence of late presentation is 22.2%. Mean gestation age at first ANC visit among late presenters is 21.3±  5.3 (OR=1.0; CI=1.0-1.1; P=0.037) and 78.3% women visited once OR=0.2; CI=0.6-0.9; P=0.033). Majority of delivering women who came late were below 37 weeks 69.4% (OR=2.9; CI=1.9-4.5; P=<0.001 ). Women who came late during delivery, 51.6% did not know the sign and symptoms of labor ( OR=2.8;CI =1.5-5.2; p= 0.001 0. 58.7% had precipitated labour ( OR=2.7;CI=18-4.0; P=<0.001) AND 71.8% were waiting labour to advance (OR=5.5;CI=3.7-8.1; P=<0.001). 52.4% of delivering women who came late feared obstetric intervention ( OR= 1.8;CI1.2-2.7; P=0.004) )and 76.9% did not prepare for delivery (OR=4.5;CI=1.1-18; P=0.039). 70.8%  of delivering women who presented late did not having family member to accompany them to the HF (OR=2.7;CI=1.6-4.5; P=<0.001) and 68.2% were told to labour at home by family members (OR=0.5;CI=0.3-.=0.8; P=0.008).  Of those who have poor family /social support 53.6% (142/265) presented late at HF (OR=1.6; CI=1.0-2.4; P=0.046).

Conclusion: Starting first ANC attendance at advanced gestation age and making less than four times is associated with late presentation. Individual factors like poor knowledge of labour, fast labour, fear of obstetric intervention, waiting labour to advance and inability to prepare for delivery are factors associated with late presentation at health facility. Others factors are sociocultural such as absence of a family member to accompany delivering women to the health facility and being told to labour at home by family members are reason for late presentation at health facility during labour. 



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