Maternal health care service utilization and associated factors in finoteselam town adminstration,amhara regional state, west gojjam zone, north ethiopia.

Abstract

A community based cross sectional study was conducted from January 15-28/2011 in Finoteselam town west Gojjam zone Amhara Regional state to assess ‘’maternal health care service utilization and associated factors.factors affecting utilization of maternal health care services’’ among women during their second trimester of pregnancy and above and women within 24 months of post delivery from data collection time. Census conducted and house numbers with eligible mothers were registered for five days. The total sample size was 290 and to select these participants simple random sampling lottery method was used. Data was collected using a pre-tested and structured questionnaire by grade 10 completed female data collectors. Data entry and analysis was done by SPSS version 16.0. Chi-square and odds ratio were used to see the association between dependant and independent variables. These finding revealed that 78.6% of the women had at least one prenatal visit during their recent pregnancy. Among antenatal care attendants 53% made their first visit during their second trimester of pregnancy and 63.2% had less than four antenatal care visits. Regarding to place of delivery 71.7% took place at health institution and the majority of home deliveries 92.7% were assisted by their families. Postnatal care utilization was also assessed during the study, among respondents 37.24% had post natal care visit during their last pregnancy and 52.8% were visited less than three times. Among the main reasons for non attendance given by non attendants were lack of awareness to the service, poor client handling and financial problems in nature. Regarding to knowledge on danger signs of pregnancy and child birth 46.9% of respondents had knowledge on danger signs and able to name at least one of it. Among respondents 28.6% had history of illness to their last pregnancy. Chi-square and odds ratio were used to see the association between variables. Factors such as (OR=11.11,95%CI:4.76,25.00),Income >1000Birr/month,(OR=3.45,95%CI:1.20,9.92), Family size > 5,(OR=3.33,95%CI: 1.01,11.11), Planed pregnancy (OR=5.26,95%CI:2.33,11.11) and knowledge on danger signs of pregnancy & child birth (OR=2.56,95%CI: 2.44,11.11) were positively associated with ANC service utilization(Table 6). Health institution delivery was also affected by Education secondary & above (OR=5.90,95%CI: 2.07,16.84), monthly house hold income > 1000Birr (OR=6.12, 95%CI: 2.11, 17.60), Christian religion (OR=3.79,95%CI:1.24,11.63),Positive husbands attitude to the service (OR=4.72,95%CI:2.07,10.75) and history of ANC follow up for last pregnancy,(OR=7.69,95%CI:3.57,16.67) were positively associated with health institution delivery.(Table8 ). Post natal care utilization was also affected by house hold monthly Income >1000Birr/month,(OR=2.38, 95%CI: 1.14, 5.10),positive husbands attitude to the service (OR=5.26, 95%CI: 2.22, 12.50) , history of ANC follow up (OR=8.33,95%CI:2.38,33.33) and parity <1 (OR=6.79,95%CI:1.29, 29.55) were positively associated with post natal care utilization.In conclusion, even though the study should improvement on maternal health service utilization in the area, demographic and socio cultural factors were found to be associated to utilization of maternal health care services. By focussing on these associated factors interventions need to be designed and implemented. IV