Title:
Factors Influencing Low Utilization of Health Facility during Labor and Delivery: The Case of Ethiopia
Authors:
Agidew, Birtukan Seid
Year:
2013
PAGE:
iii, 44
Language:
En
Subject:
Maternal Health – Lessons Learned
Keywords:
Skilled Birth Attendant, Institutional Delivery, Emoc, Barriers, Determinants, Home Delivery, Normal Labour, Ethiopia
Abstract:
Background: Ethiopia is one of the least developed countries in Sub-Sahara Africa and has low maternal health service utilization. About 90% of child birth took place outside health facilities, and without the help of skilled birth attendants. As a result 20,000 mothers die every year due to pregnancy- and child birth- complications that could have been prevented by these births having been attended at health facility with skilled birth attendants. Objective: to explore factors influencing low utilization of health facilities during labour and delivery in Ethiopia, which is the key intervention for reduction of maternal and neonatal mortality, and to make feasible recommendations aimed to increase the number of births taking place in health facilities. Methods: A literature review on skilled birth attendants/institutional delivery service utilization was undertaken. The frame-work social determinant of maternal health service utilization was used for analysis of the available literatures. Results: All the following four levels of determinants were contributing to low utilization of health facility during child birth in Ethiopia: individual and family-related, health service-related, community-related, and governance and policy-related factors. Of these the following were the leading factors: lower education status of women and self-efficacy, influence from husbands or relatives, low acceptability of delivery care at health facility, low financial accessibility due to low enforcement of user fee abolition policy, multiple traditional and health beliefs, and deeply rooted gender biased decision making. Conclusion: In Ethiopia, all interlinked individual, family, community, health service, governance, and policy level determinants influence the low level of health facility delivery service utilization. Low socio economic status and women disempowerment with multiple traditional and health beliefs were responsible for extremely low utilization of health facility for child birth. Failure to meet expectation of labouring mothers at health facilities was also an important finding in the majority of studies. Recommendations: Exploring context specific barriers for utilization of health facility during childbirth, women empowerment, increasing awareness activities on the importance of skilled birth attendant at health facility to husbands and families, and health service quality improvement, are recommended.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institue)
Department:
Development Policy & Practice
Country:
Ethiopia, Federal Democratic Republic of
Training:
Master of Public Health / International Course in Health Development (ICHD)
Category:
Research
Right:
© 2013 Agidew
Document type:
Thesis/dissertation
File:
ssqpd4nW19_20161026142713945.pdf