Determinants of access to skilled birth attendants by women in Galkacyo District, Somalia
Mohamed, Suleiman Yusuf
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ABSTRACT Globally over half million women of reproductive age (15-49 years) die every year as result of pregnancy and childbirth complications, and 300 million women endure from debilitating injuries. The lack of availability and access to basic and obstetric emergency care is a major cause of the high levels of maternal mortality and morbidity in Somalia. Barriers to accessing skilled birth attendant services are many as reflected, in Somalia only one out of 6 women receive the appropriate care. WHO report states during 2011, 55.5%, of pregnant mother preferred to deliver at homes instead of health facilities and the availability and accessibility of traditional birth attendants influenced their choices. The main objective of this study was to investigate the determinants of access to skilled birth attendants by women in Galkacyo district, Somalia. The specific objectives were to determine the proportion of women accessing to skilled birth attendants, to investigate demographic characteristics, socio-cultural practices, and socio-economic factors that influence access to skilled birth attendants by women in Galkacyo district, Somalia. This study was descriptive cross-sectional. The study was conducted in Galkacyo district, Puntland, Somalia. The target population of this study was women of reproductive age (15-49 years).In this study administered questionnaires was used to collect data from the respondents while key informants interview was done to find overall picture on access to SBAs. Purposive sampling was used to select key informants. Convenience sampling was used in this study to select 384 respondents who met inclusion criteria. Informed consent was obtained from the study participants. SPSS version 20 was used for data analysis. After entry, cross tabulation was done followed by chi square statistics to get the independent variables that were significantly associated with access to skilled SBAs. Logistic regression was used to generate odds ratios on the variables that were significant at chi square level. Information generated was then presented in forms of text, tables and graphs. Qualitative data was analyzed using content analysis based on key themes generated from the objectives. This study found that low proportion of women (27%) had access to skilled birth attendants in Galkacyo district, Somalia (27%) of respondents delivered with assistance of skilled birth attendants. The following factors were significantly associated with access to skilled birth attendants in the study area: Respondents level of education (OR=10.11; 95% CI: 4.8 – 21.28; p<0.001). Marital status (OR=0.23; 95% CI: 1.11 – 0.46; p<0.001). Husband's level of education (OR=4.99; 95% CI: 2.285 – 10.90; p<0.001). Decision maker about delivery (OR=0.15; 95% CI: 0.03 – 0.66; p=0.012).Respondent's occupation(OR=3.17;95% CI=1.52-6,62; P= 0.002). Husband's occupation (OR=2.69; 95%CI: 1.02-7.09; P=0.046). Household's monthly income(OR=0.20; 95%CI: 0.11-0.37,P<0.001). This study recommends that there is need to upgrade educating young girls, so that they enable to make informed choice for their health outcomes. To overcome socio-cultural practices influencing access to SBAs, MOH should increase community health education. Women should be economically improved as to enable them access to higher quality of services including delivery care, more jobs should be created for women.