Mekonnen BaizeKebede Dagnachew2021-06-172023-11-062021-06-172023-11-062011-06http://etd.aau.edu.et/handle/123456789/26880Background: Skilled attendant for every pregnant woman during childbirth is the most critical intervention for improving maternal and child health. Evidence showed that the majority of births are delivered at home and the proportion of deliveries assisted by skilled birth attendant is very low. Every day, at least 1,600 women die worldwide from the complications ofpregnancy and childbirth, 90% of which occurring in Asia and sub-Saharan Africa. Maternal mortality rate was shown to have the largest discrepancy between developed and developing countries. A lifetime risk of maternal death in developing countries is forty times higher than that of the developed world. In Ethiopia, maternal and infant mortality and morbidity levels are among the highest in the world. Studies had clearly demonstrated that the utilization of existing maternal health services is very low in the country. Only a quarter of Ethiopian women received antenatal care (ANC) and less than 10 percent of mothers deliveries assisted by skilled birth attendant. Objective: To assess utilization of skilled birth attendant at delivery, among mothers who gave birth the past two year prior to the survey in yirgachefe town. Methods: A community based cross-sectional quantitative study method was conducted among women residing in Yirgacheffe town. The study populations were randomly selected women who gave birth in the last two year in the town. After establishing the sampling frame of each household, systematic random sampling technique was used to identify the list of households in each kebele’s to reach to 440 women included in the survey. Data was collected using adapted interviewee administered Amharic version questionnaires and data analyzed using SPSS version16. A different proportion was computed and crude and adjusted Odds ratios and confidence intervals were performed for the association between variables and stepwise multiple logistic regressions were used to identify factors that affect utilization of skilled birth attendant. Result: A total of 440 women were included in the study. 58.9% of the women utilize skilled birth attendant during delivery. Reasons given for home delivery includes, feeling of more comfortable just being at home, usual practice, close attention from relatives & family members, short and smooth labor, to exercise cultural values, not liking health facility due to bad experience, unwelcoming approach of health workers and other reasons. Births to women with primary education are two times more likely (OR=2.3 and 95% CI=1.24-4.2), and births to women with secondary and above education are four times more likely (OR=3.6 and95%CI=1.5-8.4) to utilize SDA as compared to illiterate women. Women who are Governmental employee were four times more likely to utilize SDA than those who had private bissnuss(OR=3.6 and 95%CI=1.5-8.4). Women with one and two to four pregnancies and births were three and two times more likely utilize SDA than women who have >=5 pregnancies and births(OR=2.6, 95% CI= 1.17 to 4.45) and (OR=2.3, 95% CI=1.41 to 4.65) respectively. Women who have ANC visits (,OR=16.7 and (95%CI= 8.2, 33.89), more likely utilized SDA than who did not visit. Preference of the respondent’s husbands and families, those who prefer delivery with health professional were four times and five times more likely to utilize skilled delivery attendant as compared with those, their husbands and families prefer delivery without health professional (TTBA,TBA and family and relatives) OR= 4.03 (95%CI=1.37 to 11.8),OR=4.6,95%CI=1.5 to13.9) respectively. Conclusion: The study finding revealed that utilization of SDA was more than half, still there isa gap between users and providers and those are interrelated to each other. Consequently, Community members should be discouraged harmful traditional and usual practices that hinder health facility delivery care utilization. Incourage favorable influences from their husbands and relatives about their delivery practices, women empowerment, promotion of maternal education, prenatal care utilization, communication on obstetric risks and general health service expansion were recommended.en-USBirth,womenThesis