Model and Non-Model Mothers Are Similar Over Significant Aspects of Maternal-Child Health Behaviors in Rural Contexts of Central Ethiopia: Diffusing Healthy Behaviors
Science Journal of Public Health
Volume 7, Issue 1, January 2019, Pages: 10-24
Received: Jan. 17, 2019;
Accepted: Feb. 16, 2019;
Published: Mar. 11, 2019
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Yohannes Kebede, Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
Gemechis Etana, Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
Eshetu Girma, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
Background: Health Extension Program (HEP) was launched-innovative community health service since 2002 in Ethiopia. Since then, families were graduated as models for the HEP. Maternal and child Health (MCH) was one of the major packages in HEP. This study intended to compare model and non-model families (MFs and NMFs) on MCH behaviors. Method: Correlational study was conducted between mothers' model status and MCH service use in Sebeta Hawas district, Oromia special zone surrounding Finfine. A total of 305 samples were involved in the study from both MFs and NMFs. We applied simple random sampling. A pretested and structured questionnaire adopted from literatures together with discussion guides was used. It mainly composed of utilization of Family Planning (FP), antenatal care (ANC), delivery care (DC), postnatal care (PNC) and immunization. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) version 16. We used frequency tables to describe model status. Odds Ratio (OR) was used to identify demarcations between MFs and NMFs. Finally, quantitative and qualitative findings was triangulated. Result: The study showed statistically significant key variations between MFs and NMFs over family size, knowledge of (ANC, delivery complications and PNC) and utilization of (FP and ANC visits). These variables were positively linked with being from MFs. For example, 114/201 (56.7%) current FP users, 120/222 (54.1%) any ANC visitors, and 56/82 (68.3%) repeated (>=4) ANC visitors were from MFs compared to NMFs (PV<0.001). However, mothers from MFs & NMFs had no variation on delivery, PNC & immunization utilization. Closure of health posts at work time, inaccessible institutional delivery service (for MFs) and perceived invulnerability to delivery complications (for NMFs) hampered the MCH behaviors. Conclusion: Though MFs and NMF were similar over some MCH service knowledge and utilization, they vary over FP and ANC. MFs can be advocate for enhancing adoption and diffusion of earlier stage MCH behaviors. However, beyond the control contexts hindered MFs from playing their role of modeling late stages MCH behaviors (DC/ PNC/immunization).Therefore, HEP designers and implementers shall work on system challenges and create separate models for those behaviors and assign new name.
Model and Non-Model Mothers Are Similar Over Significant Aspects of Maternal-Child Health Behaviors in Rural Contexts of Central Ethiopia: Diffusing Healthy Behaviors, Science Journal of Public Health.
Vol. 7, No. 1,
2019, pp. 10-24.
John J Hall and Richard Taylor: Health for all beyond 2000: the demise of the Alma-Ata Declaration and primary health care in developing countries, Med J August 2003; 178 (1): 17-20.
Ministry of Health: 1986. Comprehensive Health Service Directory. Addis Ababa.
Ministry of Health. 1985. Primary Health Care Review. Addis Ababa.
Federal Democratic Republic of Ethiopia Ministry of Health. Health Sector Development Program IV 2010/11 – 2014/15 October 2010.
Health Extension and Education Center. Federal Ministry of Health Addis Ababa, Ethiopia June 2007.
Federal Ministry of Health of Ethiopia: Health extension program in Ethiopia. Addis Ababa: Health Education Center, 2007.
World Health Organization. 2005. World Health Report 2005: Make Every Mother and Child Count. World Health Organization, Geneva.
Improved access to maternal health services. WHO 98.7. Geneva: WHO. World Health Organization (WHO). 1998.
Better health in Africa: Experience and lessons learned. Washington, D. C.: World Bank. World Bank. 1994a.
Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival.
The United Nations Children's Fund (UNICEF). Ethiopia Statistics. Basic Indicators 2012:Re-trievedon February 17,2012:http://www.unicef.org/infobycountry/ethiopia_statistics.html.
The Millennium Development Goals Report 2012. United Nations; New York, 2012.
Ethiopia Demographic and Health Survey 2005. Central Statistical Agency Addis Ababa, Ethiopia ORC Macro Calverton, Maryland, USA September 2006.
Ethiopia Demographic and Health Survey 2011. Central Statistical Agency Addis Ababa, Ethiopia ICF International Calverton, Maryland, USA March 2012.
Central Statistical Agency [Ethiopia] and ICF International. 2012. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International.
Ahmed A: Maternal Mortality Trend in Ethiopia. Ethiop J Health Dev. 2010, 24 (1): 117–120.
Yalem Tsegay Assfaw, Determinants of Antenatal Care, Institutional Delivery and Skilled Birth Attendant Utilization in Samre Saharti District, Tigray, Ethiopia.
Negalign B., Yohannes H/M., Utilization of clean and safe delivery service package of health services extension program and associated factors in rural gandas of Kafa zone, southwest Ethiopia.
Zelalem B., Gashaw A., Tadesse A., Gizachew A., and Digsu N. Determinants of skilled attendance for delivery in Northwest Ethiopia: a community based nested case control study: 2013.
Alemayehu Sh., Fekadu M., and Solomon M.: Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: A community - based cross sectional study.
Yared M. and Asnaketch M., Utilization of Maternal Health Care Services in Ethiopia, Ethiopian Health and Nutrition Research Institute Addis Ababa, Ethiopia ORC Macro Calverton, Maryland, USA. November 2002.
Gurmesa T. etal:Antenatal care service utilization and associated factors in Metekel zone, Northwest Ethiopia Benishangul Gumuz Region, North West Ethiopia: January-February 2007.
Alemayehu Sh., Fekadu M. and Solomon M. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela District, North West of Ethiopia: A community - based cross sectional study: August, 2010.
Addis Alem F. and Meaza D. Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state: December 2012.
Zewdie B., Ameyu G, Yohannes K., Mulusew G. Mothers' experiences and satisfactions with health extension program in Jimma zone, Ethiopia: a cross sectional study: BMC Health Services Research 2013, 13: 74.
Integrated Community-based Maternal, Newborn and child health and Nutrition Intervention Dakar 2011.
Rose NM, Japhet Z K, Melkzedeck T., Leshabari, Siriel NM. Albrecht J, Declare M.: Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets: December 2007.
Leslie, J., and G. R. Gupta. Utilization of formal services for maternal nutrition and health care. Washington, D. C.: International Center for Research on Women. 1989.
Determinants of use of maternal-child health services in rural Ghana. Journal of Biosocial Science 32 (1): 1-15. Addai, I. 2000.
African Journal of Reproductive Health 2 (1): 73-80. Addai I. 1998. Demographic and sociocultural factors influencing use of maternal health services in Ghana.
Response of parents to five killer diseases among children in a Yoruba community, Nigeria. Social Science & Medicine 32 (12): 1379-1387. Adetunji, J. A. 1991.
Rogers, E. M. Diffusion of Innovations. (5th ed.) New York: Free Press, 2003.
2007 Population and Housing Census of Ethiopia: Results for Oromia Region, Volume 1 (accessed 13 January 2012).
Karen Glanz, Barbara K. Rimer, K. Viswanath, editors. Health Behavior and Health Education: Theory, Research and Practice. 4th edition. Chapter 8. Pages 169-185. 4th edition. Jossy-Bass a Wiley Imprint. www.jossybass.com.
Yitayal M, Berhane Y, Worku A, Kebede Y. The community based Health-extension program significantly improved contraception utilization in West Gojjam Zone, Ethiopia, Journal of Multidisciplinary Health care, 2014: 7 pages 201-208. https: //doi.org/10.2147/JMDH.s62294.
Fisseha G., Yemane B., Alemayehu W., Wondessen T. Distance from Health Facility and Mothers perception of quality related to skilled delivery service utilization in northern Ethiopia. International Journal of Women’s Health. 2017: 9 749-756.
WHO. Service availability and readiness assessment 2016. Summary report. Ministry of Health (MOH) Ethiopia.