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Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys.

作者信息

Mezmur Markos, Navaneetham Kannan, Letamo Gobopamang, Bariagaber Hadgu

机构信息

Department of Population Studies, University of Botswana, Gaborone, Botswana.

出版信息

PLoS One. 2017 Sep 14;12(9):e0184688. doi: 10.1371/journal.pone.0184688. eCollection 2017.


DOI:10.1371/journal.pone.0184688
PMID:28910341
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5598994/
Abstract

Despite evidence that social contexts are key determinants of health, research into factors associated with maternal health service utilization in Ethiopia has often focused on individual and household factors. The downside is that this underestimates the importance of taking contextual factors into account when planning appropriate interventions in promoting safe motherhood in the country. The purpose of this study is to fill this knowledge gap drawing attention to the largely unexplored contextual factors affecting the uptake of skilled attendance at delivery in a nationally representative sample. Data for the study comes from two rounds of the Ethiopian Demographic and Health Surveys (EDHS) conducted in the year 2005 and 2011. Analysis was done using a two-level multivariable multilevel logistic regression model with data from 14, 242 women who had a live birth in the five years preceding the surveys clustered within 540 (in the year 2005) and 624 (in the year 2011) communities. The results of the study point to multiple levels of measured and unmeasured factors affecting the uptake of skilled delivery care in the country. At community level, place of residence, community level of female education and fertility significantly predict the uptake of skilled delivery care. At individual and household level, maternal age, birth order, maternal education, household wealth and access to media predict the uptake of such service. Thus, there is a need to consider community contexts in the design of maternal health programs and employ multi-sectorial approach to addressing barriers at different levels. For example, improving access and availability of skilled delivery care should eventually enhance the uptake of such services at community level in Ethiopia. At individual level, efforts to promote the uptake of such services should constitute targeted interventions paying special attention to the needs of the youth, the multiparous, the less educated and women in the poorest households.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e799/5598994/fe49f50cffb1/pone.0184688.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e799/5598994/fe49f50cffb1/pone.0184688.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e799/5598994/fe49f50cffb1/pone.0184688.g001.jpg

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本文引用的文献

[1]
Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

Afr Health Sci. 2014-12

[2]
Individual and contextual determinants of adequate maternal health care services in Kenya.

Women Health. 2015

[3]
Factors associated with use of maternal health services in Haiti: a multilevel analysis.

Rev Panam Salud Publica. 2014-7

[4]
Gender inequality and the use of maternal healthcare services in rural sub-Saharan Africa.

Health Place. 2014-7-1

[5]
Individual and local level factors and antenatal care use in Colombia: a multilevel analysis.

Cad Saude Publica. 2014-5

[6]
Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey.

BMC Pregnancy Childbirth. 2014-5-7

[7]
Determinants of Maternal Health Care Utilization in Nigeria: a multilevel approach.

Pan Afr Med J. 2014-1-18

[8]
Factors associated with Institutional delivery service utilization among mothers in Bahir Dar City administration, Amhara region: a community based cross sectional study.

Reprod Health. 2014-3-14

[9]
Determinants of maternal health care utilization in Holeta town, central Ethiopia.

BMC Health Serv Res. 2013-7-3

[10]
Factors associated with maternal healthcare services utilization in nine high focus states in India: a multilevel analysis based on 14 385 communities in 292 districts.

Health Policy Plan. 2014-8

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