Summary

In this Study Session, you have learned that:

• Many health initiatives strongly emphasise ensuring the availability and accessibility of skilled care during pregnancy and childbirth, of which institutional delivery is one element. This would avoid most maternal deaths occurring from preventable obstetric complications. However, various studies have clearly demonstrated, the utilisation of existing maternal health services is very low in Ethiopia
• Socio-economic factors are reported to influence institutional delivery. Rural, uneducated and poor women were less likely to deliver in health institutions. In addition to that the age, birth order of the child, house hold index, previous ANC service utilisation and exposure to mass media also affect institutional delivery.
• Other factors affecting institutional delivery in developing countries were also identified which includes the unavailability of health services, inadequate number of skilled personnel, geographical inaccessibility and poor quality of care, financial constraints, no perceived need for such services and preference for home delivery because it is much less expensive.
• The lower educational status of women is one of the barriers for lower institutional delivery. Hence, designing and providing tailored health promotion and communication strategies by applying the basic principles and approach of health education is very important. Thus, bridging the gaps between communities and the formal health sector through community-based counselling and health education is important. This can be provided by well-trained and supervised health extension workers who inform villagers about promotive and preventive health services, including maternal and neonatal health is crucial.
• You should involve TBAs in the health education practice because collaborating with them would result in a positive change of the community since they are an important partner.