Utilization of Clean and Safe Delivery Service Package of Health Services Extension Program and Associated Factors in Rural Kebeles of Kafa Zone, Southwest Ethiopia

BACKGROUND In Ethiopia, 94% of births take place at home unattended by trained persons. The government introduced an innovative strategy, Health Services Extension Program in 2003. Clean and safe delivery service is a component of maternal and child healthcare package of the program. However, little is known about the status of uptake of the service. This study thus aimed to assess utilization of clean and safe delivery service and associated factors in rural kebeles of Kafa Zone, Ethiopia. METHODS A community based cross sectional survey was conducted in rural kebeles of Kefa Zone from January 21(st) to February 25(th), 2009 using a sample of 229 mothers. Kafa Zone is located 465 kilometres away from Addis Ababa to southwest of Ethiopia. Data were collected using a structured questionnaire and analyzed using SPSS for windows version 16. OR and 95% CI were calculated. P< 0.05 was considered statistically significant. RESULTS Utilization of clean and safe delivery service was 43(19%). Women with formal schooling and those who knew at least two danger signs of pregnancy and labor were more likely to use the service than their counterparts; (AOR=5.8, 95% CI=2.1, 16) and (AOR=3.0, 95% CI=2.2, 10.6), respectively. Of 108(47.8%) mothers who had at least one antenatal care visit, 36(33.3%), were not advised about danger signs. Women who had at least one ANC visit and those who were advised about the danger signs of pregnancy and labor appeared to be more likely to use the service than their counterparts; (AOR=6.1, 95% CI=1.9, 21.3), and (AOR=5.4, 95%CI= 1.4, 21.7), respectively. CONCLUSION Utilization of the service is low and was determined by women's educational status, history of abortion, knowledge of danger signs and antenatal care attendance. Educating women and improving their knowledge about danger signs of pregnancy and labor is recommended. Health extension workers should consider antenatal care visits as opportunities for this purpose.