Determinants of Maternal Health Care Services Utilization: The Case of Gozamn Woreda, East Gojjam One of Amhara Region, Ethiopia
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Date
2010-06
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Addis Ababa Univerisity
Abstract
Many of women in developing countries are at a great risk in terms of high maternal morbidity
and mortality due to factors related to pregnancy and childbirth in these countries. A cross
sectional study was conducted from February 15 to March 15, 2010 in Gozamin Woreda in
Amhara Regional State to assess factors affecting utilization of maternal health care services. A
total of 587 women who had at list one live births in the five years preceding the survey were
selected systematically. Data were collected using a pre-tested and structured questionnaires and
FGD were used to collect quantitative and qualitative data, respectively. The analysis revealed
that about 59.3% of the women had at least one prenatal visit during their recent pregnancy.
About forty five percent of those women attending antenatal care had their first visit during their
first trimester of pregnancy. Among ANC users 64% of had less than four antenatal care contacts
in the recent pregnancy. The most important reasons for not attending ANC care were being
healthy and being too busy. Majority of deliveries took place at home; about 71% of deliveries
took place at home. Presence of relatives nearby, Transportation problem, and lack of privacy
were the main reasons cited for resorting to home delivery. The majority of the respondents were
able to name the danger sign of pregnancy related problems. In multivariate analysis the risk of
non-attendance of ANC and home delivery was higher for those women whose residence was
rural, low educational status, higher parity and being housewife at old age. In addition ANC
service utilization significantly affect utilization of delivery care provided in health institutions
(P-value less than 0.05). In conclusion, the study revealed that more women attend ANC during
pregnancy than those derived at health institutions. Demographic and socio-cultural factors were
found to be barriers to utilization of maternal health care services. Educating girls, providing
health education on maternal health care services, and improving the services of health extension
workers in rural areas were recommended to improve utilization of both services.
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Keywords
Maternal health care, antenatal care, place of delivery, Amhara