2005 Fiscal Year Final Research Report Summary
Determinants of Birth Attendant Choice of Women in Rural Cambodia and Outcome Differences -Comparison between Skilled and Unskilled Attendants-
| Project/Area Number |
15390683
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Community health/Gerontological nurisng
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| Research Institution | Shinshu University (2004-2005)
Mie Prefectural College of Nursing (2003) |
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Principal Investigator |
YANAGISAWA Satoko Shinshu University, Faculty of Medicine, Associate Professor, 医学部, 助教授 (30310618)
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| Co-Investigator(Kenkyū-buntansha) |
WAKAI Susumu The Tokyo University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (30158571)
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| Project Period (FY) |
2003 – 2005
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| Keywords | skilled birth attendant / maternal mortality / health seeking behavior / maternal and child health / Cambodia / antenatal care / educational status / accessibility |
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| Research Abstract |
Objectives : An increase in the utilization of skilled attendants at delivery is an effective intervention to reduce maternal mortality by the management of obstetric complications. The objectives of this study were 1) to describe the health seeking behavior of women during pregnancy and childbirth, 2) to identify the determinants of birth attendant choice, and 3) to compare perceived outcomes between skilled and unskilled attendants.
Methods : The study was conducted in Memot District, Kompong Cham Province. The study population was women who gave birth to a baby during three months prior to the survey. We located a total of 1046 pregnant women, of whom 980 were included in the analysis. Information was collected by a household survey using a structured questionnaire. Semi-structured interviews of selected women with serious complications were also conducted to explore the barriers to health services. We used logistic regression to identify determinants of birth attendant choice accord
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ing to delivery place (facility vs. non-facility), birth attendant at home births (skilled vs. unskilled), and change of birth attendant during delivery (changed vs. unchanged). Semi-structured interviews were tape-recorded, then analyzed using content analysis.
Results : Of 980 women included in the analyses, 19.8% had skilled attendant present during delivery. 78.5% had unskilled attendants, and 1.7% did not have any attendants. 10.9% took place at health facilities. Health seeking behavior analysis revealed that more than half of the women who perceived possible life-threatening conditions did not seek help from skilled personnel.
The determinants of facility delivery choices differed from those of skilled attendant choice in home births. In facility delivery choice, the significant determinants were ; school attendance of 7 years and over, frequent antenatal care attendance and having prolonged labor. For home births, the choice of skilled and unskilled attendant in preceding deliveries were positively and negatively associated with skilled attendant choice in the following delivery, respectively.
Incidences of neonatal deaths and severe bleeding during delivery and postpartum were more in facility deliveries than non-facility deliveries. However, negative incidences did not show a difference between the presence of skilled or unskilled attendant during home births.
The semi-structured interview revealed barriers to health care in all three levels of health seeking, i.e. 1) recognizing risks or deciding to seek health care, 2) reaching health care, 3) acquiring quality health care once it was accessed. Less
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Research Products
(15 results)
