Use of previous maternal health services has a limited role in reattendance for skilled institutional delivery: cross-sectional survey in Northwest Ethiopia

Figures & data

Table 1 Sociodemographic and previous obstetric characteristics of the women

Characteristics	Response	n	%
Age	<20 years	41	8.6
	21–30 years	270	56.8
	>30 years	164	34.5
Residence	Urban	114	24.0
	Rural	361	76.0
Religion	Orthodox	444	93.5
	Muslim	31	6.5
Maternal educational status	No education	363	76.4
	Primary education (1–8)	56	11.8
	Secondary education (9–12)	39	8.2
	Tertiary and above	17	3.6
Occupation	Housewife	412	86.7
	Government employee	21	4.4
	Merchant	14	2.9
	Daily laborer	28	5.9
Marital status	Married	414	87.2
	Divorced	44	9.3
	Widowed	17	3.6
Pregnancy planning	Planned	377	79.4
	Unplanned	98	20.6
Parity	One	78	16.4
	2–3	161	33.9
	4–6	153	32.2
	>6	83	17.5
Average household monthly income (in Ethiopian birr)	<500	236	54.3
	501–1000	195	44.8
	Above 1000	4	0.9
Distance from health facility by foot	<15 minutes	95	20.0
	16–30 minutes	132	27.8
	31–60 minutes	136	28.6
	>60 minutes	112	23.6
Antenatal attendance	Yes	272	57.3
	No	203	42.7
Antenatal visit (n)	Once	85	31.2
	2–3	106	39.0
	≥4	81	29.8
Gestational age at first antenatal visit	<3 months	78	28.6
	4–6 months	97	35.7
	>6 months	97	35.7
Place of delivery for last pregnancy	Home	402	84.6
	Health institution	73	15.4

Figure 1 Reasons given by women not attending or reattending institutional skilled delivery services.

Table 3 Determinants of institutional skilled delivery usage from the bivariate and multivariate analysis

Factors	Institutional delivery attendance	Odds ratio (OR) (95% CI)		P value
		Crude OR	Adjusted OR
Maternal age				0.001
Age below 20 years	7 (9.5%)	1.90 [0.65–5.43]
21 to 30 years	50 (68.5%)	2.10 [1.15–4.03]*
Above 30 years	16 (22.0%)	1.0
Educational status of women				<0.001
Uneducated	18 (24.6%)	1.0	1.0
Primary education (1–8)	15 (20.5%)	7.0 [3.83–15.80]	2.24 [0.85–6.38]
Secondary education (9–12)	30 (41.3%)	63.8 [24.50–171.50]	25.8 [13.0–106.5]*
Above secondary education	10 (13.6%)	27.3 [8.30–92.20]	15.21 [3.4–48.5]*
Residence				<0.001
Urban	48 (65.7%)	9.5 [5.46–17.25]	4.55 [2.55–9.16]*
Rural	25 (34.73%)	1.0	1.0
Distance of health facility				<0.001
Below or equal to 15 minutes	42 (57.5%)	9.93 [5.93–25.15]	5.08 [2.72–13.60]*
16 to 30 minutes	19 (26.1%)	3.61 [1.92–11.45]	1.95 [1.12–7.35]*
31 minutes to one hour	7 (9.6%)	1.16 [0.32–4.36]	0.63 [0.15–2.47]
Above one hour	5 (6.8%)	1.0	1.0
Parity
One	33 (45.3%)	4.80 [2.25–11.24]	2.85 [1.82–6.73]*	0.01
Two to three	20 (27.4%)	0.92 [0.42–2.04]	0.65 [0.15–0.86]*
Four to six	9 (12.3%)	0.45 [0.16–1.03]	0.41 [0.06–0.75]*
Seven and above	11 (15.0%)	1.0	1.0
Previous birth at health facility				<0.001
No	48 (65.8%)	1.0	1.0
Yes	25 (34.2%)	0.59 [0.33–1.02]	0.55 [0.20–0.76]*
Antenatal care follow-up
Yes	54 (73.9%)	2.34 [1.33–4.20]	1.5 [1.15–3.70]*	0.02
No	19 (26.1%)	1.0	1.0

Note:

* Significant.

Abbreviation: CI, confidence interval.

Table 2 Level of awareness of women about use of the health facility

Questions	Responses	n (%)
Did you go for ANC during your pregnancy?	Yes	272 (57.3%)
	No	203 (42.7%)
Why did you go for ANC?	Because of knowing its advantage	126 (46.3%)
	Because I became sick	111 (40.8%)
	Health professional/ my husband advised me/ encouraged me to go	27 (10.0%)
	Unidentified reason	8 (2.9%)
When do you think is the earliest time you can go for the first ANC visit during pregnancy?	Less than 3 months’ gestation	88 (18.5%)
	3–6 months’ gestation	87 (18.3%)
	More than 6 months’ gestation	116 (24.4%)
	Do not know	184 (38.8%)
Where would you like most to give birth?	Home	262 (55.2%)
	Health institution	213 (44.8%)
In whom are you interested to have as an attendant during delivery?	Traditional birth attendant	150 (31.6%)
	Family member	65 (13.7%)
	Health professionals	260 (54.7%)

Abbreviation: ANC, antenatal care.