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Published in: Reproductive Health 1/2019

Open Access 01-12-2019 | Care | Research

Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia

Authors: Gezahegn Tesfaye, Catherine Chojenta, Roger Smith, Deborah Loxton

Published in: Reproductive Health | Issue 1/2019

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Abstract

Background

Skilled delivery care utilization in Ethiopia is still very low compared with the goal set by the global community for countries with the highest maternal mortality. As a result, the country is overburdened with high maternal morbidity and mortality. We aimed to explore the predisposing, enabling, and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted with a total of 1294 women. The participants were selected using systematic sampling techniques. An interviewer-administered structured questionnaire aided by an electronic survey tool was used to collect data. Univariate analyses were conducted to describe the study sample. Bivariate and multivariate logistic regression analyses were carried out to elicit the association of predisposing, enabling, and need factors associated with skilled delivery care utilization. Separate multivariate models were fitted for primiparous and multiparous women categories. Odds ratios with 95% confidence intervals were used to assess statistical significance.

Results

More than a quarter (30.8%) of the women surveyed used skilled delivery care for their most recent birth. Significant predisposing factors were as follows: presence of educated family member; receiving education on maternal health; previous use of skilled delivery care; and best friend’s use of maternal care. Place of residence was the enabling factor that predicted skilled delivery care use. Antenatal care attendance and pregnancy intention were significant need factors associated with skilled delivery care utilization.

Conclusion

The findings of the study highlight the need for a concerted effort to establish community-based peer education programs; improve access to family planning services (to reduce unintended pregnancies); increase antenatal care uptake; and facilitate access to skilled delivery care in rural areas.
Literature
1.
go back to reference WHO. Trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015. WHO. Trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.
2.
go back to reference Bayu H, Adefris M, Amano A, Abuhay M. Pregnant women’s preference and factors associated with institutional delivery service utilization in Debra Markos Town, North West Ethiopia: a community based follow up study. BMC Pregnancy Childbirth. 2015;15(15). Bayu H, Adefris M, Amano A, Abuhay M. Pregnant women’s preference and factors associated with institutional delivery service utilization in Debra Markos Town, North West Ethiopia: a community based follow up study. BMC Pregnancy Childbirth. 2015;15(15).
3.
go back to reference Bryce J, Black R, Victora C. Millennium development goals 4 and 5: progress and challenges. BMC Med. 2013;11(225):1–4. Bryce J, Black R, Victora C. Millennium development goals 4 and 5: progress and challenges. BMC Med. 2013;11(225):1–4.
4.
go back to reference Graham W, Bell J, Bullough C. Can skilled attendance at delivery reduce maternal mortality in developing countries? vol. 17: Studies in HSO & P; 2001:97–129. Graham W, Bell J, Bullough C. Can skilled attendance at delivery reduce maternal mortality in developing countries? vol. 17: Studies in HSO & P; 2001:97–129.
5.
go back to reference Berhan Y, Berhan A. Commentary: Actions in the pipline and the way forward to reduce maternal and perinatal mortality in Ethiopia. Ethiop J Health Sci. 2014;(Special issue):149–64.CrossRef Berhan Y, Berhan A. Commentary: Actions in the pipline and the way forward to reduce maternal and perinatal mortality in Ethiopia. Ethiop J Health Sci. 2014;(Special issue):149–64.CrossRef
6.
go back to reference Campbell O, Graham W. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368:1284–99.CrossRef Campbell O, Graham W. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368:1284–99.CrossRef
7.
go back to reference Ronsmans C, Graham W. Maternal mortality: who, when, where, and why. Lancet. 2006;368(9542):1189–200.CrossRef Ronsmans C, Graham W. Maternal mortality: who, when, where, and why. Lancet. 2006;368(9542):1189–200.CrossRef
9.
go back to reference UN. The Millennium Development Goals Report. 2011. UN. The Millennium Development Goals Report. 2011.
10.
go back to reference CSA. Ethiopian Demographic and Health Survey 2016. CSA. Ethiopian Demographic and Health Survey 2016.
11.
go back to reference UNFPA. Key actions for the further implementation of the Programme of Action of the International Conference on Population and Development +5: United Nations Population Fund. New York: Twenty-first special session; 1999. UNFPA. Key actions for the further implementation of the Programme of Action of the International Conference on Population and Development +5: United Nations Population Fund. New York: Twenty-first special session; 1999.
12.
go back to reference Crowe S, Utley M, Costello A, Pagel C. How many births in sub-Saharan Africa and South Asia will not be attended by a skilled birth attendant between 2011 and 2015? BMC Pregnancy Childbirth. 2012;12(4). Crowe S, Utley M, Costello A, Pagel C. How many births in sub-Saharan Africa and South Asia will not be attended by a skilled birth attendant between 2011 and 2015? BMC Pregnancy Childbirth. 2012;12(4).
13.
go back to reference Pearson L, Gandhi M, Admasu K, Keyes E. User fees and maternity services in Ethiopia. Int J Gynecol Obstet. 2011;115:311–5.CrossRef Pearson L, Gandhi M, Admasu K, Keyes E. User fees and maternity services in Ethiopia. Int J Gynecol Obstet. 2011;115:311–5.CrossRef
14.
go back to reference Amano A, Gebeyehu A, Birhanu Z. Institutional delivery service utilization in Munisa Woreda, south East Ethiopia: a community based cross-sectional study. BMC Pregnancy Childbirth. 2012;12(105):1–6. Amano A, Gebeyehu A, Birhanu Z. Institutional delivery service utilization in Munisa Woreda, south East Ethiopia: a community based cross-sectional study. BMC Pregnancy Childbirth. 2012;12(105):1–6.
15.
go back to reference Nigussie M, Hailemariam D, Mitike G. Assessment of safe delivery service utilization among women of childbearing age in north Gondar Zone, north west Ethiopia. Ethiop J Health Dev. 2004;18(3):145–52. Nigussie M, Hailemariam D, Mitike G. Assessment of safe delivery service utilization among women of childbearing age in north Gondar Zone, north west Ethiopia. Ethiop J Health Dev. 2004;18(3):145–52.
16.
go back to reference Worku A, Yalew A, Afework M. Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis. BMC Int Health Hum Rights. 2013;13(20). Worku A, Yalew A, Afework M. Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis. BMC Int Health Hum Rights. 2013;13(20).
17.
go back to reference Workineh Y, Hailu D. Factors affecting utilization of postnatal care service in Jabitena district, Amhara region. Ethiopia Sci J Public Health. 2014;2(3):169–76.CrossRef Workineh Y, Hailu D. Factors affecting utilization of postnatal care service in Jabitena district, Amhara region. Ethiopia Sci J Public Health. 2014;2(3):169–76.CrossRef
18.
go back to reference Habte F, Demissie M. Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study. BMC Pregnancy Childb. 2015;15(299). Habte F, Demissie M. Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study. BMC Pregnancy Childb. 2015;15(299).
19.
go back to reference Dutamo Z, Assefa N, Egata G. Maternal health care use among married women in Hossaina, Ethiopia. BMC Health Serv Res. 2015;15(365). Dutamo Z, Assefa N, Egata G. Maternal health care use among married women in Hossaina, Ethiopia. BMC Health Serv Res. 2015;15(365).
20.
go back to reference Melaku Y, Weldearegawi B, Tesfay F, Abera S, Abraham L, Aregay A, et al. Poor linkages in maternal health care services? evidence on antenatal care and institutional delivery from a community-based longitudinal study in Tigray region, Ethiopia. BMC Pregnancy Childbirth. 2014;14(418). Melaku Y, Weldearegawi B, Tesfay F, Abera S, Abraham L, Aregay A, et al. Poor linkages in maternal health care services? evidence on antenatal care and institutional delivery from a community-based longitudinal study in Tigray region, Ethiopia. BMC Pregnancy Childbirth. 2014;14(418).
21.
go back to reference CSA. The Ethiopian Mini Health and Demographic Survey. Addis Ababa, Ethiopia, Calverton, Maryland, USA: Central Statistical Agency of Ethiopia, 2014. CSA. The Ethiopian Mini Health and Demographic Survey. Addis Ababa, Ethiopia, Calverton, Maryland, USA: Central Statistical Agency of Ethiopia, 2014.
22.
go back to reference USAID/MCHIP. Cultural Barriers to Seeking Maternal Health Care in Ethiopia: A Review of the Literature. 2012. USAID/MCHIP. Cultural Barriers to Seeking Maternal Health Care in Ethiopia: A Review of the Literature. 2012.
23.
go back to reference Regassa N. Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study. Afr Health Sci. 2011;11(3):390–97. Regassa N. Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study. Afr Health Sci. 2011;11(3):390–97.
24.
go back to reference Islam N, Islam MT, Yoshimura Y. Practices and determinants of delivery by skilled birth attendants in Bangladesh. Reprod Health. 2014;11:86.CrossRef Islam N, Islam MT, Yoshimura Y. Practices and determinants of delivery by skilled birth attendants in Bangladesh. Reprod Health. 2014;11:86.CrossRef
25.
go back to reference Geneti K. Statistical analysis of determinants of maternal institutional delivery service utilization in Ethiopia. Am J Theoretical App Stat. 2015;4(3):71–7.CrossRef Geneti K. Statistical analysis of determinants of maternal institutional delivery service utilization in Ethiopia. Am J Theoretical App Stat. 2015;4(3):71–7.CrossRef
26.
go back to reference Warren C. Care seeking for maternal health: challenges remain for poor women. Ethiop J Health Dev. 2010;24(Special 1):100–4. Warren C. Care seeking for maternal health: challenges remain for poor women. Ethiop J Health Dev. 2010;24(Special 1):100–4.
27.
go back to reference Andersen R. Revisiting the behavioural model and access to medical care: does it matter? J Health Soc Behav. 1995;36(March):1–10.CrossRef Andersen R. Revisiting the behavioural model and access to medical care: does it matter? J Health Soc Behav. 1995;36(March):1–10.CrossRef
28.
go back to reference Anderson R, Newman JF. Societal and individual determinants of medical care utilization in the United States remove. Milbank Mem Fund Q Health Soc. 1973;51(1):95–124.CrossRef Anderson R, Newman JF. Societal and individual determinants of medical care utilization in the United States remove. Milbank Mem Fund Q Health Soc. 1973;51(1):95–124.CrossRef
29.
go back to reference UNFPA. Summary and Statistical Report of 2007. Addis Ababa: Population and Housing Census; 2008. UNFPA. Summary and Statistical Report of 2007. Addis Ababa: Population and Housing Census; 2008.
30.
go back to reference CSA. Population Projection of Ethiopia for All Regions At Wereda Level from 2014–2017. 2014. CSA. Population Projection of Ethiopia for All Regions At Wereda Level from 2014–2017. 2014.
31.
go back to reference Kersa-DHO. Health service coverage. Kersa District Health Office, Eastern Hararge, Ethiopia. 2011. Kersa-DHO. Health service coverage. Kersa District Health Office, Eastern Hararge, Ethiopia. 2011.
32.
go back to reference Sarah M, Spencer M. On est ensemble: social capital and maternal health care use in rural Cameroon. Glob Health. 2015;11(33). Sarah M, Spencer M. On est ensemble: social capital and maternal health care use in rural Cameroon. Glob Health. 2015;11(33).
33.
go back to reference Assfaw Y. Determinants of antenatal care, institutional delivery and skilled birth attendant utilization in Samre Saharti District, Tigray, Ethiopia [master thesis ]: Umea; 2010. Assfaw Y. Determinants of antenatal care, institutional delivery and skilled birth attendant utilization in Samre Saharti District, Tigray, Ethiopia [master thesis ]: Umea; 2010.
34.
go back to reference Ayele D, Belayihun B, Teji K, Ayana D. Factors affecting utilization of maternal health Care Services in Kombolcha District, eastern Hararghe zone, Oromia regional state, Eastern Ethiopia. Int Sch Res Notices. 2014;2014:7. Ayele D, Belayihun B, Teji K, Ayana D. Factors affecting utilization of maternal health Care Services in Kombolcha District, eastern Hararghe zone, Oromia regional state, Eastern Ethiopia. Int Sch Res Notices. 2014;2014:7.
35.
go back to reference CSA. Ethiopia Demographic and Health Survey 2011 Addis Ababa, Ethiopia and Calverton. Maryland: Central Statistical Agency and ICF International; 2011. CSA. Ethiopia Demographic and Health Survey 2011 Addis Ababa, Ethiopia and Calverton. Maryland: Central Statistical Agency and ICF International; 2011.
36.
go back to reference JHPIEGO. Tools and indicators for maternal and newborn health 2004. JHPIEGO. Tools and indicators for maternal and newborn health 2004.
37.
go back to reference Tsegay Y, Gebrehiwot T, Goicolea I, Edin K, Lemma H, Sebastian M. Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: a cross-sectional study. Int J Equity Health. 2013;12(30).CrossRef Tsegay Y, Gebrehiwot T, Goicolea I, Edin K, Lemma H, Sebastian M. Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: a cross-sectional study. Int J Equity Health. 2013;12(30).CrossRef
38.
go back to reference Medhanyie A, Spigt M, Kifle Y, Schaay N, Sanders D, Blanco R, et al. The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study. BMC Health Serv Res. 2012;12(352). Medhanyie A, Spigt M, Kifle Y, Schaay N, Sanders D, Blanco R, et al. The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study. BMC Health Serv Res. 2012;12(352).
39.
go back to reference Anastasia J. Barriers to the utilization of maternal health care in rural Mali. Soc Sci Med. 2007;2007(65):1666–82. Anastasia J. Barriers to the utilization of maternal health care in rural Mali. Soc Sci Med. 2007;2007(65):1666–82.
40.
go back to reference Zimmerman E, Woolf SH. Understanding the relationship between education and health; 2014.CrossRef Zimmerman E, Woolf SH. Understanding the relationship between education and health; 2014.CrossRef
41.
go back to reference Karkee R, Baral OB, Khanal V, Lee AH. The role of obstetric knowledge in utilization of delivery service in Nepal. Health Educ Res. 2014;29(6):1041–8.CrossRef Karkee R, Baral OB, Khanal V, Lee AH. The role of obstetric knowledge in utilization of delivery service in Nepal. Health Educ Res. 2014;29(6):1041–8.CrossRef
42.
go back to reference Kebede B, Gebeyehu A, Andargie G. Use of previous maternal health services has a limited role in reattendance for skilled institutional delivery: cross-sectional survey in Northwest Ethiopia. Int J Women's Health. 2013;2013(5):79–85.CrossRef Kebede B, Gebeyehu A, Andargie G. Use of previous maternal health services has a limited role in reattendance for skilled institutional delivery: cross-sectional survey in Northwest Ethiopia. Int J Women's Health. 2013;2013(5):79–85.CrossRef
43.
go back to reference Lowe ML, Haws KL. (Im) moral support: the social outcomes of parallel self-control decisions. J Consum Res. 2014;41(2):489–505.CrossRef Lowe ML, Haws KL. (Im) moral support: the social outcomes of parallel self-control decisions. J Consum Res. 2014;41(2):489–505.CrossRef
44.
go back to reference Story WT. Social capital and the utilization of maternal and child health services in India: a multilevel analysis. Health Place. 2015;28:73–84.CrossRef Story WT. Social capital and the utilization of maternal and child health services in India: a multilevel analysis. Health Place. 2015;28:73–84.CrossRef
45.
go back to reference Fikre A, Demissie M. Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state, Ethiopia. Reprod Health. 2012;9(33):1–6. Fikre A, Demissie M. Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state, Ethiopia. Reprod Health. 2012;9(33):1–6.
46.
go back to reference Exavery A, Kanté A, Njozi M, Tani K, Doctor H, Hingora A, et al. Access to institutional delivery care and reasons for home delivery in three districts of Tanzania. Int J Equity Health. 2014;13(48):1–11. Exavery A, Kanté A, Njozi M, Tani K, Doctor H, Hingora A, et al. Access to institutional delivery care and reasons for home delivery in three districts of Tanzania. Int J Equity Health. 2014;13(48):1–11.
47.
go back to reference Fapohunda B, Orobaton N. When Women Deliver with No One Present in Nigeria: Who, What, Where and So What? PLoS One. 2015;8(7).CrossRef Fapohunda B, Orobaton N. When Women Deliver with No One Present in Nigeria: Who, What, Where and So What? PLoS One. 2015;8(7).CrossRef
48.
go back to reference Wado Y, Fantahun M, Hindin M. Unintended pregnancies and the use of maternal health services in southwestern Ethiopia. BMC Int Health Hum Rights. 2013;13(36):1–8. Wado Y, Fantahun M, Hindin M. Unintended pregnancies and the use of maternal health services in southwestern Ethiopia. BMC Int Health Hum Rights. 2013;13(36):1–8.
49.
go back to reference Birmeta K, Dibaba Y, Woldeyohannes D. Determinants of maternal health care utilization in Holeta town, central Ethiopia. BMC Health Serv Res. 2013;13(256). Birmeta K, Dibaba Y, Woldeyohannes D. Determinants of maternal health care utilization in Holeta town, central Ethiopia. BMC Health Serv Res. 2013;13(256).
50.
go back to reference Turyasiima M, Tugume R, Openy A, Ahairwomugisha E, Opio R, Ntunguka M, et al. Determinants of first antenatal care visit by pregnant women at community based education, research and service sites in northern Uganda. East Afr Med J. 2014;91(9):317–22.PubMedPubMedCentral Turyasiima M, Tugume R, Openy A, Ahairwomugisha E, Opio R, Ntunguka M, et al. Determinants of first antenatal care visit by pregnant women at community based education, research and service sites in northern Uganda. East Afr Med J. 2014;91(9):317–22.PubMedPubMedCentral
51.
go back to reference Bogale D, Markos D. Knowledge of obstetric danger signs among child bearing age women in Goba district, Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth. 2014;15(77). Bogale D, Markos D. Knowledge of obstetric danger signs among child bearing age women in Goba district, Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth. 2014;15(77).
52.
go back to reference JO P, Penn-Kekana L, Blaauw D, Balabanova D, Danishevski K, Rahman SA, et al. Health systems factors influencing maternal health services: a four-country comparison. Health Policy. 2005;73(2):127–38.CrossRef JO P, Penn-Kekana L, Blaauw D, Balabanova D, Danishevski K, Rahman SA, et al. Health systems factors influencing maternal health services: a four-country comparison. Health Policy. 2005;73(2):127–38.CrossRef
Metadata
Title
Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia
Authors
Gezahegn Tesfaye
Catherine Chojenta
Roger Smith
Deborah Loxton
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
Reproductive Health / Issue 1/2019
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-019-0829-z

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