| Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach |
| Authors: |
Seman K. Ousman, Jeanette H. Magnus, Johanne Sundby, and Mekdes K. Gebremariam |
| Source: |
International Journal of Environmental Research and Public Health, 17(5): 1712; DOI: 10.3390/ijerph17051712 |
| Topic(s): |
Antenatal care
Delivery care
Health care utilization
Institutional births
Maternal health
|
| Country: |
Africa
Ethiopia
|
| Published: |
MAR 2020 |
| Abstract: |
Risk factor approaches are often used when implementing programs aimed at enforcing
advantageous health care behaviors. A less frequently-used strategy is to identify and capitalize on
those who, despite risk factors, exhibit positive behaviors. The aim of our study was to identify
positive deviant (PD) mothers for the uptake of skilled maternal services and to explore their
characteristics. Data for the study came from two waves of the Ethiopian Demographic and Health
Surveys conducted in 2011 and in 2016. PD mothers were defined as those reporting no formal
education but with adequate use of antenatal care (ANC) and/or institutional delivery services.
Two-level multilevel regression analysis was used to analyze the data. Factors associated with PD
for the use of ANC services were: partner’s education status, involvement in household decision
making, exposure to media, and distance to the health facility. Factors associated with PD for health
facility delivery were: partner’s education, woman’s employment status, ANC visit during index
pregnancy, exposure to media, and perceived challenge to reach health facility. Rural-urban and
time-related differences were also identified. The positive deviance approach provides a means for
local policy makers and program managers to identify factors facilitating improved health
behaviour and ultimately better health outcomes while acknowledging adverse risk profiles.
Keywords: Positive deviance; skilled maternal healthcare; multilevel approach; DHS; Ethiopia |
| Web: |
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=2ahUKEwjw6qbmu4boAhUdlHIEHdaFChkQFjABegQIAhAB&url=https%3A%2F%2Fwww.mdpi.com%2F1660-4601%2F17%2F5%2F1712%2Fpdf&usg=AOvVaw1It4Onnlod- |
|