Maternal and newborn health services utilization in Jimma Zone, Southwest Ethiopia: a community based cross-sectional study

• Published in: BMC pregnancy and childbirth 2019-05, Vol.19 (1), p.178-178, Article 178
• Main Authors: Dadi, Lelisa Sena, Berhane, Melkamu, Ahmed, Yusuf, Gudina, Esayas Kebede, Berhanu, Tasew, Kim, Kyung Hwan, Getnet, Masrie, Abera, Muluemabet
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Antenatal care; Cross-Sectional Studies; Delivery services; Delivery, Obstetric - methods; Delivery, Obstetric - statistics & numerical data; Ethiopia; Facilities and Services Utilization - statistics & numerical data; Female; Health facilities; Health Facilities - statistics & numerical data; Health services utilization; Home Childbirth - statistics & numerical data; Humans; Infant, Newborn; Intervention; Jimma/Ethiopia; Logistic Models; Maternal & child health; Maternal mortality; Maternal-Child Health Services - statistics & numerical data; Mothers - statistics & numerical data; Neonatal care; Newborn babies; Odds Ratio; Patient Acceptance of Health Care - statistics & numerical data; Perinatal care; Postnatal care; Postnatal Care - statistics & numerical data; Postpartum period; Pregnancy; Prenatal care; Prenatal Care - statistics & numerical data; Public health; Surveys and Questionnaires; Survival analysis; Womens health; Young Adult
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-019-2335-2

Majority of causes of maternal and newborn mortalities are preventable. However, poor access to and low utilization of health services remain major barriers to optimum health of the mothers and newborns. The objectives of this study were to assess maternal and newborn health services utilization and factors affecting mothers' health service utilization. A community based cross-sectional survey was carried out on randomly selected mothers who gave birth within a year preceding the survey. The survey was supplemented with key informant interviews of experts/health professionals. Multivariable logistic model was used to identify factors associated with service utilization. Adjusted odds ratios (AORs) were used to assess the strength of the associations at p-value ≤0.05. The qualitative data were summarized thematically. A total of 789 (99.1% response rate) mothers participated in the study. The proportion of the mothers who got at least one antennal care (ANC) visit, institutional delivery and postnatal care (PNC) were 93.3, 77.4 and 92.0%, respectively. Three-forth (74.2%) of the mothers started ANC lately and only 47.5% of them completed ANC + visits. Medium (4-6) family size (AOR: 2.3; 95% CI: 1.1, 4.9), decision on ANC visits with husband (AOR: 30.9; 95% CI: 8.3, 115.4) or husband only (AOR: 15.3; 95%CI: 3.8, 62.3) and listening to radio (AOR: 2.5; 95%CI: 1.1, 5.6) were associated with ANC attendance. Mothers whose husbands read/write (AOR: 1.6; 95% CI: 1.1, 2.), attended formal education (AOR: 2.8; 95% CI: 1.1, 6.8), have positive attitudes (AOR: 10.2; 95% CI: 25.9), living in small (AOR: 3.0; 95% CI: 1.2, 7.6) and medium size family (AOR: 2.3; 95% CI: 1.2, 4.1) were more likely to give birth in-health facilities. The proportion of PNC checkups among mothers who delivered in health facilities and at home were 92.0 and 32.5%, respectively. The key informants mentioned that home delivery, delayed arrival of the mothers, unsafe delivery settings, shortage of skilled personnel and supplies were major obstacles to maternal health services utilization. Health information communication targeting husbands may improve maternal and newborn health services utilization. In service training of personnel and equipping health facilities with essential supplies can improve the provider side barriers.