Maternal delays in utilizing institutional delivery services, Bahir Dar, Ethiopia

Abstract

Introduction: Timely referrals and access to appropriate health care had a great impact on reduction to maternal deaths and disabilities. Maternal delay is one of the contributing factors for high maternal mortality in developing countries. Maternal delays were categorized into three levels: delay in making the decision for seeking care, delay in arrival at a health facility, and delay in receiving adequate treatment. They have been named first, second, and third delay maternal delays; respectively. This study was aimed at assessing maternal delays in utilizing institutional delivery service sin Bahir Dar, North-Western Ethiopia. Methods: A cross sectional facility based study was conducted on a sample of 422 women attending at a public health facility for delivery services. The sample size was determined by using single population proportion formula and the study participants were selected by using a systematic random sampling method. Data were collected by means of a pre-tested, standardized questionnaire; analysis was carried out using SPSS version 16. Results: Data was collected from 410 laboring mothers. First delay , 155 (37.8%) of mothers was delayed in decision making for seeking care from the public health facility and the mean delay was 8 hours. Delay in seeking emergency obstetric care [EOC] was about seven fold among illiterate mothers (AOR, 6.71; 95%CI, 3.66 - 12.29) than literate mothers; the odds of delay for EOC were three times more likely among mother were unable to make decisions by their own (AOR, 3.30; 95%CI, 1.25 -7.20) than those mothers who made the decisions of their own. Unemployed mothers were 4 times more likely to have the maternal delay in seeking EOC (AOR, 3.94; 95%CI, 2.36 -6.57) than employed mothers. Second delay , 130 (31.7%) of mothers had transportation problems in reaching health care facilities. Predictors in the first maternal delay were also the major contributing factors for this delay. The third delay , after their arrival at health facilities, 126 (30.7%) mothers reported that they did not get the services on time; the mean waiting time for getting the service was 4 hours. Conclusions: Many mothers were not getting institutional delivery care services in a timely man ner, due to the “three maternal delays”. Mothers’ literacy, decision making power and employment status were the main predictors for deliv ery service utilization. Hence, emphasis should be given for awareness creation on the risks of maternal delays, designing income generating mechanism, women empowering for in decision mak ing and ambulance services should be streng thened.