Do Health and Demographic Surveillance Systems benefit local populations? Maternal care utilisation in Butajira HDSS, Ethiopia

Mesganaw Fantahun Afework,Seifu Hagos Gebregiorgis,Meselech Assegid Roro,Alemayehu Mekonnen Lemma,Saifuddin Ahmed

doi:10.3402/gha.v7.24228

Abstract

Background The benefits of Health and Demographic Surveillance sites for local populations have been the topic of discussion as countries such as Ethiopia take efforts to achieve their Millennium Development Goal targets, on which they lag behind. Ethiopia's maternal mortality ratio is very high, and in the 2011 Ethiopia Demographic and Health Survey (2011 EDHS) it was estimated to be 676/100,000 live births. Recent Global Burden of Disease (GBD) and estimates based on the United Nations model reported better, but still unacceptably high, figures of 497/100,000 and 420/100,000 live births for 2013. In the 2011 EDHS, antenatal care (ANC) utilization was estimated at 34%, and delivery in health facilities was only 10%. Objectives To compare maternal health service utilization among populations in a Health and Demographic Surveillance System (HDSS) to non-HDSS populations in Butajira district, south central Ethiopia. Design A community-based comparative cross-sectional study was conducted in January and February 2012 among women who had delivered in the 2 years before the survey. Results A total of 2,296 women were included in the study. One thousand eight hundred and sixty two (81.1%) had attended ANC at least once, and 37% of the women had attended ANC at least four times. A quarter of the women delivered their last child in a health facility. Of the women living outside the HDSS areas, 715 (75.3%) attended ANC at least once compared to 85.1% of women living in the HDSS areas [adjusted odds ratio (AOR) 0.59; 95% CI 0.46, 0.74]. Of the women living outside the HDSS areas, only 170 (17.9%) delivered in health facilities and were assisted by skilled attendants during delivery, whereas 30.0% of those living in HDSS areas delivered in health facilities (AOR 0.66; 95% CI 0.48, 0.91). Conclusion This paper provides possible evidence that living in an HDSS site has a positive influence on maternal health. In addition, there may be a positive influence on those living nearby or in the same district where an HDSS is located even when not included in the surveillance system.

Highlights

The benefits of Health and Demographic Surveillance sites for local populations have been the topic of discussion as countries such as Ethiopia take efforts to achieve their Millennium Development Goal targets, on which they lag behind
Seven hundred and fifteen (75.3%) of the women living outside the Health and Demographic Surveillance System (HDSS) areas attended antenatal care (ANC) at least once compared to 85.1% of women living in the HDSS areas [adjusted odds ratio (AOR) 0.59]
We used a community-based study to assess whether living in an area in which an HDSS is being run contributes to better maternal health service utilization or not

Summary

Introduction

The benefits of Health and Demographic Surveillance sites for local populations have been the topic of discussion as countries such as Ethiopia take efforts to achieve their Millennium Development Goal targets, on which they lag behind. Ethiopia’s maternal mortality ratio is very high, and in the 2011 Ethiopia Demographic and Health Survey (2011 EDHS) it was estimated to be 676/100,000 live births. Objectives: To compare maternal health service utilization among populations in a Health and Demographic Surveillance System (HDSS) to non-HDSS populations in Butajira district, south central Ethiopia. Of the women living outside the HDSS areas, 715 (75.3%) attended ANC at least once compared to 85.1% of women living in the HDSS areas [adjusted odds ratio (AOR) 0.59; 95% CI 0.46, 0.74]. Of the women living outside the HDSS areas, only 170 (17.9%) delivered in health facilities and were assisted by skilled attendants during delivery, whereas 30.0% of those living in HDSS areas delivered in health facilities (AOR 0.66; 95% CI 0.48, 0.91). There may be a positive influence on those living nearby or in the same district where an HDSS is located even when not included in the surveillance system

Objectives

Methods

Results

Conclusion