TITLE:
Maternal delays in utilizing institutional delivery services, Bahir Dar, Ethiopia
AUTHORS:
Worku Awoke, Kenie Seleshi
KEYWORDS:
Maternal Delays; Delivery Service; Ethiopia
JOURNAL NAME:
Health,
Vol.5 No.6,
June
11,
2013
ABSTRACT:
Introduction: Timely referrals and access to appropriate health care had
a great impact on reduction to maternal deaths and disabilities. Maternal
delay is one of the contributing factors for high maternal mortality in
developing countries. Maternal delays were categorized into
three levels: delay in making the decision for seeking care, delay in arrival
at a health facility, and delay in receiving adequate treatment. They have
been named first, second, and third delay maternal delays; respectively. This
study was aimed at assessing maternal delays in utilizing institutional
delivery service sin Bahir Dar, North-Western Ethiopia. Methods: A cross sectional
facility based study was conducted on a sample of 422 women attending at a
public health facility for delivery services. The sample size was determined by
using single population proportion formula and the study participants were
selected by using a systematic random sampling method. Data were collected by
means of a pre-tested, standardized questionnaire; analysis was carried out
using SPSS version 16. Results: Data was collected from 410 laboring mothers. First delay, 155 (37.8%) of mothers was
delayed in decision making for seeking care from the public health facility and
the mean delay was 8 hours. Delay in seeking emergency obstetric care [EOC]
was about seven fold among illiterate
mothers (AOR, 6.71; 95%CI, 3.66 -12.29) than literate mothers; the odds
of delay for EOC were three times more likely among mother were unable to make
decisions by their own (AOR, 3.30; 95%CI, 1.25 -7.20) than those mothers who
made the decisions of their own. Unemployed mothers were 4 times more likely to have the maternal delay in seeking
EOC (AOR, 3.94; 95%CI, 2.36 -6.57) than employed mothers. Second delay, 130 (31.7%) of mothers had transportation problems
in reaching health care facilities. Predictors in the first maternal delay
were also the major contributing factors for this delay. The third delay, after their arrival at health facilities, 126
(30.7%) mothers reported that they did not get the services on time; the mean
waiting time for getting the service was 4
hours. Conclusions: Many mothers were not getting institutional delivery care
services in a timely manner, due to the “three maternal delays”.
Mothers’ literacy, decision making power and employment status were the main
predictors for delivery service utilization. Hence, emphasis
should be given for awareness creation on the risks of maternal delays,
designing income generating mechanism, women empowering for in decision making and ambulance services should be strengthened.