Abstract
AbstractIntroductionStudies examining skilled birth attendants (SBA) use and its correlation with maternal mortality at lower administrative levels are scarce. This study assessed the coverage and variations of SBA, the physical accessibility of health facilities for SBA, and the association of SBA with maternal mortality.Materials and methodsA cross-sectional study using a population-based household survey was conducted in six Sidama National Regional State, southern Ethiopia districts, from July 2019 to May 2020. Women who had given birth in the past two years prior to the study were included. Stata 15 and ArcGIS 10.4.1 were used for data analysis. A multilevel logistic regression analysis was conducted to assess the effect of the sampling units and identify factors independently associated with SBA. The association between SBA and maternal mortality was examined using data from a maternal mortality household survey.ResultsA total of 3191 women were interviewed. The coverage of SBA was 46.7%, with high variations in the districts. Thirty percent of SBA use was accounted for by the differences among the districts. One-third of the women travel more than two hours to access the nearest hospital. Districts with low coverage of SBA and located far away from the regional referral centre had high maternal mortality. Education of the mother, occupation of the husband, pregnancy-related complications, use of antenatal care, parity, and distance to the nearest hospital and health centre were associated with the use of SBA.ConclusionsThe coverage of SBA in the Sidama Region was low, with high variations in the districts. Low SBA use was associated with high maternal mortality. Due attention should be given to districts with low coverage of SBA and those located far away from the referral centre. Access to hospitals has to improve. All women should be encouraged to get antenatal care services.
Publisher
Cold Spring Harbor Laboratory
Reference53 articles.
1. A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries
2. WHO. Defining competent maternal and new-born health professionals. Joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA. Geneva: World Health Organization. 2018. Available from: https://apps.who.int/iris/handle/10665/272817
3. Sustainable Development Goals. Every Woman, Every Child: The Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030). 2015.
4. United Nations Children’s Fund. Delivering for Women: Improving maternal health services to save lives. New York: UNICEF. 2022.
5. Correlates of maternal mortality in developing countries: an ecological study in 82 countries