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Saturday, June 8, 2013

Nigatu Regassa
Hawassa University, P.O. BOX 679, Hawassa, SNNPR, Ethiopia
Korespondenční autor: Nigatu Regassa (negyon@yahoo.com)
ISSN 1804-7181 (On-line)
Full verze:
Full version
Submitted:22. 1. 2012
Accepted:17. 5. 2012
Published online:28. 6. 2012
Objectives: This study is aimed at examining the contribution of selected pregnancy and postnatal health care services to Infant Mortality (IM) in Southern Ethiopia.
Method: Data were collected from 10 rural villages of the Sidama Zone, Southern Ethiopia, using a structured interview schedule. The 1,094 eligible women respondents were selected using a combination of simple random and multi-stage sampling techniques. The main outcome variable of the study (IM) was measured by reported infant deaths during the twelve months preceding the survey, and was estimated at 9.6% or 96 infant deaths per 1,000 births. Pregnancy and health care variables were used as the main explanatory variables along with other household and individual characteristics.
Results: The predicted probabilities, using three models of logistic regression analysis, have shown that four pregnancy and postnatal health care variables (antenatal care, immunisation, exclusive breast feeding and wantedness of the pregnancy) and women’s age are found to be significant predictors of IM in the study areas.
Conclusions: Finally, based on the key findings, some recommendations are given: promoting of institutional delivery seeking behaviour through behavioural change communications, training more Traditional Birth Attendants (TBAs), and maximising the use of the Health Extension Workers (HEWs) stationed at village level to make a house-to-house visit so as to encourage pregnant women to seek pregnancy and delivery care services.
Keywords: delivery care; infant mortality; immunisation; maternal health care; Southern Ethiopia
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Aroressa is a beautiful, green mountainous area, with small coffee plantations irrigated by natural waterfalls and streams that meander down the steep slopes of the valleys, with cliffs falling 300 metres and more. At the bottom, cattle graze alongside the streams and children play outside onion shaped huts, typical of the Sidama zone, south of Ethiopia.
Two Médecins Sans Frontières (MSF) programmes are located in these highlands, separated by dusty mountain roads of more than 80 kilometres. The beauty of the area can deceive the visitor regarding the very serious health problems faced by the population.
Health centres are scarce; as are qualified medical personnel, and maternal and child mortality rates are high. The mountainous terrain makes it difficult for pregnant women to trek to their nearest health centre, which could be 20 or more kilometres away.
MSF teams have met many stranded people ferrying sick people or pregnant women to a nearby health centre while driving or horse riding from one health centre to the other. Many lives have been lost on these wearisome journeys.
In a bid to reduce maternal and child mortality rates, MSF has established two mothers’ waiting houses, in the divisions of Chire and Mejo. These houses shelter heavily pregnant women who come from distant villages and cannot access medical assistance quickly, who are experiencing or have experienced complications during their pregnancy, or who have conditions requiring regular medical attention.
These women come to the waiting house, are examined by MSF’s medical staff and kept under regular observation so that in case urgent treatment is needed, immediate action can be taken.
“I came to the waiting house because I had pains and bleeding during my pregnancy and knew that MSF is offering help to expectant women,” says Birtu Kawato, a 25-year-old woman from Baya Faficho Kebele (division), staying at the MSF waiting house.
Uncomplicated births are assisted by an MSF midwife in the health centres, while women with complications are referred to nearby hospitals. Presently, each waiting house has a carrying capacity of 20 beds.
Since the establishment of the waiting house in Mejo in the final quarter of last year, 251 women have delivered successfully. Their satisfaction drives them to pass the message to other women in their communities.
“Most of these women trek for as long as eight hours from their villages to the waiting house just because they know MSF is here and they will get quality medical care,” states Eva Dominguez confidently, a nurse and midwife with MSF in Aroressa.
The waiting house is a way of encouraging women to seek medical assistance during delivery and to reduce maternal and child mortality in the area. It mostly targets women of child bearing age in the zone, which is presently estimated at 50,556.
In both health centres, MSF, in cooperation with the Ethiopian Ministry of Health provides antenatal and postnatal services, family planning and medical and psychological assistance to victims of sexual violence.