Abera Mulumebet, Gebremariam Abebe, Belachew Tefera
Department of Population & Family Health, College of Public Health and Medical Sciences, Jimma University.
Ethiop J Health Sci. 2011 Aug;21(Suppl 1):95-106.
Evidence show that lack of access to and use of, essential obstetric care services to be a crucial factor that contributes to the high maternal morbidity and mortality. Skilled attendance during labor, delivery and early post-partum period could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. There is limited information on the mothers' use of skilled delivery services in the study area. This study assessed the predictors of safe delivery service utilization in Arsi Zone, Southeast Ethiopia.
A cross- sectional community based study using quantitative and qualitative methods was conducted from February 15(th) to March 15(th) 2006. A total of 1089 women who had at least one birth one year prior to the study were involved in the study from nine rural and four urban kebeles in three Woredas (Districts) selected using a systematic sampling method from all households in the study area. A pre-tested structured interviewer administered questionnaire was used to collect data. Information on the utilization of safe delivery service and socio-demographic, individual and institutional factors and past obstetric history were collected. Focus Group Discussion guide was used for qualitative data collection. The data were edited, cleaned, and entered into a computer and analyzed using SPSS for windows version 12.0.
One thousand seventy four women who had at least one birth were interviewed making a response rate 98.6%. Two hundred seventy one (75.0%) of urban and 373(52.0%) rural women received antenatal care from skilled health professional at least once during their last pregnancy. Thirty-one (4.3%) of rural and 145 (40.4%) of urban women delivered in health institution. In multivariate analysis showed that residential area OR= 8.5, 95%CI; (5.1,13.9), parity OR=0.18, 95%CI; (0.08, 0.42), and ANC service use OR= 4.5, 95%CI; (2.2,8.9), and maternal education OR=4.6, 95%CI; (1.7,12.8), were most significant predictors of safe delivery service use by mothers (P< 0.01).
Birth attended by skilled personnel was low in the study area. Maternal education, her birth experience and her use of prenatal services are important predictors. Promoting information, education and communication on safe delivery service utilization, expansion of health service and empowerment of women are needed.
有证据表明，无法获得和利用基本产科护理服务是导致孕产妇高发病率和高死亡率的关键因素。分娩、接生和产后早期有专业人员护理可减少因难产、出血、败血症和子痫导致的死亡。关于研究地区母亲使用专业接生服务的信息有限。本研究评估了埃塞俄比亚东南部阿尔西地区安全接生服务利用的预测因素。
2006年2月15日至3月15日开展了一项采用定量和定性方法的基于社区的横断面研究。采用系统抽样方法从研究地区所有家庭中选取了三个县（区）的9个农村社区和4个城市社区，共有1089名在研究前一年至少生育过一次的妇女参与了研究。使用经过预测试的结构化访谈问卷收集数据。收集了关于安全接生服务利用情况、社会人口统计学、个人和机构因素以及既往产科病史的信息。焦点小组讨论指南用于定性数据收集。对数据进行编辑、清理，录入计算机，并使用SPSS for windows 12.0版本进行分析。
对1074名至少生育过一次的妇女进行了访谈，回复率为98.6%。271名（75.0%）城市妇女和373名（52.0%）农村妇女在其最后一次怀孕期间至少接受过一次专业卫生人员的产前护理。31名（4.3%）农村妇女和145名（40.4%）城市妇女在医疗机构分娩。多变量分析显示，居住地区OR = 8.5，95%CI；（5.1，13.9），产次OR = 0.18，95%CI；（0.08，0.42），产前护理服务利用情况OR = 4.5，95%CI；（2.2，8.9），以及母亲教育程度OR = 4.6，95%CI；（1.7，12.8），是母亲使用安全接生服务的最显著预测因素（P < 0.01）。
研究地区由专业人员接生的比例较低。母亲的教育程度、生育经历和产前服务利用情况是重要的预测因素。需要推广关于安全接生服务利用的信息、教育和宣传，扩大卫生服务并增强妇女权能。
