Institutional delivery service utilization and its associated factors among women who gave birth during the past one year in Mizan Aman City Administration, Bench Maji Zone, South West Ethiopia, 2017

Background: Maternal mortality due to unsafe abortion, prolonged labour, eclampsia and other reasons has been the major problem across the globe especially in developing countries. This is because; most of those deliveries occur outside health care facilities and assisted with nonprofessionals. Aim: To assess magnitude and factors associated with institutional delivery practice and its determinants among mothers who gave birth during the past one year in Mizan Aman Town, Bench Maji zone, South West Ethiopia. Methods and Materials: Community based cross sectional study was conducted among mothers who gave birth during the past one year from April 10 to May 10, 2017. Structured and pretested questionnaire was used for data collection. Data was analyzed using SPSS version 20 software. Crude and adjusted Odds ratios were computed for selected variables and P-value less than 0.05 was considered to be statistical significant. Results: Only 54.2% of mothers gave birth at health facilities. Husbands educational level, decision about the cost related to health care/for referral or reaching health facility and place of antenatal care follow up were associated with institutional delivery service utilization. Conclusion: In contrast to studies conducted in other parts of the country and the Ethiopia Demographic health survey result of 2016, the number of women who had given birth at health care facilities in Mizan Aman city administration was higher. However, it was below the health sector transformation plan of the country that has a plan to raise institutional delivery supported by health personnel to 95%. Thus increasing awareness of mothers and their partners about the benefits of institutional delivery services are recommended

Utilization of Post-Abortion Care Services in Three Regional States of Ethiopia

Background: In Ethiopia; utilization of post-abortion care service is minimal and it seems that the expanding services are underutilized. The purpose of this study was to assess factors which influence decisions for utilization of abortion related services at community level. Methodology: The study was carried out in six selected districts (woredas) within the three big regions of the country; namely Amhara; Oromiya and SNNPR. The study employed a descriptive cross-sectional design. Both quantitative and qualitative study techniques; including structured interview questionnaires; focus group discussions (FGDs); and in-depth interviews. The study population comprised randomly selected 1;492 women of reproductive age; service providers; and key informants of the sampled districts. Results: Majority of respondents said that they prefer public health facilities. According to the respondents; the reason why women do not visit health facility for PAC services include lack of community support; unavailability of services; services are expensive; facilities are distantly located and lack of means of transportation. From the multivariate analysis it appears that public health facilities are preferred by younger respondents; those with no education; those with no history of unwanted pregnancy and those with better income. The qualitative study indicated that women do not go to health facilities for PAC mainly because of inappropriate treatment by providers at the health facilities. Conclusion: Public health facilities especially health centers are the most preferred but there are barriers that should improve. Introduction of supportive supervision should be considered as a tool for improving quality of care. A mechanism should be in place to obtain community opinion regularly and use it to continuously improve services. To correct some misconceptions and improve community awareness on abortion related issues community providers; including reproductive health agents and health extension workers can teach about availability of services and about abortion related complications

Choice of Place for Childbirth: Prevalence and Correlates of Utilization of Health Facilities in Chongwe District; Zambia

Objectives: To determine the prevalence and correlates for utilization of health facilities for childbirth in a rural Chongwe district; Zambia. Design: A cross sectional study was carried among 250 mothers who had delivered babies within one year prior to the survey. A Backward multiple logistic regression method was used to determine independent predictors for utilization of health services for childbirth. Main Outcome Measures: Percent utilization of health facilities. Results: A total of 250 mothers were recruited into the study; of whom the majority were below the age of 25 year (41.2) and were married (84.0). A third (32.8) of the mothers were not able to read and write. The rate of health facility utilization for childbirth was 42.8. Independent predictors for utilization of a health facility were place of last childbirth; and knowledge that traditional birth attendants (TBAs) are given none food items (excluding money) after assisting delivery. Compared to mothers who delivered their last pregnancy At a health facility; mothers who had their last childbirth at home were 85(AOR=0.15; 95CI [0.10; 0.22]) less likely to deliver their current pregnancy at a health facility. Knowledge that a TBA was given none food Items (excluding money) after assisting delivery was negatively associated with delivery at a health facility (AOR=0.55; 95CI [0.37; 0.83]). Conclusion: The importance of giving birth at a health facility should be communicated to mothers who give birth at home; during postnatal visits or clinic outreach sessions