BACKGROUND: Maternal healthcare services in Tamil Nadu are provided both by public and private sector. The changing pattern in the place of delivery over years is influenced by multitude factors. This includes personal preferences, family choices, and other system related factors. This study aims at determining the factors that influence choice of delivery among women who delivered in the year 2022 in Tamil Nadu.
METHODS : Quantitative study using descriptive design was done among mothers who delivered in the last 1 month (August 2022) in Tamil Nadu. One Urban and rural PHC was randomly selected from each Health Unit District excluding Chennai. All women who delivered in the month of August 2022 was obtained from PICME irrespective of the outcome of delivery in the selected PHC area. Mothers who did not give consent to participate in the study and those who were not available even after three attempts were excluded from the study. The mothers were approached by the Mobile Medical Unit of the respective block and the women interviewed using semi-structured questionnaire.
RESULTS : A total of 1143 mothers were approached, out of which 865 women consented to participate in the study. Among the 865 study participants, 538 (62% -95% CI -58.8- 65.4%) had delivered at a public facility ,in particular more than 25% of the deliveries happened in medical college hospital and10% in PHC. Among the various demographic factors, 75% of rural women delivered in public facility compared to only 50% in urban slum and non-slum area. There is also difference based on religion, caste, education level, economic status on place of delivery. Public health facilities are sought after for registration and getting antenatal services. The place of delivery is chosen predominantly based on distance, familiarity with the facility and availability of skilled personnel and medicine.
CONCLUSION : The choice of place of delivery is defined by the socioeconomic and demographic factors. As the population moves up in the social ladder, preference for private facilities is higher. Public facilities can be assigned specific roles and referral linkage shall be strengthened with regard to maternal care to increase its efficiency, with PHCs performing antenatal and postnatal care services, the higher centres shall focus on providing intrapartum care.