Assessment of the Magnitude of Bypassing Public Health Center Delivery Service and Associated factors among Postnatal Women in Negist Eleni Memorial Hospital, South Ethiopia

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Date

2016-06

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Addis Abeba Universty

Abstract

Introduction: Quality obstetric, medical and nursing care under safe, skilled and well equipped health facilities during pregnancy, child birth and within 6 weeks after birth can reduce the risk of obstetric complications that may cause death or serious illness to the mother, the baby or both. The use of recommended appropriate standard facility in the catchment area for delivery and post partum care strengthen maternal and child health care at individual, community, health care planners and the government level. In developing countries including Ethiopia, bypassing the nearby health facility for childbirth service wastes resources at all levels. However, the magnitude and factors influencing bypassing closer health facilities for childbirth care were not adequately explored. Objective: To assess magnitude of bypassing public health centers to hospital for childbirth and identify factors associated with bypassing in postnatal women in Negist Eleni Memorial hospital. Method: Facility based cross sectional study was conducted among postnatal women in Negist Eleni Memorial hospital from February to March 2016.A pretested and structured interviewer administered questionnaire was used to gather data from 393 randomly selected postpartum women included by using systematic random sampling technique, and then every 2nd eligible woman was interviewed. The data was coded and entered into Epi Info version-7 and exported, cleaned and analyzed using STATA12.1. Tables and charts were used to describe study population and to display results. Bivariate and multivariate analysis was done to identify correlates of bypassing public health centers to hospital for delivery service. Finding: Sixty seven percent of mothers who gave birth in Negist Eleni Memorial hospital bypassed their catchment public health centers. The likelihood of bypassing health center for delivery service were 4.5 times higher among respondents whose husband’s educational level was above secondary education [AOR=4.5; 95%CI=1.06, 20.29],Past obstetric complications[AOR=0.28; 95% CI=0.09,0.86] and antenatal care(ANC) attendance in the health centers[AOR=0.13; 95% CI=0.04,0.46] were associated with less likely hood of bypassing. The odds of bypassing were 7.8 times higher [AOR=7.8:95%CI=3.5, 17.5]for those who were living within 13.02km to Nigist Eleni Memorial hospital compared to those living farther. Conclusion: The proportion of women bypassing health centers to receive childbirth care at hospital in our study is high. Preference of the type of health facility for delivery care is associated with husband education, past obstetric complication, place of ANC follow up and distance to hospital.

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Assessment of the Magnitude of Bypassing Public Health

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