BackgroundEvery pregnant woman is considered to be at risk and some risks may not always be foreseeable or detectable. Therefore, the presence of a skilled birth attendant at every delivery is considered to be the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia, the proportion of births attended by skilled personnel in urban settings can be as low as 10%. Therefore, the main purpose of this research was to identify factors affecting unplanned home delivery in urban settings, where there is relatively good access in principle to modern healthcare institutions.DesignA community-based follow-up study was conducted from 17 January 2014 to 30 August 2014, among second- and third-trimester pregnant women who had planned for institutional delivery in South Tigray Zone. A systematic sampling technique was used to get a total of 522 study participants. A pre-tested and structured questionnaire was used to collect relevant data. Bivariate and multivariate data analyses were performed using SPSS version 16.0.ResultsThe study revealed that among 465 pregnant women who planned for institutional delivery, 134 (28.8%) opted out and delivered at their home (missed opportunity). Single women (AOR 2.34, 95% CI 1.17–4.68), illiterate mothers (AOR 6.14, 95% CI 2.20–17.2), absence of antenatal clinic visit for indexed pregnancy (AOR 3.11, 95% CI 1.72–5.61), absence of obstetric complications during the index pregnancy (AOR 2.96, 95% CI 1.47–5.97), poor autonomy (AOR 2.11, 95% CI 1.27–3.49), and absence of birth preparedness and complication readiness (AOR 3.83, 95% CI 2.19–6.70) were significant predictors of unplanned home delivery.ConclusionsA significant proportion of pregnant women missed the opportunity of modern delivery assistance. Educational status, antenatal care status, lack of obstetric complications, poor autonomy, and lack of birth preparedness and complication readiness were among the important predictors of unplanned home delivery.

Background: Acute diarrhea is defined as experience of three or more watery stools, with or without blood, in 24 hours period. It is a leading cause of mortality and morbidity in children under the age of five in developing countries. On the African continent, diarrhea cause more child deaths than Malaria, HIV/AIDS, and measles.

IntroductionWorldwide, each year more than 500,000 women, 99% of them in developing countries, die from pregnancy and childbirth-related complications and an additional 15 to 20 million women suffer from debilitating consequences of pregnancy [1]. The major causes of maternal deaths are hemorrhage, infection, obstructed labor, hypertensive disorders in pregnancy, and complications of unsafe abortion [2].Maternal deaths due to unsafe abortion in developing countries fall within a narrow range from 9% to 17% of all maternal deaths [3]. Both the lowest and the highest figures are found in Africa (9% in Southern Africa and 17% in Eastern Africa), reflecting the combined impact of the legal abortion and health systems, with more liberal access to abortion and post abortion care in the health systems [3].Ethiopia is one of the counties with highest maternal mortality ratio which is currently estimated at 676/100,000 live births [4]. Main contributing factors for this high death includes unsafe abortion, among others [5]. Several studies in Ethiopia indicated that unsafe abortion may account for up to 25-35% of the maternal deaths [6][7][8]. A recent nationwide study on abortion related complications has shown that an estimated number of 17 patients are seen in hospitals for post abortion complications in a month and complications due to abortion were also reported from low-level facilities, which do not provide post abortion care services [9]. From a community based large-scale survey in Addis Ababa, Ethiopia, maternal mortality in the city was estimated to be 566 per 100,000 live births and abortion was major contributor to the deaths [4,8,10]. In addition, safe abortion service is a recent trend and a formal post abortion care (PAC) service in the country is not yet well expanded [3,11,12]. Thus this study assessed the influencing factors of PAC utilization in selected health institutions in Addis Ababa, Ethiopia. Methods Study design, area and periodAn institution-based cross sectional study was conducted among reproductive age women (15-49 years) who were attending maternal and child health (MCH) services using structured interviews. A total of 153 respondents were recruited from six MCH clinics in Addis Ababa, Ethiopia. Data were collected between February and April, 2012. There were 620 clients attending MCH services that obtained from monthly registration report of MCH clinics in these six MCH clinics. Respondents were recruited proportionally to the client flow from each MCH clinics. For the purpose of this study, we defined users of post abortion care as women of childbearing age who had received all components of post abortion care services, and non users of post abortion care as women of childbearing age who had not received all of the components. We used the inclusion criteria as all reproductive age women with at least one abortion history in the last one year, and exclusion criteria as all reproductive age women who had no any abortion history, women with hearing problem, and mentally incompetent women d...