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Am J Public Health. 2008 Oct;98(10):1849-56. doi: 10.2105/AJPH.2007.123471. Epub 2008 Aug 13.

Determinants of skilled birth attendant utilization in Afghanistan: a cross-sectional study.

Author information

  • 1Vancouver Coastal Health, and Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Ave, Vancouver, BC V6T 1Z3, Canada. mmayhew07@shaw.ca

Abstract

OBJECTIVES:

We sought to identify characteristics associated with use of skilled birth attendants where health services exist in Afghanistan.

METHODS:

We conducted a cross-sectional study in all 33 provinces in 2004, yielding data from 617 health facilities and 9917 women who lived near the facilities and had given birth in the past 2 years.

RESULTS:

Only 13% of respondents had used skilled birth attendants. Women from the wealthiest quintile (vs the poorest quintile) had higher odds of use (odds ratio [OR] = 6.3; 95% confidence interval [CI] = 4.4, 8.9). Literacy was strongly associated with use (OR = 2.5; 95% CI = 2.0, 3.2), as was living less than 60 minutes from the facility (OR = 1.5; 95% CI = 1.1, 2.0) and residing near a facility with a female midwife or doctor (OR = 1.4; 95% CI = 1.1, 1.8). Women living near facilities that charged user fees (OR = 0.8; 95% CI = 0.6, 1.0) and that had male community health workers (OR = 0.6; 95% CI = 0.5, 0.9) had lower odds of use.

CONCLUSIONS:

In Afghanistan, the rate of use of safe delivery care must be improved. The financial barriers of poor and uneducated women should be reduced and culturally acceptable alternatives must be considered.

PMID:
18703445
[PubMed - indexed for MEDLINE]
PMCID:
PMC2636465
Free PMC Article
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