Pregnant Women Perceived Community Acceptance on Continuum of maternal and newborn care its Correlates in Ethiopia: Community based 2 year Cohort follow up Study
Résumé
Abstract Background: Among the critical determinants of the success of the new maternal, new born and child health care continuum (MCH) paradigm shift is acceptance and support of the community for women and new born to get the three recommend cares and their retention in the care. This is less explored, leading dearth of evidence, hence, this study determined the level of pregnant women perceived community acceptance on that women and new born should get the recommend continuum of care package and be retained in it and associated factors with the aim to provide actionable evidence. Methods: This study used PMA cohort 1 baseline data which enrolled and collected data from currently pregnant women. Frequency was computed to describe the study participant’s characteristics. Multinomial logistics regression was employed to identify correlates that pregnant women perceived that most/some/few people in their community encourage women to get the three recommended domains of maternal and new born continuum of care. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05. Results: The proportion of pregnant women who perceived no people encourage that women obtain the three domains of continuum of care is 7.03% (5.89%, 8.38%) while 33.66.83% (31.42, 35.96) and 31.93 (29.60%, 34.36%) perceived that most and few people respectively encourage women to get the three domains (4+ antenatal care and skilled delivery and postnatal care) of maternal and new born health care continuum. Women age, secondary educational status, ever used contraceptive method, health facility as desired place of delivery and residing in Oromiya Regions were found to increase the likelihood of pregnant women to perceive that most/some people in their community encourage women to obtain the three recommended domains of the continuum of care. On the contrary, this likelihood was lowered by factors: higher birth order, rural residence, higher wealth index and family member/TBA as desired birth attendant. Conclusions: Then finding that only one third pregnant women perceive that most people in their community encourage pregnant women to obtain the three recommended maternal and new born care domains is an alarm that the global community have a long way to go to achieve nearly almost women get the three recommended cares by averting such bottlenecks which hider women to use the service. Given pregnancy delivery and child bearing is a social event, activities and intervention need to focus in averting the influence of the people in the community on service use. Activities and targets who focusing on women education and, which encourage contraceptive use for spacing, women economic empowerment and advocating health facility delivery and skilled attendant are likely to nurture women perceived acceptance for most people in the community encourage women to use the three domains of CoC thereby improving the positive impact on women of significant others on maternal health service use (halting the negative effect of other and women be able to decide their health service needs). Such activities and efforts need to be age sensitive and target rural residents. Increasing awareness creation and advocating birth preparedness and complication readiness is like to improve women perception that people in their community encourages women to get the three recommended cares along the continuum of care.
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