Assessment of Practices of Women during Pregnancy and Childbirth with the Perspectives of HEW’s Role, Gubalafto Woreda, North Wollo Zone, ANRS, Ethiopia

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Addis Ababa University


Background: Pregnancy and childbirth and their consequences are still the leading causes of death, disease and disability among women of reproductive age in developing countries more than any other single health problem. Nearly 536 000 women die each year from pregnancy and childbirth related complications globally. Effective antenatal care use has been shown to influence women’s use of delivery services, probably the most effective intervention in reducing maternal mortality in the developing world. Supporting women at delivery is an essential part of public health care. Objective: This study assessed practices of women during pregnancy and childbirth with the perspective of HEWs role in this regard. Methodology: A cross sectional community based survey supplemented by qualitative design was conducted in Gubalafto Woreda, North Wollo zone from February to March 2009. Multistage cluster sampling technique was used to select the sample of 841 women. Data were collected through structured, pre-tested questionnaires. The data were entered in to Epi Info version 3.5.1 and analyzed on SPSS version 13 computer software. A univariate, bivariate and multivariate analyses were done using frequencies, chi-square and binary logistic regressions respectively. The study was conducted after approval of Institutional Review Board of faculty of Medicine, Addis Ababa University and by ascertainment of informed verbal consent from study participants. Result: The result of the study revealed that 63.4% of ANC attendance and 8.4% of HFs delivery to their last pregnancies of the respondent women. Harmful traditional practices that are commonly experienced during pregnancy and childbirth like abdominal massage and leaving the cord untied were found prevalent. Around 35% of mothers and more discussants expressed their dissatisfaction with HEWs less involvement in conducting normal labor and most of the HEWs themselves described as they had never attended normal labor. Multivariate analysis had shown that maternal age, marital status, age at first pregnancy, perceived pregnancy and childbirth risks and women’s decision making status were significantly associated with ANC attendance. Women who were able to decide by themselves for health service utilization were found to utilize ANC more than two times than their counter parts (AOR=2.53, CI= 1.86, 3.45). In this study, previous ANC attendance and ever delivered at HF prior to the last pregnancy are found to be significant predictors of health facility delivery. Women who had antenatal care attendance at least once were almost three times more likely to give birth in the health facility than who did not have any ANC attendance (AOR= 2.86, CI= 1.34, 6.11). Conclusion: The main reasons mentioned for ANC non attendance and not giving birth in the HF were associated with the maternal low awareness of the need of care, and socio-economic factors. In line with this, HEWs inability to attend normal labor contributed to the very low HF delivery. As a result, IEC/BCC to increase women’s awareness on obstetric risks and general health seeking behavior, promotion of prenatal and delivery care service utilization, training for HEWs, equipping and staffing HFs are recommended. Keywords: Practices, pregnancy, childbirth, HEWs



Socio-economic factors