Dakar, 20 October -- The majority of communities in four selected African countries still prefer to have babies delivered at home rather than in health facilities, according to the findings of a study conducted in four countries by the World Health Organization (WHO).

"The survey, conducted in Angola, Ethiopia, Nigeria and Senegal over a four-month period in 2003, shows that an average of 70% of deliveries in these counties were in the home" said Dr Andrew Kosia, the Regional Adviser for Reproductive Health Research at the Brazzaville-based WHO Regional Office for Africa, which initiated the study.

Dr Kosia presented the findings of the study at the second meeting of the WHO Africa Regional Reproductive Health Task Force taking place from 20-24 October in Dakar, Senegal.

The trend of home deliveries in all four countries surveyed followed a largely similar pattern in both urban and rural areas with rural areas having higher percentages of home deliveries, Dr Kosia told the meeting.

In Angola, 75% of deliveries documented were in urban areas while 90% were in rural areas. The findings for the other three countries were: Ethiopia - 76.4% urban, 94% rural; Nigeria 70% urban, 92% rural; and Senegal, 70% urban and 76% rural. The Nigeria study focused on Kano State, one of most populous of the 36 states in the country.

Other findings of the study were that 61% of home deliveries in the four countries were handled by Traditional Birth Attendants (TBAs), 20% by nurses, 15% by midwives and 4% by doctors.

The study also identified reasons for the high percentage of home deliveries in the four countries which represent Africa's four sub-regions.

These range from fear of surgical procedures, to the negative attitude of staff in health facilities -- where services are expensive and often unaffordable -- to the purely cultural, as communities regard the arrival of a new baby as a joyful occasion which should take place in the home, rather than outside it.

The objectives of the study were to investigate the practice of home deliveries, determine the linkage between the practice of deliveries at home and in health facilities, and document the positive and negative aspects of home deliveries.

Among the criteria used for the selection of the countries surveyed were geographical location, size of country, linguistic consideration, level of maternal mortality, diversity of cultural practices and the willingness of the countries to participate in the survey.

The presentation by Dr Kosia was followed by a lively discussion on the desirability or otherwise of promoting institutional deliveries. The weaknesses of African health systems that prevent women from delivering there were also discussed extensively.

Participants agreed that the study provided important preliminary data on the reality of home deliveries in the Region and that further research was needed to determine policy and implementation issues regarding home deliveries in the Region.

For further information,

Media contacts: 
Samuel T. Ajibola Khalifa, Mbengue
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Email: ajibolas [at] afro.who.int ; mbengueh [at] oms.sn

Technical contact: 
Dr Doyin Oluwole 
Director, Division of Family and Reproductive Health 
Tel: +47 241 39478
Email: oluwoled [at] afro.who.int