Abstract

BackgroundMajority of causes of maternal and newborn mortalities are preventable. However, poor access to and low utilization of health services remain major barriers to optimum health of the mothers and newborns. The objectives of this study were to assess maternal and newborn health services utilization and factors affecting mothers’ health service utilization.MethodsA community based cross-sectional survey was carried out on randomly selected mothers who gave birth within a year preceding the survey. The survey was supplemented with key informant interviews of experts/health professionals. Multivariable logistic model was used to identify factors associated with service utilization. Adjusted odds ratios (AORs) were used to assess the strength of the associations at p-value ≤0.05. The qualitative data were summarized thematically.ResultsA total of 789 (99.1% response rate) mothers participated in the study. The proportion of the mothers who got at least one antennal care (ANC) visit, institutional delivery and postnatal care (PNC) were 93.3, 77.4 and 92.0%, respectively. Three-forth (74.2%) of the mothers started ANC lately and only 47.5% of them completed ANC4+ visits. Medium (4–6) family size (AOR: 2.3; 95% CI: 1.1, 4.9), decision on ANC visits with husband (AOR: 30.9; 95% CI: 8.3, 115.4) or husband only (AOR: 15.3; 95%CI: 3.8, 62.3) and listening to radio (AOR: 2.5; 95%CI: 1.1, 5.6) were associated with ANC attendance.Mothers whose husbands read/write (AOR: 1.6; 95% CI: 1.1, 2.), attended formal education (AOR: 2.8; 95% CI: 1.1, 6.8), have positive attitudes (AOR: 10.2; 95% CI: 25.9), living in small (AOR: 3.0; 95% CI: 1.2, 7.6) and medium size family (AOR: 2.3; 95% CI: 1.2, 4.1) were more likely to give birth in-health facilities. The proportion of PNC checkups among mothers who delivered in health facilities and at home were 92.0 and 32.5%, respectively. The key informants mentioned that home delivery, delayed arrival of the mothers, unsafe delivery settings, shortage of skilled personnel and supplies were major obstacles to maternal health services utilization.ConclusionsHealth information communication targeting husbands may improve maternal and newborn health services utilization. In service training of personnel and equipping health facilities with essential supplies can improve the provider side barriers.

Highlights

  • Majority of causes of maternal and newborn mortalities are preventable

  • In spite of the unreserved efforts made by the government and other partners, the maternal mortality ratio and infant mortality rate remain unacceptably high and among the unachieved Millennium Development Goal (MDGs) targets in Ethiopia

  • It has been estimated that SDG 3.1 can be achieved if coverages of first antenatal care visit (ANC1), fourth antenatal care visit (ANC4), institutional delivery and skilled birth attendance reach 91, 78, 81, and 87%, respectively [5]

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Summary

Introduction

Majority of causes of maternal and newborn mortalities are preventable. Curbing preventable maternal and newborn mortality is critical to achieving the Sustainable Development Goals (SDGs) [2]. A health facility-based study conducted in central Ethiopia [6] revealed that in spite of high ANC1 (89.4%), institutional delivery (82.4%) and postnatal care (PNC) within six hours of delivery (74.6%), below half (46.6%) and only 14 (1.2%) of the study participants reported to have had three or more ANC and PNC visits, respectively. An earlier community-based study conducted in Northwest Ethiopia [7] showed that only 12.1% of the mothers gave birth in health institutions during the 12 months preceding the survey

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