Alemayehu Mulunesh, Mekonnen Wubegzier
Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Biomed Res Int. 2015;2015:436938. doi: 10.1155/2015/436938. Epub 2015 Oct 4.
The low utilization of skilled birth attendants sustained high maternal mortality. The aim of this study was to assess its magnitude and correlates in Northwest Ethiopia. A study was conducted on 373 randomly selected women who gave birth in the 12 months preceding the survey. Correlates were identified using binary logistic regression. Skilled birth attendance was 18.8%. Inability to perform cultural practices in health facilities (65.5%), expecting smooth delivery (63.4%), and far distance (62%) were the main barriers. Women with urban residence (AOR = 5.46: 95% CI [2.21-13.49]), primary (AOR = 2.10: 95% CI [0.71-6.16]) and secondary-plus (AOR = 6.12: [1.39-26.92]) educational level, four-plus ANC visits (AOR = 17.33: 95% CI [4.22-71.29]), and proximity to health centers (AOR = 5.67: 95% CI [1.47-25.67]) had higher odds of using skilled birth attendants though women with no labor complications had lower odds (AOR = 0.02: 95% CI [0.01-0.05]). Skilled birth attendance use was low. Urban residence, primary-plus level of education, frequent ANC visits, living nearby the health centers, and a problem during labor were positively correlated with skilled birth attendance utilization. Stakeholders should enhance girls' education beyond primary level and ANC services and shorten distances to health facilities.
熟练接生员利用率低致使孕产妇死亡率居高不下。本研究旨在评估埃塞俄比亚西北部地区这一情况的严重程度及其相关因素。对在调查前12个月内分娩的373名随机选取的妇女进行了研究。采用二元逻辑回归确定相关因素。熟练接生服务的利用率为18.8%。在医疗机构无法进行文化习俗活动(65.5%)、期望顺产(63.4%)以及距离远(62%)是主要障碍。居住在城市的妇女(调整后比值比[AOR]=5.46:95%置信区间[CI][2.21 - 13.49])、小学(AOR = 2.10:95% CI [0.71 - 6.16])及初中以上(AOR = 6.12:[1.39 - 26.92])文化程度、产前检查4次及以上(AOR = 17.33:95% CI [4.22 - 71.29])以及距离健康中心较近(AOR = 5.67:95% CI [1.47 - 25.67])的妇女使用熟练接生员的几率更高,不过无分娩并发症的妇女几率较低(AOR = 0.02:95% CI [0.01 - 0.05])。熟练接生服务的使用率较低。城市居住、小学及以上文化程度、频繁的产前检查、居住在健康中心附近以及分娩时出现问题与熟练接生服务的利用呈正相关。利益相关者应提高女童小学以上教育水平及产前检查服务质量,并缩短到医疗机构的距离。