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A community based cross sectional study was conducted from October to December 2004 in
Ayssaita and Dubti towns in Afar Regional state to assess factors affecting utilization of maternal
health care services among women during their third trimester of pregnancy and with in 12
months post delivery preceding the survey. Data were collected using a pre-tested and
standardized questionnaire in 642 eligible women from four kebeles by clustered random
sampling technique.
Analysis revealed that close to 80% of the women had at least one prenatal visit during their
recent pregnancy. Most of the antenatal care (ANC) attendants made their first visit during their
second trimester of pregnancy. Among ANC users 53% of had less than four antenatal care
contacts. Majority of deliveries took place at home, of which 93.7% were attended by TBAs.
Absences of a health problem, lack of awareness, work overload and distant health service were
the main reasons for no ANC attendance. Presence of relatives nearby, more trust on TBAs, lack
of privacy, and male professionals assistance during labor at health facilities, were the main
reasons cited for resorting to home delivery. Of the total, 45% of the women had knowledge on
danger signals of pregnancy and childbirth related health problems. The majorities were able to
name the danger signs of pregnancy related health problems. Most of the women neither
perceived pregnancy related morbidity nor experienced illness in the recent pregnancy.
Bivariant and multivariate analysis showed significant association between ANC attendance and
maternal age, occupation, wanted pregnancies, illness experience and perceived susceptibility to
dangerous health problems related to pregnancy and childbirth. Education (OR=5.26,95%
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CI=3.12,8.92), religion (OR=2.77,95% CI=1.80,4.27), income (OR=2.59,95% CI=1.55,5.00) and
ANC attendance (OR=0.21,95% CI=0.13, 0.35) were associated with choice of delivery site.
Orders of pregnancy and husbands’ attitude were found to be strong predictor of both antenatal
care and skilled attendance at birth.
In conclusion, the study revealed low maternal health care utilization in the area. Demographic
and socio cultural factors were found to be barriers to utilization of maternal health care services.
Increasing maternal health service coverage and promotion of IEC in the community are
recommended.
Key words: Maternal health care, antenatal care, preferred place of delivery, Afar Region. |
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