Risk Factors for Non-use of Skilled Birth Attendants: Analysis of South Sudan Household Survey, 2010
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Risk Factors for Non-use of Skilled Birth Attendants: Analysis of South Sudan Household Survey, 2010 Ngatho Samuel Mugo1
•
Kingsley E. Agho2 • Michael J. Dibley1
Published online: 9 March 2016 Ó Springer Science+Business Media New York 2016
Abstract Objectives South Sudan has the lowest percentage of births attended by skilled health personnel in the world. This paper aims to identify potential risk factors associated with non-use of skilled birth attendants at delivery in South Sudan. Methods Secondary data analyses of the 2010 South Sudan Household Health Survey second round were conducted with data for 3504 women aged 15–49 years who gave birth in the 2 years prior to the survey. The risk of non-use of skilled birth attendants was examined using simple and multiple logistic regression analyses. Results The prevalence rates for skilled, unskilled and no birth attendants at delivery were 41 [95 % confidence interval (CI) 38.2, 43.0], 36 [95 % CI 33.9, 38.8], and 23 % [95 % CI 20.6, 24.9] respectively. Multivariable analyses indicated that educated mothers [adjusted odds ratio (AOR) 0.70; 95 % CI 0.57, 0.86], mothers who had three and more complications during pregnancy [AOR 0.77; 95 % CI 0.65, 0.90], mothers who had at least 1–3 ANC visits [AOR 0.38; 95 % CI 0.30, 0.49] and mothers from rich households [AOR 0.52; 95 % CI 0.42, 0.65] were significantly more likely to use skilled birth attendants (SBAs) at delivery. Mothers who lived in rural areas [AOR
1.44; 95 % CI 1.06, 1.96] were less likely to deliver with SBAs. Conclusion Intensive investments to recruit and train more skilled birth attendants’ on appropriate delivery care are needed, as well as building a community-based skilled birth attendants’ program to reduce avoidable maternal mortality in South Sudan. Keywords Skilled birth attendants Maternal health services Socioeconomic factors South Sudan
Significance What is already known on this subject? Very limited published data on type of delivery attendants in South Sudan. The use of skilled birth attendants is known to be very low in South Sudan. What this study adds? Factors associated with unskilled birth attendance at delivery include low levels of maternal education, non-use of ANC services, living in rural areas and mothers from poor households.
Introduction & Ngatho Samuel Mugo [email protected] Kingsley E. Agho [email protected] Michael J. Dibley [email protected] 1
School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia
2
School of Science and Health, Building (24), University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia
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The burden of high rates of maternal morbidity and mortality remains a significant challenge in developing countries [1, 2]. Many of these deliveries are still taking place at home without assistance from SBAs [2]. It is estimated that 13–33 % of maternal mortality could have been prevented if pregnant women had access to SBAs at every delivery [3, 4]. The high level of the maternal mo
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