Examining Individual- and Community-Level Factors Affecting Skilled Delivery Care among Women Who Received Adequate Antenatal Care in Ethiopia: Using Multilevel Analysis

Autor: Eshetu E. Chaka, Peng Bao
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Rural Population
medicine.medical_specialty
Adolescent
Urban Population
Article Subject
Intraclass correlation
education
MEDLINE
behavioral disciplines and activities
Health Services Accessibility
General Biochemistry
Genetics and Molecular Biology
Young Adult
03 medical and health sciences
0302 clinical medicine
Pregnancy
Environmental health
medicine
Humans
030212 general & internal medicine
General Immunology and Microbiology
business.industry
030503 health policy & services
Public health
Mortality rate
Multilevel model
International community
Prenatal Care
General Medicine
Middle Aged
Delivery
Obstetric
Birth order
Cross-Sectional Studies
Maternal Mortality
Socioeconomic Factors
Multilevel Analysis
Medicine
Female
Ethiopia
Rural area
0305 other medical science
business
Research Article
Zdroj: BioMed Research International, Vol 2020 (2020)
BioMed Research International
ISSN: 2314-6141
2314-6133
Popis: Introduction. Maternal mortality continues to be a major public health and development challenge in Africa even after the permissible commitment of the international community. Although the use of skilled delivery care is the key intervention and is effective to lower maternal mortality rates, it is still at a lower proportion. The study is aimed at investigating the individual- and community level factors affecting the use of skilled delivery care among those women who had received adequate antenatal care. Materials and Methods. Data were extracted from the 2016 Ethiopian Demographic and Health Survey on women aged 15-49 years and gave birth within five years prior to the survey ( N = 957 ). Multilevel logistic regression model with two levels were fitted to assess the influence of the individual- and community-level factors on the use of skilled delivery care. Results. Women who were exposed to media were more likely to use skilled delivery care ( OR = 1.81 ; 95% CI: 1.20-2.74). Having six or more birth order ( OR = 0.33 ; 95% CI: 0.16-0.69) and residing in rural areas ( OR = 0.40 ; 95% CI: 0.21-0.79) were associated with less likelihood use of skilled delivery care. Attaining primary and secondary educational level, being older women, being from the richest household, and having a urine test during antenatal visits were significantly associated with the use of skilled delivery care. The value of intraclass correlation coefficient supported a significant community-level effect on the likelihood of using skilled delivery care. Conclusions. Factors operating both at the individual level and community level were found significantly associated with the use of skilled delivery care in Ethiopia. A considerable variation at community level accounts for the difference in the use of skilled delivery level.
Databáze: OpenAIRE
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