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Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets
Open accessAbstract
BACKGROUND: Almost two decades since the initiation of the Safe motherhood Initiative, Maternal Mortality is still soaring high in most developing countries. In 2000 WHO estimated a life time risk of a maternal death of 1 in 16 in Sub- Saharan Africa while it was only 1 in 2800 in developed countries. This huge discrepancy in the rate of maternal deaths is due to differences in access and use of maternal health care services. It is known that having a skilled attendant at every delivery can lead to marked reductions in maternal mortality. For this reason, the proportion of births attended by skilled health personnel is one of the indicators used to monitor progress towards the achievement of the MDG-5 of improving maternal health. METHODS: Cross sectional study which employed quantitative research methods. RESULTS: We interviewed 974 women who gave birth within one year prior to the survey. Although almost all (99.8%) attended ANC at least once during their last pregnancy, only 46.7% reported to deliver in a health facility and only 44.5% were assisted during delivery by a skilled attendant. Distance to the health facility (OR = 4.09 (2.72-6.16)), discussion with the male partner on place of delivery (OR = 2.37(1.75-3.22)), advise to deliver in a health facility during ANC (OR = 1.43 (1.25-2.63)) and knowledge of pregnancy risk factors (OR 2.95 (1.65-5.25)) showed significant association with use of skilled care at delivery even after controlling for confounding factors. CONCLUSION: Use of skilled care during delivery in this district is below the target set by ICPD + of attaining 80% of deliveries attended by skilled personnel by 2005. We recommend the following in order to increase the pace towards achieving the MDG targets: to improve coverage of health facilities, raising awareness for both men and women on danger signs during pregnancy/delivery and strengthening counseling on facility delivery and individual birth preparedness.
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“Findings are in line with previous studies reporting correlations between facility delivery and the distance to the nearest health facility [43, 45–47].”
From Impact of smartphone-assisted prenatal home visits on women’s use of facility delivery: Results from a cluster-randomized trial in rural Tanzania (2018) · cites this paper as [47]
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Chiumia, I. K., Munthali, A., McVeigh, J., Mannan, H., & MacLachlan, M. (2019) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2019.67 · Cited by 18
Metadata
- Authors
- Mpembeni, R. N., Killewo, J. Z., Leshabari, M. T., Massawe, S. N., Jahn, A., Mushi, D., & Mwakipa, H.
- Affiliations
- Muhimbili University of Health and Allied Sciences (TZ)
- Heidelberg University (DE)
- Corresponding author
- Mpembeni, Rose NM
- Venue
- BMC Pregnancy and Childbirth
- Published
- 2007-12
- Volume
- 7
- Issue
- 1
- Pages
- 29-29
- ISSN
- 1471-2393 (ISSN-L)
- PMC
- PMC2222241
- OpenAlex
- W2077416544
- Cited by
- 414
- References
- 21
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 23 · 2021: 22 · 2020: 31 · 2019: 29 · 2018: 31 · 2017: 35 · 2016: 32 · 2015: 38 · 2014: 51 · 2013: 36 · 2012: 23
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Pregnancy and Childbirth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IHI Repository (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- skilled birth attendance, institutional delivery, maternal mortality, prenatal care, distance to health facility, male partner involvement, pregnancy danger signs, childbirth preparation, southern Tanzania
- MeSH terms
- Adult, Clinical Competence, Cross-Sectional Studies, Female, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Maternal Health Services, Maternal Welfare, Midwifery, Nurse-Patient Relations, Pregnancy, Pregnancy Complications, Quality of Health Care, Tanzania, Confidence Intervals, Odds Ratio, Health Care Surveys
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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