Doctoral thesis
This study examined the extent of maternal health care utilization and assessed factors influencing antenatal, delivery and postnatal care utilization among women in Dodoma Region.
The study employed cross sectional study methods using both quantitative and qualitative methods. Structured questionnaires, focus group discussion guides and interview guide were used. Quantitative data analysis was done, using SPSS Version 21. The confidence interval of 95% was used to assess statistical significance of a P level of 0.05. Binary logistic regression model was applied to determine the significant associations between selected dependent and independent variables. Qualitative content analysis was done whereby Computer Assisted Qualitative Data Analysis (CAQDA) using NVIVO version 7 software packages aided in the sorting of the data
The study revealed that 99.6% of respondents attended antenatal visits at least once during pregnancy and 68.1% respondents started antenatal visit in their second and third trimester of pregnancy. Regarding the place of delivery, 78.6% of respondents delivered at health facilities while 18.6% delivered at home and 2.6 % delivered while travelling to the health facility. About three quarter (72.5%) of respondents received postnatal care service at least once after delivery. The results from bivariate logistic regression analysis showed that factors such as age of respondents, number of children, cost of transport, distance to the health facility, perceived quality of health services, source of information and place of delivery were significant associated with maternal health care utilization during pregnancy, delivery and postnatal period (P<0.05). Qualitative finding also showed that perceived quality of health care, attitude towards health care providers, transport cost, unsupportive
partners and traditional practices were among the factors hindering utilization of maternal health services. Again limited number of health facilities, health care providers and supplies of drugs and equipments also affect utilization of maternal health care services in the study area.
In conclusion, maternal health care services among women in Dodoma Region were not adequately utilised. It is, therefore, recommended that the health care practitioners, policymakers, planners and other stakeholders should scale-up the existing programmes and interventions for maternal health. Strengthening health system functioning and clients- service providers relationship, effective community mobilization and improve policies surrounding maternal health services were identified as a possible solution. Designing effective programs should be base on the identified determinants for low utilization of maternal health care in the study area.