ABSTRACT
Objectives To determine factors contributing to home delivery in Kongwa District. Methods: A community-based cross-sectional study was conducted in September 2009 in which women of child-bearing age were interviewed. The variables mainly included: accessibility of maternal health care; practicing TBA's; existence of beliefs; traditional practices and reasons for home delivery. Results: Of the 400 respondents; majority (92.5) had information about the presence of a Government heath facility that provides maternal health care including delivery services. Two thirds of the respondents were found living more than 5 km away from the health facilities. Carts; bicycle and walking were the means of transport used by about 89of the Pregnant Women in the District. Only a minority(9.5) never attended the health facility for maternal health care. TBA's were known to almost 90of respondents. 65of the respondents had once delivered at home from where 62were assisted by TBA`s; 34by mothers; and 4by husbands. The main reasons for home delivery included natural habits (57.7) and unsatisfactory maternal health care (53.8). Conclusion: The proportion of women delivering at home in Kongwa district is high refl ecting an inevitable high maternal mortalityratio. Natural Habits; traditional practices and unsatisfactory maternal health care are the main factors contributing to the problem. Deliberate initiatives focusing on community based maternal health education and improving the quality of maternal care in health facilities are needed to counteract these factors in order to scale up health facility deliveries and reduce maternal death