Determinants of Childbirth Choice in Rural Senegal: Mixed-Methods Analysis Using Data from the Niakhar Demographic Surveillance System

Background: Faced with high rates of home births and maternal mortality, the Senegalese government has made enormous efforts to improve the provision of care. However, the use of health facilities for home births remains a challenge. Materials and methods: The study used a mixed-methods approach. Data from women who gave birth in the Niakhar observatory area between 1983 and 2020 were used, and chi-square tests and qualitative analyses were performed. Results: The results show that all variables are significant at the 0.5% level. Women giving birth at home were those who were married, griottes, poor, uneducated, aged 35-49, had given birth more than four times and had had fewer than two antenatal consultations. Qualitative results showed that physical condition, lack of understanding, privacy concerns of older women and economic barriers all contributed to the increase in the phenomenon. Conclusion: In rural areas, health problems are complex and require a more integrated approach. Determinants can run counter to the public policies put in place. It is therefore essential, when developing health policies, to integrate measures adapted to the type of population.