Determinants of Access to Skilled Birth Attendants by Women in Galkacyo District, Somalia

Background: Globally over half million women of reproductive age (15-49 years) die every year as result of pregnancy and childbirth complications, and 300 million women endure from debilitating injuries. Barriers to accessing skilled birth attendant services are many. In Somalia, one out of six women received appropriate care due to lack of accessible basic and obstetric emergency care resulting into high levels of maternal mortality and morbidity. About 55.5%, of pregnant mother prefer to deliver at homes instead of health facilities and the availability and accessibility of traditional birth attendants influenced their choices. This study determined factors influencing access to skilled birth attendants by women.

Methods: This was descriptive cross-sectional study conducted among 384 women of reproductive age (15-49 years) in Galkacyo District, Puntland, drawn from two villages selected randomly. Data was collected using a pretested questionnaire and entered in a Microsoft package. Data was analysed using Statistical Package for Social Science (SPSS) version 20 using chi-square, logistic regression and association was considered significant at P<0.05.

Results: Among the women who were interviewed, 27% were delivered by a skilled birth attendant. There was significant association between access to skilled birth attendant and respondents level of education (OR=10.11; 95% CI: 4.8 – 21.28; p<0.001), Marital status (OR=0.23; 95% CI: 1.11 – 0.46; p<0.001), Husband's level of education (OR=4.99; 95% CI: 2.285 – 10.90; p<0.001), Decision maker about delivery (OR=0.15; 95% CI: 0.03–0.66; p=0.012), Respondent's occupation (OR=3.17; 95% CI=1.52-6, 62; P= 0.002), Husband's occupation (OR=2.69; 95% CI: 1.02-7.09; P=0.046) and Household's monthly income (OR=0.20; 95% CI: 0.11-0.37, P<0.001).

Conclusion: There is need to educate young girls, to enable them make informed choices for their health outcomes. The Ministry of health should increase community health educations to overcome socio-cultural practices influencing access to skilled birth attendants. Also women should be empowered economically to enable them access quality health services including delivery care.