The Effect of Birth Preparedness and Complication Readiness on Skilled Care Use: A Prospective Follow up Study in Southwest Ethiopia

INTRODUCTION:  Skilled care during and immediately after delivery has been identified as one of the key strategies in reducing maternal mortality.   However, recent estimates show that the status of skilled care during delivery remained very low in Ethiopia.   Birth preparedness and complication readiness has been implemented as comprehensive strategy to fill this gap. However, its effectiveness in improving skilled care use hasn’t been well studied. this study aimed to assess the effect of birth preparedness and complication readiness on skilled care use in Southwest Ethiopia.

METHODS: A prospective follow up study was conducted from September 2012-April 2013 in Southwest Ethiopia among randomly selected 3472 mothers. Data were collected by using pre-tested interviewer administered questionnaires and analyzed by using SPSS for windows V.20.0. Bivariate and multivariate logistic regressions were done to look at the relation between birth preparedness and complication readiness plan and skilled care use by controlling for confounders.

RESULTS: The status of skilled care use was 30.6%. Planning to use skilled care during pregnancy was found to increase actual use significantly (OR=2.24; 95%CI: 1.60, 3.15). Place of residence, educational status, husband’s occupation, wealth index and access to health facility were identified as socio-demographic and economic related factors affecting skilled care use. Knowledge of key danger signs during delivery, ANC use, number of pregnancy and inter-birth interval were among the obstetric factors affecting skilled care use. 

 CONCLUSIONS:  The status of skilled care use was found to be low as compared to MDG target. Birth preparedness and complication readiness had significant effect on skilled care use during delivery.  Socio-demographic, economic, access to health facility, knowledge of key danger signs, ANC use, number of pregnancies and birth interval were identified as determinant factors for skilled care use. Designing appropriate interventions to improve IEC/BCC, ANC, family planning and knowledge of key danger signs are recommended.