IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i5p1712-d328954.html
   My bibliography  Save this article

Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach

Author

Listed:
  • Seman K. Ousman

    (St Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa 22728/1000, Ethiopia
    Faculty of Medicine, University of Oslo, 1078 Oslo, Norway)

  • Jeanette H. Magnus

    (Faculty of Medicine, University of Oslo, 1078 Oslo, Norway
    Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA)

  • Johanne Sundby

    (Institute of Health and Society, HELSAM, University of Oslo, N-0316 Oslo, Norway)

  • Mekdes K. Gebremariam

    (Department of Nutrition, University of Oslo, 0317 Oslo, Norway)

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.

Suggested Citation

  • Seman K. Ousman & Jeanette H. Magnus & Johanne Sundby & Mekdes K. Gebremariam, 2020. "Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach," IJERPH, MDPI, vol. 17(5), pages 1-22, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1712-:d:328954
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/5/1712/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/5/1712/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Sanni Yaya & Ghose Bishwajit & Michael Ekholuenetale, 2017. "Factors associated with the utilization of institutional delivery services in Bangladesh," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-14, February.
    2. Henock Yebyo & Mussie Alemayehu & Alemayehu Kahsay, 2015. "Why Do Women Deliver at Home? Multilevel Modeling of Ethiopian National Demographic and Health Survey Data," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-14, April.
    3. Sanni Yaya & Ghose Bishwajit & Michael Ekholuenetale & Vaibhav Shah & Bernard Kadio & Ogochukwu Udenigwe, 2017. "Timing and adequate attendance of antenatal care visits among women in Ethiopia," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-16, September.
    4. Markos Mezmur & Kannan Navaneetham & Gobopamang Letamo & Hadgu Bariagaber, 2017. "Individual, household and contextual factors associated with skilled delivery care in Ethiopia: Evidence from Ethiopian demographic and health surveys," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-16, September.
    5. Miteniece, Elina & Pavlova, Milena & Rechel, Bernd & Rezeberga, Dace & Murauskienė, Liubovė & Groot, Wim, 2019. "Barriers to accessing adequate maternal care in Latvia: A mixed-method study among women, providers and decision-makers," Health Policy, Elsevier, vol. 123(1), pages 87-95.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Samuel Hailegebreal & Girma Gilano & Atsedu Endale Simegn & Binyam Tariku Seboka, 2022. "Spatial variation and determinant of home delivery in Ethiopia: Spatial and mixed effect multilevel analysis based on the Ethiopian mini demographic and health survey 2019," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-16, March.
    2. Mamunur Rashid & Mohammad Rocky Khan Chowdhury & Manzur Kader & Anne-Sofie Hiswåls & Gloria Macassa, 2022. "Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study," IJERPH, MDPI, vol. 19(5), pages 1-13, March.
    3. Sanni Yaya & Ghose Bishwajit & Michael Ekholuenetale & Vaibhav Shah & Bernard Kadio & Ogochukwu Udenigwe, 2017. "Timing and adequate attendance of antenatal care visits among women in Ethiopia," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-16, September.
    4. Jahar Bhowmik & Raaj Kishore Biswas & Nurjahan Ananna, 2020. "Women’s education and coverage of skilled birth attendance: An assessment of Sustainable Development Goal 3.1 in the South and Southeast Asian Region," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-18, April.
    5. Tesfalidet Tekelab & Catherine Chojenta & Roger Smith & Deborah Loxton, 2019. "Factors affecting utilization of antenatal care in Ethiopia: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-24, April.
    6. Lubi, Kadi & Uibu, Marko & Koppel, Katre & Mets-Oja, Silja, 2020. "The rising impact of civic activism on health policy: The analysis of the closure of smaller obstetric units in Estonia," Health Policy, Elsevier, vol. 124(11), pages 1239-1244.
    7. Victoria M Gammino & Michael R Diaz & Sarah W Pallas & Abigail R Greenleaf & Molly R Kurnit, 2020. "Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(7), pages 1-23, July.
    8. Achamyeleh Birhanu Teshale & Getayeneh Antehunegn Tesema, 2020. "Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-13, July.
    9. Tanvir M Huda & Morseda Chowdhury & Shams El Arifeen & Michael J Dibley, 2019. "Individual and community level factors associated with health facility delivery: A cross sectional multilevel analysis in Bangladesh," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-13, February.
    10. Haque, Md Rabiul & Parr, Nick & Muhidin, Salut, 2020. "The effects of household's climate-related displacement on delivery and postnatal care service utilization in rural Bangladesh," Social Science & Medicine, Elsevier, vol. 247(C).
    11. Tania Walker & Mulu Woldegiorgis & Jahar Bhowmik, 2021. "Utilisation of Skilled Birth Attendant in Low- and Middle-Income Countries: Trajectories and Key Sociodemographic Factors," IJERPH, MDPI, vol. 18(20), pages 1-12, October.
    12. Ziad El-Khatib & Emmanuel Kolawole Odusina & Bishwajit Ghose & Sanni Yaya, 2020. "Patterns and Predictors of Insufficient Antenatal Care Utilization in Nigeria over a Decade: A Pooled Data Analysis Using Demographic and Health Surveys," IJERPH, MDPI, vol. 17(21), pages 1-14, November.
    13. Cinzia Di Novi & Harshita Thakare, 2022. "Inequality of Opportunity in Accessing Maternal and Newborn Healthcare Services: Evidence from the Bangladesh Demographic and Health Survey," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 164(3), pages 1505-1529, December.
    14. HakemZadeh, Farimah & Sayin, Firat K. & Neiterman, Elena & Zeytinoglu, Isik Urla & Geraci, Johanna & Plenderleith, Jennifer & Lobb, Derek, 2021. "Does an alignment of employment policies and individual preferences affect intention to stay in the profession? Evidence from Canadian Midwives," Health Policy, Elsevier, vol. 125(4), pages 450-458.
    15. Maria Szubert & Malwina Ilowiecka & Jacek Wilczynski & Przemyslaw Bilinski & Cezary Wojtyla, 2020. "Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
    16. Teshita Uke Chikako & Reta Habtamu Bacha & John Elvis Hagan & Abdul-Aziz Seidu & Kenenisa Abdisa Kuse & Bright Opoku Ahinkorah, 2022. "Multilevel Modelling of the Individual and Regional Level Variability in Predictors of Incomplete Antenatal Care Visit among Women of Reproductive Age in Ethiopia: Classical and Bayesian Approaches," IJERPH, MDPI, vol. 19(11), pages 1-14, May.
    17. Yan Xu & Michael Yao-Ping Peng & Rolle Remi Ahuru & Muhammad Khalid Anser & Romanus Osabohien & Ayesha Aziz, 2022. "Individual and community-level factors associated with non-institutional delivery of women of childbearing-age in Nigeria," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-7, December.
    18. Jin-Won Noh & Young-mi Kim & Nabeel Akram & Ki-Bong Yoo & Jooyoung Cheon & Lena J. Lee & Young Dae Kwon & Jelle Stekelenburg, 2019. "Impact of Socio-Economic Factors and Health Information Sources on Place of Birth in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data," IJERPH, MDPI, vol. 16(6), pages 1-10, March.
    19. Sanni Yaya & Ghose Bishwajit & Olalekan A Uthman & Agbessi Amouzou, 2018. "Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-11, May.
    20. Negar Omidakhsh & Ondine S. von Ehrenstein, 2021. "Improved Water, Sanitation and Utilization of Maternal and Child Health Services in South Asia—An Analysis of Demographic Health Surveys," IJERPH, MDPI, vol. 18(14), pages 1-11, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1712-:d:328954. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.