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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Human Immunodeficiency Virus | Research

Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study

Authors: Agnes Napyo Kasede, Thorkild Tylleskär, David Mukunya, Josephine Tumuhamye, Grace Ndeezi, Anna Agnes Ojok Arach, Paul Waako, James K. Tumwine

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

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Abstract

Background

Home delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and risk factors for home delivery among women living with HIV in Lira, Northern Uganda.

Methods

This prospective cohort study was conducted between August 2018 and January 2020 in Lira district, Northern Uganda. A total of 505 HIV infected women receiving antenatal care at Lira regional referral hospital were enrolled consecutively and followed up at delivery. We used a structured questionnaire to obtain data on exposures which included: socio-demographic, reproductive-related and HIV-related characteristics. Data was analysed using Stata version 14.0 (StataCorp, College Station, Texas, U.S.A.). We estimated adjusted risk ratios using Poisson regression models to ascertain risk factors for the outcome of interest which was home delivery (which is delivering an infant outside a health facility setting under the supervision of a non-health worker).

Results

The incidence of home delivery among women living with HIV was 6.9% (95%CI: 4.9–9.5%). Single women were more likely to deliver at home (adjusted risk ratio = 4.27, 95%CI: 1.66–11). Women whose labour started in the night (night time onset of labour ARR = 0.39, 95%CI: 0.18–0.86) and those that were adherent to their ART (ARR = 0.33, 95%CI: 0.13–0.86) were less likely to deliver at home.

Conclusion

Home delivery remains high among women living with HIV especially those that do not have a partner. We recommend intensified counselling on birth planning and preparedness in the context of HIV and PMTCT especially for women who are: separated, divorced, widowed or never married and those that are not adherent to their ART.
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Metadata
Title
Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
Authors
Agnes Napyo Kasede
Thorkild Tylleskär
David Mukunya
Josephine Tumuhamye
Grace Ndeezi
Anna Agnes Ojok Arach
Paul Waako
James K. Tumwine
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-04222-5

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