BMC Pregnancy and Childbirth | |
Poor linkages in maternal health care services—evidence on antenatal care and institutional delivery from a community-based longitudinal study in Tigray region, Ethiopia | |
John Kinsman5  Yihunie Lakew4  Ashenafi Haile2  Friehiwot Eshetu2  Yemane Ashebir1  Alemseged Aregay6  Loko Abraham3  Semaw Ferede Abera1  Fisaha Haile Tesfay1  Berhe Weldearegawi1  Yohannes Adama Melaku1  | |
[1] Department of Public Health, Mekelle University, College of Health Sciences, Mekelle, Ethiopia;Center for Disease Control and Prevention, CDC-Ethiopia, Addis Ababa, Ethiopia;Department of Medicine, Mekelle University, College of Health Sciences, Mekelle, Ethiopia;Ethiopian Public Health Association (EPHA), Addis Ababa, Ethiopia;Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå 901 85, Sweden;Department of Nursing, Mekelle University, College of Health Sciences, Mekelle, Ethiopia | |
关键词: Northern Ethiopia; Kilte-Awlaelo; Health and demographic surveillance system; Institutional delivery; Antenatal care; | |
Others : 1090751 DOI : 10.1186/s12884-014-0418-7 |
|
received in 2014-03-29, accepted in 2014-12-05, 发布年份 2014 | |
【 摘 要 】
Background
Progress towards attaining the maternal mortality and maternal health targets set by Millennium Development Goal 5 has been slow in most African countries. Assessing antenatal care and institutional delivery service utilization and their determinants is an important step towards improving maternal health care services.
Methods
Data were drawn from the longitudinal database of Kilite-Awlaelo Health and Demographic Surveillance System. A total of 2361 mothers who were pregnant and who gave birth between September 2009 and August 2013 were included in the analysis. Potential variables to explain antenatal care and institutional delivery service utilization were extracted, and descriptive statistics and logistic regression were used to determine the magnitude of maternal health care service utilization and associated factors, respectively.
Results
More than three-quarters, 76% [95% CI: 74.8%-78.2%] (n = 1806), of mothers had undergone at least one antenatal care visit during their previous pregnancy. However, only 27% [95% CI: 25.3%-28.9%] (n = 639) of mothers gave birth at a health institution. Older mothers, urban residents, mothers with higher education attainment, and farmer mothers were more likely to use antenatal care. Institutional delivery services were more likely to be used among older mothers, urban residents, women with secondary education, mothers who visited antenatal care, and mothers with lower parity.
Conclusions
Despite a relatively high proportion of mothers attending antenatal care services at least once, we found low levels of institutional delivery service utilization. Health service providers in Kilite-Awlaelo should be particularly vigilant regarding the additional maternal health needs of rural and less educated women with high parity.
【 授权许可】
2014 Melaku et al.; licensee BioMed Central.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150128163112993.pdf | 379KB | download | |
Figure 5. | 26KB | Image | download |
Figure 4. | 20KB | Image | download |
Figure 3. | 34KB | Image | download |
Figure 2. | 28KB | Image | download |
Figure 1. | 20KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
Figure 5.
【 参考文献 】
- [1]Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, et al: Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013.Lancet 2014. S0140-6736(14)60696-6; http://dx.doi.org/10.1016/S0140-6736(14)60696-6.
- [2]WHO, UNICEF: Countdown to 2015: Building a Future for Women and Children. WHO and UNICEF, Geneva; 2012.
- [3]Pervin J, Moran A, Rahman M, Razzaque A, Sibley L, Streatfield PK, Reichenbach LJ, Koblinsky M, Hruschka D, Rahman A: Association of antenatal care with facility delivery and perinatal survival–a population-based study in Bangladesh. BMC Pregnancy Childbirth 2012, 12:111. BioMed Central Full Text
- [4]Adegoke A, Van den Broek N: Skilled birth attendance-lessons learnt. BJOG 2009, 116:33-40.
- [5]Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, Nampala PM, Lawn JE: Sub-Saharan Africa’s mothers, newborns, and children: where and why do they die? PLoS Med 2010, 7(6):e1000294.
- [6]Gabrysch S, Campbell OM: Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth 2009, 9:34. BioMed Central Full Text
- [7]Campbell OM, Graham WJ: Strategies for reducing maternal mortality: getting on with what works. Lancet 2006, 368(9543):1284-1299.
- [8]WHO/UNFPA/UNICEF/World Bank: Reduction of maternal mortality: a joint WHO/UNFPA/UNICEF/World Bank statement.http://whqlibdoc.who.int/publications/1999/9241561955_eng.pdf.
- [9]WHO: Antenatal Care in Developing Countries: Promises, Achievements and Missed Opportunities: an Analysis of Trends, Levels and Differentials, 1990–2001. Geneva: Switzerland; 2003.
- [10]Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L: Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014, 2:e323-e333.
- [11]Central Statistical Agency [Ethiopia]: Ethiopia Mini Demographic and Health Survey 2014. Addis Ababa, Ethiopia; 2014.
- [12]Ali A, Osman M, Abbaker A, Adam I: Use of antenatal care services in Kassala, Eastern Sudan. BMC Pregnancy Childbirth 2010, 10:67. BioMed Central Full Text
- [13]Teffera S, Alemu M, Woldeyohannes M: Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: a community based cross sectional study. BMC Pregnancy Childbirth 2012, 12:74. BioMed Central Full Text
- [14]Abeje G, Azage M, Setegn T: Factors associated with Institutional delivery service utilization among mothers in Bahir Dar City administration, Amhara region: a community based cross sectional study. Reproductive Health 2014, 11:22. BioMed Central Full Text
- [15]Ochako R, Fotso JC, Ikamari L, Khasakhala A: Utilization of maternal health services among young women in Kenya: insights from the kenya Demographic and Health Survey, 2003. BMC Pregnancy Childbirth 2011, 11:1. BioMed Central Full Text
- [16]Simkhada B, Teijlingen ER, Porter M, Simkhada P: Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. J Adv Nurs 2008, 61(3):244-260.
- [17]Stella B, Adesegun F: Determinants of use of maternal health Services in Nigeria-looking beyond individual and household factors. BMC Pregnancy Childbirth 2009, 9:43. BioMed Central Full Text
- [18]Agus Y, Horiuchi S: Factors influencing the use of antenatal care in rural West Sumatra, Indonesia. BMC Pregnancy Childbirth 2012, 12:9. BioMed Central Full Text
- [19]Fekede B, G/Mariam A: Antenatalcare services utilization and factors associated in Jimma Town (south west Ethiopia). Ethiop Med J 2007, 45:123-133.
- [20]Singh PK, Rai RK, Alagarajan M, Singh L: Determinants of maternity care services utilization among married adolescents in Rural India. PLoS One 2012, 7(2):e31666. doi:10.1371/journal.pone.0031666
- [21]Titaly R, Hunter L, Dibley J, Heywood P: Why do some women still prefer traditional birth attendants and home delivery?-a qualitative study or delivery care service in west Java province, Indonsia. BMC Pregnancy Childbirth 2010, 10:43. BioMed Central Full Text
- [22]Das S, Bapat U, More S, Chordhekar L, Joshi W, Osrin D: Prospective study of determinants and costs of home births in Mumbai slums. BMC Pregnancy Childbirth 2010, 10:38. BioMed Central Full Text
- [23]Wilunda C, Quaglio G, Putoto G, Lochoro P, Dall’Oglio G, Manenti F, Atzori A, Lochiam RM, Takahashi R, Mukundwa A, Oyerinde K: A qualitative study on barriers to utilisation of institutional delivery services in Moroto and Napak districts, Uganda: implications for programming. BMC Pregnancy Childbirth 2014, 14:259. BioMed Central Full Text
- [24]CSA: ICF International Ethiopia Demographic and Health Survey 2012. Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2011.
- [25]Mpembeni RN: Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy Childbirth 2007, 7:29. BioMed Central Full Text
- [26]Stanton C, Blanc AK, Craft T, Choi Y: Skilled care at birth in the deveoping world: progress to date and strategies to expanding coverage. J Biosoc Sci 2007, 39:109-120.
- [27]Weldearegawi B, Ashebir Y, Gebeye E, Yohannes M, Mussa S, Berhe H, Abebe Z: Emerging chronic non-communicable diseases in rural communities of Northern Ethiopia: evidence using population-based verbal autopsy method in KiliteAwlaelo surveillance site. Health Policy Plan 2013, 1:8. doi:10.1093/heapol/czs135
- [28]Weldearegawi B, Spigt M, Berhane Y, Dinant G: Mortality level and predictors in a Rural Ethiopian Population: community based longitudinal study. PLoS One 2014, 9(3):e93099. doi:10.1371/journal.pone.0093099
- [29]WHO: Global Health Observatory (GHO). Antenatal care, 2014. http://www.who.int/gho/urban_health/services/antenatal_care_text/en/ [accessed on August 14, 2014].
- [30]Medhanyie A, Spigt M, Kifle Y, Schaay N, Sanders D, Blanco R, GeertJan D, Berhane Y: 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. BioMed Central Full Text
- [31]Gogia S, Sachdev HS: Home visit is community health worker to prevent the neonatal in developing countries: a systemic review. Bull World Health Organ 2010, 188(9):658-666B.
- [32]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. BioMed Central Full Text
- [33]Ntambue ML, Malonga K, Dramaix-Wilmet M, Donnen P: Determinants of maternal health services utilization in urban settings of the Democratic Republic of Congo – a case study of Lubumbashi City. BMC Pregnancy Childbirth 2012, 12:66. BioMed Central Full Text
- [34]Sohail A, Thomas W: Determinants of institutional delivery in rural Jhang, Pakistan. Int J Equity Health 2011, 10:31. BioMed Central Full Text
- [35]Gebrehiwot T, Goicolea I, Edin K, Sebastian S: Making pragmatic choices: women’s experiences of delivery care in Northern Ethiopia. BMC Pregnancy Childbirth 2012, 12:103. BioMed Central Full Text
- [36]Lohela TJ, Campbell OMR, Gabrysch S: Distance to care, facility delivery and early neonatal mortality in Malawi and Zambia. PLoS One 2012, 7(12):e52110. doi:10.1371/journal.pone.0052110
- [37]Kabakyenga JK, Ostergren P-O, Turyakira E, Pettersson KO: Influence of birth preparedness, decision-making on location of birth and assistance by skilled birth attendants among women in South-Western Uganda. PLoS One 2012, 7(4):e35747. doi:10.1371/journal.pone.0035747
- [38]Hazemba AN, Siziya S: Choice of place for childbirth: prevalence and correlates of utilization of health facilities in Chongwe district. Zambia Med J Zambia 2008, 35(2):53-57.
- [39]Pathak PK, Singh A, Subramanian SV: Economic inequalities in maternal health care: prenatal care and skilled birth attendance in India, 1992–2006. PLoS One 2010, 5(10):e13593. doi:10.1371/journal.pone.0013593
- [40]Mostafa K: Factors affecting utilization of skilled maternity care services among married adolescents in Bangladesh. Asian Popul Stud 2009, 5(2):156-164.
- [41]CSA: ICF International Ethiopia Demographic and Health Survey 2000. Addis Ababa, Ethiopia and Calverton, Maryland, USA; 2000.
- [42]Kawakatsu Y, Sugishita T, Oruenjo K, Wakhule S, Kibosia K, Were E, Honda S: Determinants of health facility utilization for childbirth in rural western Kenya: cross sectional study. BMC Pregnancy Childbirth 2014, 14:265. doi:10.1186/1471-2393-14-265 BioMed Central Full Text