School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, PO. Box 445, Debre Berhan, Ethiopia.
Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Pregnancy Childbirth. 2022 Mar 16;22(1):213. doi: 10.1186/s12884-022-04447-y.
Low maternal healthcare service utilization contributes to poor maternal and newborn health outcomes in rural Ethiopia. 'Motivational factors influence women's intention to perform a specific health behavior, and the intention of subsequent home delivery and related risks that may contribute to women's death is less known. Therefore, this study aimed to assess the intention of maternal health service utilization among women who gave birth at home in the rural Sehala Seyemit district.
A community-based cross-sectional study was conducted from September 1 to October 15, 2020, among 653 women. A two-stage sampling technique was used to select the study participants. First, a semi-structured, pretested, and interviewer-administered questionnaire were used. The mean of the sum score was also used to categorize the intention as intended and not intended. Second, multivariable logistic regression analysis was computed to identify factors associated with women's intention to use maternal health services. Adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05 were used to declare statistical association.
Of the women who gave birth at home the intention to use maternal health service was 62.3% (95% CI; 59, 66). Women's age of > 30 years (AOR = 6.04; 95%CI: 2.34, 15.60), short time to reach health facility (AOR = 2.52; 95% CI: 1.57, 4.10), media exposure (AOR = 2.10; 95% CI: 1.16, 3.65), history of obstetric danger signs (AOR = 4.60; 95% CI: 2.33, 9.10), positive subjective norms (AOR = 11.20; 95% CI; 6.77, 18.50) and last delivery assisted by traditional birth attendants (AOR = 0.15; 95% CI: 0.06, 0.33) were factors associated with women's intention to use maternal health services.
In this study, maternal health service utilization intention is still unsatisfactory compared to the national target plan. Maternal age, media exposure, obstetric danger signs, distance to a health facility, positive subjective norms, and delivery assistant at delivery were predictors of women's intention to use maternal healthcare services. Improving women's awareness of maternal healthcare services and developing strategies to increase women's access to mass media, skilled birth attendants, and transportation for rural women may enhance their intention to use maternal healthcare services.
在埃塞俄比亚农村地区，低孕产妇医疗服务利用率导致孕产妇和新生儿健康状况不佳。“动机因素会影响女性执行特定健康行为的意愿，而随后的家庭分娩及其可能导致女性死亡的相关风险则知之甚少。因此，本研究旨在评估在农村 Sehala Seyemit 区在家中分娩的妇女对孕产妇医疗服务的利用意愿。
2020 年 9 月 1 日至 10 月 15 日，采用两阶段抽样技术对 653 名妇女进行了一项基于社区的横断面研究。第一阶段，使用半结构式、预测试和访谈者管理的问卷进行。总和得分的平均值也用于将意图分类为有意图和无意图。第二阶段，进行多变量逻辑回归分析以确定与妇女使用孕产妇保健服务意图相关的因素。使用 95%置信区间的调整优势比 (AOR) 和 p 值≤0.05 用于宣布统计学关联。
在家中分娩的妇女中，使用孕产妇保健服务的意图为 62.3%（95%CI；59，66）。妇女年龄>30 岁（AOR=6.04；95%CI：2.34，15.60）、到达保健设施的时间短（AOR=2.52；95%CI：1.57，4.10）、媒体接触（AOR=2.10；95%CI：1.16，3.65）、产科危险信号史（AOR=4.60；95%CI：2.33，9.10）、积极的主观规范（AOR=11.20；95%CI；6.77，18.50）和最后一次分娩由传统助产士协助（AOR=0.15；95%CI：0.06，0.33）是与妇女使用孕产妇保健服务意图相关的因素。
与国家目标计划相比，本研究中孕产妇保健服务利用率仍不理想。产妇年龄、媒体接触、产科危险信号、到保健设施的距离、积极的主观规范以及分娩时的助产妇是影响妇女利用孕产妇保健服务意愿的预测因素。提高妇女对孕产妇保健服务的认识，并制定增加农村妇女获得大众媒体、熟练助产士和交通服务的策略，可能会增强她们利用孕产妇保健服务的意愿。
