Determining factors associated with the prevalence of knowledge, attitude, and practice in seeking skilled maternal healthcare services among women in a remote area of Gesha district

Abstract

Background Skilled health care is essential for the mother's and newborn's health and well-being during pregnancy, labor, and the postpartum period. This study aimed to analyze women's knowledge, attitudes, and practices while requesting competent assistance for maternity healthcare in Gesha District, Southwest Region of Ethiopia. Methods A community-based cross-sectional study design was conducted from September 20, 2021 to October 19, 2021. A total of 424 mothers participated in this study and a systematic sampling technique was used to select the respondents. The data were collected using a pretested and structured questionnaire. Statistical software SPSS-20 and R-4.1.2 were used to enter and analyze the data respectively. The factors associated with the prevalence of Knowledge, Attitude, and Practice in seeking Skilled Maternal Healthcare Services were identified using descriptive analysis and a binary logistic regression model. Results This study result revealed that the overall proportions of good knowledge, positive attitude, and good practice in seeking skilled maternal health care services were 39.15%, 37.5%, and 34.67% respectively. Estimated odds of having knowledge, attitude, and practice were as follows: for having age between 20–24 years at first pregnancy 1.859, 1.86, and 1.799; having a plan for pregnancy 2.74,2.315 and 2.579; mothers attended elementary education 2.337, 2.565 and 3.312; having maternal age 20–24 years 4.336,4.989 and 5.870; maternal age 25–29 years 2.917, 3.794 and 4.017; maternal age 35–49 years 2.837, 2.991 and 3.412; having husbands who had attended elementary education level 2.736, 2.542 and 2.134; secondary and above education 3.464, 3.360 and 2.508; rich mothers 2.261, 1.995 and 2.452; having antenatal care 4 times and above 2.606, 2.570, 2.682; having transportation access 1.921, 1.956 and 2.404; having media access 1.979, 2.171 and 2.715 respectively. The odds of having attitude and practice respectively were as follows: married 1.762, and 2.208; having medium wealth index 1.933 and 2.424. The odds of having previous pregnancy complications was 2.147 which significantly affect the practice of seeking skilled maternal care assistance. Conclusions This study discovered that the study participants' knowledge, attitude, and practice of skilled maternal health care are low. Associated factors included age at first pregnancy, planned pregnancy, maternal education level, husband’s education level, maternal age, antenatal care service visits, transport access, and access to media were found to significantly affect the knowledge, attitude, and practice of the respondents in seeking skilled maternal care assistance in common. The household wealth index was also associated with attitude. Pregnancy complications, current marital status, and household wealth index also significantly affect the practice of seeking skilled maternal care assistance. As a result of the findings, initiatives to increase women's knowledge, attitudes, and use of expert maternal health services in the research area are needed for women residing in rural areas.

Mapping Evidence on the Determinants of Postnatal Care Knowledge among Postpartum Women in sub-Saharan Africa: A Literature Review

“…The other determinants of PNC knowledge reported in this review include the number of previous pregnancies (Beraki et al, 2020;Yaya Tessema, et al, 2023;Leta, 2022;Berhan & Gulema, 2018;Mose et al, 2021;Kebede et al, 2020;Yitayew et al, 2021;Roney et al, 2021;Kanu et al, 2014;Meseka et al, 2017), whether the pregnancy was planned or not (Hassen & Lelisho, 2022;Kebede et al, 2020), family size (Tesfaye et al, 2022), whether the woman stayed with the father of the baby (Tesfaye et al, 2022;Nchimbi & Joho, 2022), involvement of the father of the baby in PNC activities (Kebede et al, 2020;Roney, et al, 2021), and whether the woman had self-decision making power to seek care for herself and her baby (Yaya Tessema et al, 2023). All the studies that reported on the number of pregnancies as a determinant of PNC knowledge (Beraki et al, 2020;Yaya Tessema et al, 2023;Leta, 2022;Berhan & Gulema, 2018;Mose et al, 2021;Kebede et al, 2020;Yitayew et al, 2021;Roney et al, 2021;Kanu et al, 2014) revealed that women who had more children were more likely to have PNC knowledge compared to those who had fewer, except for one (Meseka et al, 2017) that revealed that primiparous women were more likely to have good PNC knowledge compared to multiparous women.…”

“…All the articles reported on quantitative cross-sectional studies. Sixteen of the articles were from studies conducted in Ethiopia (Beraki et al, 2020;Yaya Tessema et al, 2023;Leta, 2022;Berhan & Gulema, 2018;Getachew et al, 2022;Berhea et al, 2018;Mose et al, 2021;Hassen & Lelisho, 2022;Mekonnen et al, 2021;Seifu et al, 2020;Guta et al, 2020;Kebede et al, 2020;Tesfaye et al, 2022;Yitayew et al, 2021;Bulto et al, 2019;Degefa, et al, 2019), two each in Kenya (Kiragu et al, 2021;Roney et al, 2021), Tanzania (Msiba et al, 2022;Nchimbi & Joho, 2022), and Rwanda (Batamuriza & Uwingabire, 2020;Deynu & Nutor, 2023), and one each in Sierra Leone (Kanu et al, 2014), Zambia (Chembe & Siziya, 2017), and South Sudan (Meseka et al, 2017). Eight of the articles (Mose et al, 2021;Guta et al, 2020;Kebede et al, 2020;Tesfaye et al, 2022;Yitayew et al, 2021;Bulto et al, 2019;Degefa, et al, 2019;Roney et al, 2021) reported on studies that researched on knowledge of neonatal danger signs (NDS), seven (Leta, 2022;Berhan & Gulema, 2018;Getachew et al, 2022;Berhea, et al, 2018;Msiba, et al, 2022;…”

“…All the articles included in this review reported on the individual-level determinants of PNC knowledge among postpartum women. The individual-level determinants of PNC knowledge include place of residence (Beraki et al, 2020;Mose et al, 2021;Mekonnen et al, 2021;Yitayew, et al, 2021;Deynu & Nutor, 2023), age of the mother (Beraki et al, 2020;Batamuriza & Uwingabire, 2020), age at first pregnancy, marital status (Beraki et al, 2020;Deynu & Nutor, 2023), educational level of the mother (Beraki et al, 2020;Yaya Tessema et al, 2023;Leta, 2022;Getachew et al, 2022;Berhea et al, 2018;Hassen & Lelisho, 2022;Seifu et al, 2020;Yitayew et al, 2021;Bulto et al, 2019;Degefa et al, 2019;Roney et al, 2021;Nchimbi & Joho, 2022;Kanu et al, 2014;Chembe & Siziya, 2017), educational level of the father (Hassen & Lelisho, 2022;Yitayew et al, 2021), and religion of the mother (Getachew et al, 2022). All articles that reported on place of residence as a determinant of PNC knowledge (Beraki et al, 2020;Mose et al, 2021;Mekonnen et al, 2021;Yitayew et al, 2021;Deynu & Nutor, 2023) revealed that those who stayed in urban areas were more likely to have good PNC knowledge compared to those who stayed in rural areas.…”

“…Two studies that reported on marital status (Beraki et al, 2020;Deynu & Nutor, 2023) revealed that women who were married were more likely to have good PNC knowledge compared to those who were not married. All the studies that reported on the educational level of the mother (Beraki et al, 2020;Yaya Tessema et al, 2023;Leta, 2022;Getachew et al, 2022;Berhea et al, 2018;Hassen & Lelisho, 2022;Seifu et al, 2020;Yitayew et al, 2021;Bulto et al, 2019;Degefa et al, 2019;Roney et al, 2021;Nchimbi & Joho, 2022;Kanu et al, 2014;Chembe & Siziya, 2017) revealed that mothers who had a higher educational level were more likely to have good PNC knowledge compared to those who had a lower educational level. The two studies that reported on the association between the educational level of the father and the mother's PNC knowledge (Hassen & Lelisho, 2022;Yitayew et al, 2021), revealed that mothers who had partners with a higher educational level were more likely to have good PNC knowledge compared to those whose partners had a lower educational level.…”

“…All the studies that reported on the educational level of the mother (Beraki et al, 2020;Yaya Tessema et al, 2023;Leta, 2022;Getachew et al, 2022;Berhea et al, 2018;Hassen & Lelisho, 2022;Seifu et al, 2020;Yitayew et al, 2021;Bulto et al, 2019;Degefa et al, 2019;Roney et al, 2021;Nchimbi & Joho, 2022;Kanu et al, 2014;Chembe & Siziya, 2017) revealed that mothers who had a higher educational level were more likely to have good PNC knowledge compared to those who had a lower educational level. The two studies that reported on the association between the educational level of the father and the mother's PNC knowledge (Hassen & Lelisho, 2022;Yitayew et al, 2021), revealed that mothers who had partners with a higher educational level were more likely to have good PNC knowledge compared to those whose partners had a lower educational level. Only one study (Getachew et al, 2022) that reported on religion as a determinant of PNC knowledge among postpartum women revealed that Muslims were more likely to have good PNC knowledge compared to Christians.…”