Determinants of Health Facility Utilization at Birth in South Sudan

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2019 Jul 21

PMID 31324060

Citations 4

Authors

Justin Bruno Tongun

David Mukunya

Thorkild Tylleskar

Mohamedi Boy Sebit

James K Tumwine

Grace Ndeezi

Affiliations

Soon will be listed here.

Abstract

South Sudan has a high maternal mortality ratio estimated at 800 deaths per 100,000 live births. Birth in health facilities with skilled attendants can lower this mortality. In this cross-sectional study, we determined the level and determinants of health facility utilization and skilled birth attendance in Jubek State, South Sudan. Mothers of children aged less than two years were interviewed in their homes. Multivariable regression analysis was performed to determine factors associated with health facility births. Only a quarter of the mothers had given birth at health facilities, 209/810 (25.8%; 95% CI 18.2-35.3) and 207/810 had a skilled birth attendant (defined as either nurse, midwife, clinical officer, or doctor). Factors positively associated with health facility births were four or more antenatal visits (adjusted odds ratio (AOR) 19; 95% CI 6.2, 61), secondary or higher education (AOR 7.9; 95% CI 3, 21), high socio-economic status (AOR 4.5; 95% CI 2.2, 9.4), and being primipara (AOR 2.9; 95% CI 1.5, 5.4). These findings highlight the need for efforts to increase health facility births in South Sudan.

Citing Articles

Determinants of health seeking behaviour in South Sudan: a cross-sectional household survey.

Obels I, Coleman H, Straetemans M, van Gurp M, Lutwama G, Jacobs E BMC Public Health. 2025; 25(1):46.

PMID: 39762807 PMC: 11702148. DOI: 10.1186/s12889-024-19798-8.

A scoping review of the social determinants of maternal health in the MENA region.

Moujahid C, Turman J, Amahdar L Pan Afr Med J. 2024; 47:205.

PMID: 39247769 PMC: 11380623. DOI: 10.11604/pamj.2024.47.205.42499.

A Review of Vitamin A Supplementation in South Sudan: Successes, Challenges, and Opportunities for the Way Forward.

Haselow N, Joshi V, Bayo P, Murye J, Shaban S, Abebe K Glob Health Sci Pract. 2022; 10(3).

PMID: 36332070 PMC: 9242605. DOI: 10.9745/GHSP-D-21-00660.

Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016.

Sserwanja Q, Mukunya D, Musaba M, Kawuki J, Kitutu F BMC Health Serv Res. 2021; 21(1):1160.

PMID: 34702251 PMC: 8549198. DOI: 10.1186/s12913-021-07179-5.

Community-level factors associated with the use of facility-based delivery assistance in Uganda: a multilevel analysis.

Micah A, Hotchkiss D BMC Pregnancy Childbirth. 2020; 20(1):195.

PMID: 32245431 PMC: 7118861. DOI: 10.1186/s12884-020-2851-0.

References

Kibria G, Burrowes V, Choudhury A, Sharmeen A, Ghosh S, Mahmud A . Determinants of early neonatal mortality in Afghanistan: an analysis of the Demographic and Health Survey 2015. Global Health. 2018; 14(1):47. PMC: 5944060. DOI: 10.1186/s12992-018-0363-8. View

Jennings L, Yebadokpo A, Affo J, Agbogbe M . Antenatal counseling in maternal and newborn care: use of job aids to improve health worker performance and maternal understanding in Benin. BMC Pregnancy Childbirth. 2010; 10:75. PMC: 3002891. DOI: 10.1186/1471-2393-10-75. View

Ronsmans C, Graham W . Maternal mortality: who, when, where, and why. Lancet. 2006; 368(9542):1189-200. DOI: 10.1016/S0140-6736(06)69380-X. View

Sami S, Kerber K, Kenyi S, Amsalu R, Tomczyk B, Jackson D . State of newborn care in South Sudan's displacement camps: a descriptive study of facility-based deliveries. Reprod Health. 2017; 14(1):161. PMC: 5707872. DOI: 10.1186/s12978-017-0417-z. View

Tongun J, Sebit M, Ndeezi G, Mukunya D, Tylleskar T, Tumwine J . Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey. Glob Health Action. 2018; 11(1):1523304. PMC: 6179051. DOI: 10.1080/16549716.2018.1523304. View

Bishanga D, Drake M, Kim Y, Mwanamsangu A, Makuwani A, Zoungrana J . Factors associated with institutional delivery: Findings from a cross-sectional study in Mara and Kagera regions in Tanzania. PLoS One. 2018; 13(12):e0209672. PMC: 6306247. DOI: 10.1371/journal.pone.0209672. View

Kyei-Nimakoh M, Carolan-Olah M, McCann T . Barriers to obstetric care at health facilities in sub-Saharan Africa--a systematic review protocol. Syst Rev. 2015; 4:54. PMC: 4411746. DOI: 10.1186/s13643-015-0045-z. View

Lawn J, Blencowe H, Oza S, You D, Lee A, Waiswa P . Every Newborn: progress, priorities, and potential beyond survival. Lancet. 2014; 384(9938):189-205. DOI: 10.1016/S0140-6736(14)60496-7. View

Kane S, Rial M, Kok M, Matere A, Dieleman M, Broerse J . Too afraid to go: fears of dignity violations as reasons for non-use of maternal health services in South Sudan. Reprod Health. 2018; 15(1):51. PMC: 5859446. DOI: 10.1186/s12978-018-0487-6. View

10.

Kyei-Nimakoh M, Carolan-Olah M, McCann T . Access barriers to obstetric care at health facilities in sub-Saharan Africa-a systematic review. Syst Rev. 2017; 6(1):110. PMC: 5461715. DOI: 10.1186/s13643-017-0503-x. View

11.

Margolis R . Educational differences in healthy behavior changes and adherence among middle-aged Americans. J Health Soc Behav. 2013; 54(3):353-68. PMC: 3998203. DOI: 10.1177/0022146513489312. View

12.

Mugo N, Dibley M, Damundu E, Alam A . "The system here isn't on patients' side"- perspectives of women and men on the barriers to accessing and utilizing maternal healthcare services in South Sudan. BMC Health Serv Res. 2018; 18(1):10. PMC: 5759875. DOI: 10.1186/s12913-017-2788-9. View

13.

Bohren M, Hunter E, Munthe-Kaas H, Souza J, Vogel J, Gulmezoglu A . Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis. Reprod Health. 2014; 11(1):71. PMC: 4247708. DOI: 10.1186/1742-4755-11-71. View

14.

Mugo N, Dibley M, Damundu E, Alam A . Barriers Faced by the Health Workers to Deliver Maternal Care Services and Their Perceptions of the Factors Preventing Their Clients from Receiving the Services: A Qualitative Study in South Sudan. Matern Child Health J. 2018; 22(11):1598-1606. DOI: 10.1007/s10995-018-2555-5. View

15.

Cutler D, Lleras-Muney A . Understanding differences in health behaviors by education. J Health Econ. 2009; 29(1):1-28. PMC: 2824018. DOI: 10.1016/j.jhealeco.2009.10.003. View

16.

Kruk M, Kujawski S, Moyer C, Adanu R, Afsana K, Cohen J . Next generation maternal health: external shocks and health-system innovations. Lancet. 2016; 388(10057):2296-2306. PMC: 5167371. DOI: 10.1016/S0140-6736(16)31395-2. View

17.

Kinney M, Kerber K, Black R, Cohen B, Nkrumah F, Coovadia H . Sub-Saharan Africa's mothers, newborns, and children: where and why do they die?. PLoS Med. 2010; 7(6):e1000294. PMC: 2888581. DOI: 10.1371/journal.pmed.1000294. View

18.

Bennett S, Woods T, Liyanage W, Smith D . A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q. 1991; 44(3):98-106. View

19.

Casey S, Chynoweth S, Cornier N, Gallagher M, Wheeler E . Progress and gaps in reproductive health services in three humanitarian settings: mixed-methods case studies. Confl Health. 2015; 9:S3. PMC: 4331815. DOI: 10.1186/1752-1505-9-S1-S3. View

20.

Geleto A, Chojenta C, Musa A, Loxton D . Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature. Syst Rev. 2018; 7(1):183. PMC: 6234634. DOI: 10.1186/s13643-018-0842-2. View