Determinants of Use of Skilled Birth Attendance among Mothers Who Gave Birth in the Past 12 months in Raya Alamata District, North East Ethiopia

Background: A large number of women are dying due to factors related to pregnancy and childbirth, especially in developing countries including Ethiopia, where maternal mortality ratio is one of the highest in the world. It is known that having a skilled birth attendant at every delivery can lead to marked reductions in maternal mortality. In Ethiopia, most births take place at home, particularly in rural areas, being not attended by a skilled birth attendant. The utilization of maternal health services is a complex phenomenon and it is influenced by several factors. Objectives: This study assessed factors that determine the utilization of skilled birth attendants among mothers who gave birth in the past 12 months in Raya Alamata District, Ethiopia. Methods: Community-based cross sectional study was conducted among mothers who gave birth in the past 12 months. A total of 600 study participants were recruited for the study. Logistic regression was performed using SPSS version 16.0 software and thematic interpretation based on main categories was done for the qualitative data. Results: A total of 584 mothers (189 urban and 395 rural) were included in the analysis. Only 23.5% of births were attended by Skilled Birth Attendants. Over 43% of urban women delivered with skilled assistance compared to 13.9% of rural women. In multivariate analysis urban residence, Age at interview, maternal formal education, Ante Natal Care visit during the last pregnancy, joint final decision making, knowledgeable and favorable attitude towards danger signs of pregnancy, child birth and delivery services were most significant determinants of skilled birth attendant use by mother. Conclusion and recommendation: Utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified persons at home. Promotion of universal Ante Natal Care followup and encouragement of mothers regarding the need for Skilled Birth Attendants during childbirth is of paramount importance.