Abstract:
Background: The fifth Millennium Development Goal calls for a reduction of maternal
mortality ratio by 75% between 1990 and 2015. A key indicator to measure this goal is the
proportion of births attended by skilled health personnel. Skilled birth attendance is
correlated with lower maternal mortality rates globally and in Sub-Saharan Africa.
Moreover providing skilled care during labor, delivery and early post-partum period also
could reduce deaths due to obstructed labor, hemorrhage, sepsis and eclampsia. However,
the proportion of births with a skilled attendant is only 20.4% in Ethiopia. Therefore
identifying the determinants of skilled attendance for delivery is a priority area to give
policy recommendations.
Objective: The study aimed to estimate the prevalence and the effects of predisposing,
enabling and need factors on the use of skilled assistance at delivery by pregnant women.
Methods: A community based cross sectional study that employed both quantitative and
qualitative data collection method was conducted from April 18 to 28 ,2014 in Lokaabaya district, Sidama zone, south east Ethiopia. Multi stage sampling technique was used
for selection of study participants. A pre tested semi-structured questionnaires via
interview was used to collect data on different variables. Bivirate and multivariate Logistic
regression analysis was used to identify the determinants of skilled birth attendance. Focus
group discussion (FGDs) was utilized for Qualitative data collection.
Results: 550 mothers were included in the analysis. The respondents with age of 20- 34yrs
were four hundred and fifty (82%) with [AOR (95% CI) =3.15 (1.01, 9.79)], About
263(48%) of the mothers having married to husbands who have attended secondary and
above level of education [AOR (95%CI) = 14.79 (3.01, 65.60], mothers having first birth
[AOR (95%CI) = 7.01 (3.60, 13.63 Similarly, mothers who had ever given birth at health
facility [AOR (95% CI) =67.03(31.8, 141.00)] and had known the risk of home delivery
[AOR (95%CI) =7.79(2.29, 26.5)] were independent predictors of skilled birth attendance.
Conclusions: The prevalence of utilization of skilled birth attendance is very low in the
study area. Maternal age at interview, husbands’ education, Birth order, ever use of health
facility during previous delivery and maternal knowledge on risk of home delivery were
found to be independent determinants of skilled birth attendance
