A THESIS SUBMITTED TO THE DEPARTMENT OF PUBLIC HEALTH, COLLEGE OF MEDICINE AND HEATLH SCIENCES, ARBA MINCH UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTERS OF PUBLIC HEALTH

Abstract

Background: Maternal health delay that have a significant contribution to maternal death in developing countries including Ethiopia are: delay in deciding to seek care, reaching health facility, and receiving appropriate care. There is low information as well as minimal evidence on the maternal delays and associated factors among post-natal women in rural parts in Ethiopia. Hence, this study aimed to assess the magnitude of maternal delays and associated factors among postnatal mothers who gave birth at public health facilities in selected rural Woredas in Gamo zone, Southern Ethiopia. Methods: A cross sectional facility based study was conducted among 394 postnatal mothers. The data were collected using pre-tested face to face interviewer administered questionnaires. Systematic random sampling method was employed. Bivariate and multivariable logistic regression analysis were conducted to identify the associated factors for the three delays. Significance were declared by using p value of <0.05 and AOR with 95% confidence intervals. Result: The magnitude of first maternal delay was 46.8%. Unemployed women [AOR: 2.2, 95%CI: (1.15, 4.16)], birth preparedness [AOR: 2.7, 95%CI: (1.29, 5.71)], husband’s decisions making [AOR: 6, 95%CI :( 2.87, 12.42)] were found to be significantly associated with 1st delay. Mothers who faced the second delay were 44%. Distance to health facility [AOR: 7, 95%CI: (3.58, 13.71)], and means of transportation [AOR: 3.3, 95%CI: (1.13, 9.54)] were found to be significantly associated with the second delay. Mothers who experienced the third maternal delay were 31.7%. Availability of obstetric drugs [AOR: 8.4, 95%CI: (3.76, 18.76)], and availability of skilled health provider [AOR: 10.4, 95%CI: (4.24, 25.69)] were found to be significantly associated with the third delay to utilize institutional delivery services. Conclusion: This study showed that the magnitude of 1st ,2nd and 3rd maternal delays were high which indicates that most of mothers were not receive institutional delivery services in a timely manner. Maternal socio-economic and obstetric factors as well as health care system factors affected the three delays in this study. Hence, emphasis should be given for awareness creation on key danger signs during labor and child birth, women empowering for in decision making, strengthening ambulance services and ensuring or availing obstetric drugs at health center levels were recommended.