Development of an integrated framework for delivery care seeking behaviour among pregnant women in rural Ethiopia

Abstract

The aim of this study was to identify factors affecting facility-based delivery with the purpose of developing a framework for the promotion of facility-based delivery among women living in rural Ethiopia. Explanatory mixed methods design, comprising of four phases-the descriptive (quantitative), explorative (qualitative), meta-inference and development phases was employed. The quantitative phase was conducted first using a structured questionnaire to identify the variables influencing facility-based delivery care seeking behaviour. A sample of 389 responses were used for data analysis using Structural Equation Modeling. The quantitative phase conducted next to explain the determinants that contributed to influencing facility-based delivery care seeking behaviour. Sixteen participants who were involved the first phase were involved in the follow-up second phase. As illustrated by the results of the study, the majority of women in the study areas continued to deliver at home, putting themselves at risk of dying from pregnancy related causes. As highlighted by the key findings from the quantitative and qualitative data of this study, the most influential factors in predicting and explaining delivery care seeking behaviour are response efficacy, attitude, subjective norm, and perceived behavioural control which are shaped by mothers’ confidence in the outcome, quality of care, interpersonal relations with family members, willingness to conform, access to services, and their decision making power. The way these findings emphasized the factors attitude, subjective norm and perceived behavioural control were consistent with the Theory of Planned Behaviour, while the significance of response efficacy was in line with Protection Motivation Theory. The study developed a framework to help promote facility-based delivery among mothers living in rural Ethiopia.