Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets

Abstract

BackgroundAlmost two decades since the initiation of the Safe motherhood Initiative, Maternal Mortality is still soaring high in most developing countries. In 2000 WHO estimated a life time risk of a maternal death of 1 in 16 in Sub- Saharan Africa while it was only 1 in 2800 in developed countries. This huge discrepancy in the rate of maternal deaths is due to differences in access and use of maternal health care services. It is known that having a skilled attendant at every delivery can lead to marked reductions in maternal mortality. For this reason, the proportion of births attended by skilled health personnel is one of the indicators used to monitor progress towards the achievement of the MDG-5 of improving maternal health.MethodsCross sectional study which employed quantitative research methods.ResultsWe interviewed 974 women who gave birth within one year prior to the survey. Although almost all (99.8%) attended ANC at least once during their last pregnancy, only 46.7% reported to deliver in a health facility and only 44.5% were assisted during delivery by a skilled attendant. Distance to the health facility (OR = 4.09 (2.72–6.16)), discussion with the male partner on place of delivery (OR = 2.37(1.75–3.22)), advise to deliver in a health facility during ANC (OR = 1.43 (1.25–2.63)) and knowledge of pregnancy risk factors (OR 2.95 (1.65–5.25)) showed significant association with use of skilled care at delivery even after controlling for confounding factors.ConclusionUse of skilled care during delivery in this district is below the target set by ICPD + of attaining 80% of deliveries attended by skilled personnel by 2005. We recommend the following in order to increase the pace towards achieving the MDG targets: to improve coverage of health facilities, raising awareness for both men and women on danger signs during pregnancy/delivery and strengthening counseling on facility delivery and individual birth preparedness.

Antenatal Care Utilization and It’s Associated Factors in East Wollega Zone, Ethiopia

“…On the other hand, women who live within 30 min walking distance from the health facility were more likely to use ANC. Previous studies in Ethiopia and other African countries have also shown an association between ANC utilization and proximity to a health facility [15,7,20,31,[33][34][35]. The distance from health facilities may incur them extra expense for transportation costs which in turn could hinder them from receiving ANC services.…”

Rethinking How to Promote Maternity Care-Seeking: Factors Associated With Institutional Delivery in Guinea

“…Other researchers (Barber, 2006;Bloom, et al, 1999;Kabakyenga et al, 2012;Mpembeni et al, 2007) have highlighted the positive relationship between the quantity of ANC (measured in terms of number of visits) and women's use of institutional delivery care. Our findings underscore the importance of the counseling that women receive during these visits.…”

“…Because the clinical and counseling content of ANC has been shown to influence care-seeking during childbirth (Barber 2006;Bloom, Lippeveld, & Wypij, 1999;Mpembeni et al, 2007), a composite variable was developed to summarize the counseling provided to women during their ANC visits. The BP/CR Counseling Index was based on whether women reported that, during any of their ANC visits, they were advised to deliver at a health facility; advised about danger signs during pregnancy and delivery; and advised on any of the following delivery preparations: saving money, arranging for transport, discussing delivery plans with family members, or identifying a blood donor.…”

Perceptions about the cultural practices of male partners during postpartum care in rural Tanzania: a qualitative study

“…violence, unwanted pregnancy and human immunodeficiency virus (HIV) infection [4–7]. However, men can also play a positive role, and men’s involvement in pregnancy and childbirth has been shown to benefit the health of mothers and newborns [1,8–13]. Men’s involvement in reproductive health can also enhance gender equality and empower individual women to make their own decisions [14,15].…”