Factors associated with utilisation of health unit maternity services among women who attend antenatal care in Tororo district.
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INTRODUCTION: The MMR for Tororo is estimated at 1,200/100,000 live birth compared to national figure of 506/100,000. Low utilization of delivery services had not been well documented. OBJECTIVE: To determine factors that are associated with utilization of health unit maternity services among mothers who attend antenatal care in order to generate information to be used in the design of interventions to improve maternity services in Tororo District. METHODS: This was an unmatched case-control health facility based study involving 180 cases and 180 controls attending ANC in Tororo District who had at least one delivery prior to the current pregnancy regardless of the outcome. RESULTS: Utilization of health unit maternity services was associated with higher education level (OR=1.12, CI=1.11-1.13), Socio-economic status (OR=3.0, CI=1.8-5.3) and positive perception about interpersonal relations (2.07, CI=1.11-3.84). Rural residence (OR=0.45, CI=0.27-0.77) and longer travel time (OR=0.23, CI=0.08-0.64) were associated with low utilization of health unit maternity services. CONCLUSION: Socio-economic status, distance/ travel time and interpersonal relations with health staff are the main factors influencing utilization of health unit maternity services in Tororo district. Enhancement of girl-child education by the district council and training of health staff in communication and counseling skills by the district health team are recommended. Identification of income generating activities for mothers by both the district council and the district health team is further recommended to improve utilization of health unit maternity services aimed at reducing maternal mortality rate in Tororo district. Strengthening lower health units could reduce distance and provide services to the rural communities and may reduce the high MMR in Tororo.