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Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach

Risk factor approaches are often used when implementing programs aimed at enforcing advantageous health care behaviors. A less frequently-used strategy is to identify and capitalize on those who, despite risk factors, exhibit positive behaviors. The aim of our study was to identify positive deviant...

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Autores principales: Ousman, Seman K., Magnus, Jeanette H., Sundby, Johanne, Gebremariam, Mekdes K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084325/
https://www.ncbi.nlm.nih.gov/pubmed/32151041
http://dx.doi.org/10.3390/ijerph17051712
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author Ousman, Seman K.
Magnus, Jeanette H.
Sundby, Johanne
Gebremariam, Mekdes K.
author_facet Ousman, Seman K.
Magnus, Jeanette H.
Sundby, Johanne
Gebremariam, Mekdes K.
author_sort Ousman, Seman K.
collection PubMed
description Risk factor approaches are often used when implementing programs aimed at enforcing advantageous health care behaviors. A less frequently-used strategy is to identify and capitalize on those who, despite risk factors, exhibit positive behaviors. The aim of our study was to identify positive deviant (PD) mothers for the uptake of skilled maternal services and to explore their characteristics. Data for the study came from two waves of the Ethiopian Demographic and Health Surveys conducted in 2011 and in 2016. PD mothers were defined as those reporting no formal education but with adequate use of antenatal care (ANC) and/or institutional delivery services. Two-level multilevel regression analysis was used to analyze the data. Factors associated with PD for the use of ANC services were: partner’s education status, involvement in household decision making, exposure to media, and distance to the health facility. Factors associated with PD for health facility delivery were: partner’s education, woman’s employment status, ANC visit during index pregnancy, exposure to media, and perceived challenge to reach health facility. Rural-urban and time-related differences were also identified. The positive deviance approach provides a means for local policy makers and program managers to identify factors facilitating improved health behaviour and ultimately better health outcomes while acknowledging adverse risk profiles.
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spelling pubmed-70843252020-03-24 Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach Ousman, Seman K. Magnus, Jeanette H. Sundby, Johanne Gebremariam, Mekdes K. Int J Environ Res Public Health Article Risk factor approaches are often used when implementing programs aimed at enforcing advantageous health care behaviors. A less frequently-used strategy is to identify and capitalize on those who, despite risk factors, exhibit positive behaviors. The aim of our study was to identify positive deviant (PD) mothers for the uptake of skilled maternal services and to explore their characteristics. Data for the study came from two waves of the Ethiopian Demographic and Health Surveys conducted in 2011 and in 2016. PD mothers were defined as those reporting no formal education but with adequate use of antenatal care (ANC) and/or institutional delivery services. Two-level multilevel regression analysis was used to analyze the data. Factors associated with PD for the use of ANC services were: partner’s education status, involvement in household decision making, exposure to media, and distance to the health facility. Factors associated with PD for health facility delivery were: partner’s education, woman’s employment status, ANC visit during index pregnancy, exposure to media, and perceived challenge to reach health facility. Rural-urban and time-related differences were also identified. The positive deviance approach provides a means for local policy makers and program managers to identify factors facilitating improved health behaviour and ultimately better health outcomes while acknowledging adverse risk profiles. MDPI 2020-03-05 2020-03 /pmc/articles/PMC7084325/ /pubmed/32151041 http://dx.doi.org/10.3390/ijerph17051712 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ousman, Seman K.
Magnus, Jeanette H.
Sundby, Johanne
Gebremariam, Mekdes K.
Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach
title Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach
title_full Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach
title_fullStr Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach
title_full_unstemmed Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach
title_short Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach
title_sort uptake of skilled maternal healthcare in ethiopia: a positive deviance approach
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084325/
https://www.ncbi.nlm.nih.gov/pubmed/32151041
http://dx.doi.org/10.3390/ijerph17051712
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