Determinants Of Home Births Among Women in Mazabuka District Of Southern Province, Zambia

Determinants of Home Births among women in Mazabuka District of Southern Province, Zambia 1Olivet Banda, 2Prof. Catherine Ngoma, 3Ms Susan Mutemwa 1 Postgraduate student, 2 Senior Lecturer, 3 Lecturer 1Institute of Distance Education, School of Nursing Sciences, 1University of Zambia, Lusaka, Zambia 1 [email protected],[email protected],[email protected] Corresponding author: Olivet Banda, email address : [email protected] Background: Home births remain a major public health concern, particularly in developing regions such as Zambia, where many women give birth without skilled assistance. Despite recommendations by the World Health Organisation for skilled birth attendance, women continue to deliver from home. This contributes to high neonatal and maternal morbidity and mortality, undermining efforts to achieve the third Sustainable Development Goal of reducing the global maternal mortality rate to less than 70 per 100,000 live births by 2030. This study therefore investigated the determinants of home births in Mazabuka district, Zambia. Methods: The study was conducted in four health facilities (Shimungalu Rural Health Post, Mugoto Rural Health Centre, Nakambala Urban Health Centre, and Mazabuka General Hospital) in Mazabuka District, Southern Province of Zambia. The study employed a quantitative analytical cross-sectional design, involving 428 randomly selected postnatal women. The data was collected through a researcher-administered structured interview questionnaire and analysed using SPSS version 25.0 at 5% significance level. Results: Study participants had a median age of 28 years (IQR: 22–32), most were married (59.4%, n=254), attained secondary education (40.9%, n=175), and earned below K5,000 monthly (76%, n=276). Home births occurred in 5.8% (n=25) of participants. At bivariate analysis, factors associated with home births included age (p=0.0024), marital status (p=0.004), education (p=0.004), employment status (p=0.043), monthly income (p=0.037), parity (p=0.027), timing of ANC (p<0.001), gestation at delivery (p<0.001), financial preparedness (p=0.003), and distance to health facilities (p<0.001). Multivariable analysis revealed that higher education (aOR=0.36, 95% CI: 0.14–0.92, p=0.032), previous caesarean delivery (aOR=0.10, 95% CI: 0.02–0.53, p=0.007), full-term delivery (aOR=0.25, 95% CI: 0.09–0.73, p=0.011), and proximity to health facilities (aOR=0.14, 95% CI: 0.05–0.38, p<0.001) significantly reduced odds of home births. Conclusion: The study revealed a low prevalence of home births in Mazabuka District, reflecting progress in maternal health. However, socio-demographic and obstetric factors were identified as key barriers to facility delivery. Addressing home births in the district requires improving education, reducing financial barriers, and enhancing healthcare infrastructure.