Factors Determining The Choice Of Health Care Facilities By Pregnant Women

1.2 Statement of the Problem 

Basing on the fact that various efforts have been put in place by the Government of Ethiopia, through free maternity services to increase the percentage of mothers who deliver from the health facility under the assistance of a skilled health worker, the majority of mothers still deliver at home without skilled birth attendants. Statistics by the District Health information System (DHIS) indicate that only 36% of births in Addis Ababa are attended by a skilled birth attendant. This is way too far the targets set at the International Conference on Population and Development(ICPD) whose goal is to have more than 80% of deliveries assisted by skilled attendants globally by 2005, 85% by 2010 and 90% by 2015 (UNFPA 2010). 

Home deliveries are poorly managed and inadequate care is offered during the critical hours of a woman’s life. This exposes the mother and the baby to health risks and complications which include anemia, bleeding, infection and if immediate interventions are not taken this can lead to death or damage of the reproductive organs.  It is evident from reports that every day, almost 800 women die in pregnancy or childbirth worldwide. Evidence shows that infants whose mothers die are more likely to die before reaching their second birthday than infants whose mothers survive. And for every woman who dies, 20 or more experience serious complications (UNFPA 2010).  

Maternal health services have been improved upon in all the health centers in the region. However, many women do not utilize these facilities and instead seek delivery care from high risk places. Giving birth without the assistance of a skilled birth attendant can pose life threatening situations incase complications occur during the process.  This study, therefore, was set to investigate factors that influence the choice of health care facilities by pregnant women in Addis ababa.

1.3 Objective of the study

This study aims to systematically explore the differences and the factors that influence women’s preferences for places to give birth in Addis Ababa.Specifically it aims:

1. To determine the Socioeconomic and Demographic Characteristics of the pregnant women.

2. To examine the determinants of choice of healthcare facilities by pregnant women.

1.4 Research Question

The study seeks to answer the following research questions

1. What is the Socioeconomic and Demographic Characteristics of the pregnant women?

2. What are the determinants of choice of healthcare facilities by pregnant women?

1.5 significance of the study

The findings of this study may have both theoretical and practical implications for the future of suitability of place of delivery in Addis Ababa. Theoretically, the study may contribute to the advancement of knowledge about factors determining the choice of place of delivery in Ethiopia specifically Addis Ababa. The study might also have practical significance in that, it may assist in determining the level of utilization of SBAs and TBAs at birth. The findings may be of immediate benefit to the Ministry of Health in the formulation of future public health policies aimed at integrating TBAs in the health system as agents of change to enhance places of delivery. Similarly, results of this study may enlighten the public especially mothers and spouses on the importance of considering a suitable and safe place of delivery. In addition, this can lead to appropriate interventions by non-governmental organizations and other key stakeholders that have established or intend to establish reproductive health programs. The study may also forms a base on which others can develop their studies based on the gaps identified.

1.6 Scope/limitation of the study

This study will be carried out with Addis Ababa as the case study, its divided into 10 sub-cities and each sub-city is further divided into several small administrative units called Kebeles.

Limitations of the Study  

The limitations of the study were; inadequate time to collect data, therefore two research assistants were hired to assist in carrying out the task.  

Cases of respondents not cooperating were experienced and even some had to withdraw from the exercise after answering some questions because they were not convinced if the study was done for genuine reasons.

1.7 Definition of terms used in the study 

Women: This refers to all females of reproductive age that is, 15 years to 49 years of age.  

Choice of place of delivery: This is the preferred option by the women who are giving birth; it could either be home, health facility or assisted by traditional birth attendant.                                   

No. of children: This refers to the number of children a woman has at the time of making the choice. 

No. of household members: This refers to the number people in a particular household.   

Marital status: This refers to whether a person is married, single, divorced or widowed.

Level of education: This refers to the level of schooling a person has reached, that is, primary education, secondary or tertiary education.

Antenatal Care: This entails the care that is given to women who are expectant or pregnant. 

Decision maker: This is the person who makes a choice regarding family issues.

Occupation: This is the type of work that a person does.  

Level of monthly household income: This refers to the total monthly earnings in a given family.

Transportation means: This refers to what is used to move from one place to another, that is, on foot, motorbike, private or public means

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