College of Development Studies, Center for Population Studies, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Health Serv Res. 2013 Jul 3;13:256. doi: 10.1186/1472-6963-13-256.
In developing countries a large number of women are dying due to factors related to pregnancy and child birth. Implementing and assuring utilization of maternal health care services is potentially one of the most effective health interventions for preventing maternal morbidity and mortality. However, in Ethiopia the utilization of maternal health care is low.
A cross-sectional study was conducted from January 20 to February 20, 2012 in Holeta town, central Ethiopia, to assess the determinants of maternal health care utilization among women who had given birth in the past three years prior to the survey. Structured questionnaire and focus group discussion guides were used for data collection. Data were collected from a sample of 422 women in the town. Descriptive, bivariate and multivariate logistic regression analyses were conducted. Statistical tests were done at a level of significance of p<0.05.
The study revealed that 87% of the women had at least one antenatal visit during their last pregnancy. Among the antenatal service users, 33.7% had less than four antenatal visits. More than half of the antenatal care (ANC) attendants made their first visit during their second and third trimester of pregnancy although WHO recommended ANC should be started at the first trimester of the pregnancy. There was a significant association (P<0.05) between ANC attendance and some demographic, socio-economic and health related factors (age at last birth, literacy status of women, average monthly family income, media exposure, attitude towards pregnancy, knowledge on danger signs of pregnancy and presence of husband approval on ANC). The study also revealed that about 61.6% of the women had given birth in the health institutions. Parity, literacy status of women, average monthly family income, media exposure, decision where to give birth, perception of distance to health institutions (HI) and ANC attendance were found to be significantly associated (P<0.05) with delivery care (DC) attendance.
The utilization of ANC and DC service is inadequate in the town. The utilization of ANC and DC were influenced by demographic, socio-economic and health related factors. Improving the status of women by expanding educational opportunities, strengthening promotion of antenatal and delivery care by enhancing community awareness about the importance of ANC and DC are recommended.
在发展中国家，有大量妇女因妊娠和分娩相关因素而死亡。实施和确保孕产妇保健服务的利用，是预防孕产妇发病率和死亡率的最有效卫生干预措施之一。然而，在埃塞俄比亚，孕产妇保健服务的利用率很低。
2012 年 1 月 20 日至 2 月 20 日，在埃塞俄比亚中部的霍勒塔镇进行了一项横断面研究，以评估过去三年中在调查前生育过的妇女使用孕产妇保健服务的决定因素。采用结构化问卷和焦点小组讨论指南收集数据。从该镇的 422 名妇女中抽取样本进行研究。采用描述性、双变量和多变量逻辑回归分析。在 p<0.05 的显著性水平下进行统计检验。
研究表明，87%的妇女在最近一次怀孕时至少进行了一次产前检查。在接受产前服务的妇女中，有 33.7%的人产前检查次数少于四次。尽管世界卫生组织建议应在妊娠的第一孕期开始产前检查，但超过一半的产前护理（ANC）护理人员在妊娠的第二和第三孕期才进行第一次检查。ANC 就诊与一些人口统计学、社会经济和健康相关因素（上次分娩时的年龄、妇女的文化程度、平均月家庭收入、媒体接触、对妊娠的态度、对妊娠危险信号的认识以及丈夫对 ANC 的认可）之间存在显著关联（P<0.05）。研究还表明，约有 61.6%的妇女在医疗机构分娩。产次、妇女的文化程度、平均月家庭收入、媒体接触、分娩地点的决定、对医疗机构（HI）距离的认知以及 ANC 就诊与分娩护理（DC）就诊显著相关（P<0.05）。
该镇的 ANC 和 DC 服务利用率不足。ANC 和 DC 的利用受到人口统计学、社会经济和健康相关因素的影响。建议通过扩大教育机会来改善妇女的地位，通过增强社区对 ANC 和 DC 重要性的认识来加强 ANC 和 DC 的推广，以改善这一状况。
