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Southern Ethiopian skilled birth attendant variations and maternal mortality: a multilevel study of a population-based cross-sectional household survey

Article scientifique 2023 Anglais

Résumé

Abstract Introduction Studies 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 methods A 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. Results A 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. Conclusions The 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.

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Kea, A., Lindtjørn, B., Gebretsadik, A., Hinderaker, S. (2023). Southern Ethiopian skilled birth attendant variations and maternal mortality: a multilevel study of a population-based cross-sectional household survey. https://doi.org/10.1101/2023.09.18.23295756

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Auteur(s)

Aschenaki Zerihun Kea Bernt Lindtjørn Achamyelesh Gebretsadik Sven Gudmund Hinderaker

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