Boosting Maternal Health Care Seeking Behavior in Rural Low Income Communities: A Case Study of West Gojam and South Wollo Zones in Amhara, Ethiopia

Abstract

Taking the national scenario in maternal health care, it was taken for granted that Ethiopia would not meet the millennium development goal in the reduction of maternal death: assisted birth at a health institution for example was as low as 10% in 2011. Although, the introduction of the health extension program since has enabled the health sector to make major strides towards health promotion and disease prevention, health facility utilization in maternal health care remained low. An ecologically driven health development army (HAD) of thirty members sub structured into community cell based networking of 1-5 has been introduced to guide social mobilization and community participation in health as of 2012. The networking requires all women and men to be teamed in 1-5 cells, actively participate in learning and practicing good health. The analysis of the effect of the networking on boosting maternal health care seeking behavior in rural communities was made using qualitative data obtained from informant interviews and focus group discussions in Amhara, West Gojam and South Wolo Zones. The data analysis looked into inputs, processes, outcomes/outputs, effects and impacts of the networking in maternal health care. The analysis showed that the networking of communities in HAD of 1-30 and substructures of 1-5 is transformative in boosting health care seeking behavior. Study participants demonstrated, irrespective of age, religion and gender, shared health information and attitude towards pregnancy, birth, and the need to mitigate health risks by attending care and treatment services at health facilities. All stakeholders at community and leadership position give credit to the social network of HDA for enhancing maternal care seeking behavior in beneficiaries and responsiveness of heath providers in health facilities to meet health care needs of mothers. The impact of the networking is that communities are empowered and are assuming ownership with regards to dealing with their health care needs. In effect they are demanding for availability of quality of maternal health care services at closer locations. The lesson learnt is that through the use of innovative methodologies and approaches, communities can assume leadership in producing good health. In such a scenario, it is suggested that governments should mobilize resources, local and as well international to improve the supply side of maternal and child health care services. Failure to meet what communities are demanding in health care service delivery would result in dissatisfaction and lack of trust in the health system.