UTILIZATION OF CLEAN AND SAFE DELIVERY SERVICE PACKAGE OF HEALTH SERVICES EXTENSION PROGRAM AND ASSOCIATED FACTORS IN RURAL KEBELES OF KAFA ZONE, SOUTHWEST ETHIOPIA

Abstract

BACKGROUND: In Ethiopia, 94% of births take place at home unattended by trained persons. Thegovernment introduced an innovative strategy, Health Services Extension Program in 2003. Clean andsafe delivery service is a component of maternal and child healthcare package of the program. However,little is known about the status of uptake of the service. This study thus aimed to assess utilization ofclean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia.METHODS: A community based cross sectional survey was conducted in rural kebeles of Kefa Zonefrom January 21 st to February 25 th , 2009 using a sample of 229 mothers. Kafa Zone is located 465kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structuredquestionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. P<0.05 was considered statistically significant.RESULTS: Utilization of clean and safe delivery service was 43(19%). Women with formal schoolingand those who knew at least two danger signs of pregnancy and labor were more likely to use the servicethan their counterparts; (AOR=5.8, 95% CI=2.1, 16) and (AOR=3.0, 95% CI=2.2, 10.6), respectively. Of108(47.8%) mothers who had at least one antenatal care visit, 36(33.3%), were not advised about dangersigns. Women who had at least one ANC visit and those who were advised about the danger signs ofpregnancy and labor appeared to be more likely to use the service than their counterparts; (AOR=6.1,95% CI=1.9, 21.3), and (AOR=5.4, 95%CI= 1.4, 21.7), respectively.CONCLUSION: Utilization of the service is low and was determined by women’s educational status,history of abortion, knowledge of danger signs and antenatal care attendance. Educating women andimproving their knowledge about danger signs of pregnancy and labor is recommended. Healthextension workers should consider antenatal care visits as opportunities for this purpose.