Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #102360

Satoko Yanagisawa, PHN, MS, PhD, School of Health Sciences, Faculty of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, Japan, 81-263-37-3505, sayanag@shinshu-u.ac.jp and Sophal Oum, MD, MTH, DrPH, University of Health Sciences, 73 Blvd Monivong, Phnom Penh, Cambodia.

Background: Although the importance of having a skilled birth attendant during delivery is widely recognized, little is known regarding the mechanisms by which people choose their birth attendants. We performed a population-based survey on skilled attendant choice by women in a rural Cambodia to identify determinants of birth attendant choice, with contact with the birth attendant as an exposure factor. Methods: Subjects were women aged 15-49 who had delivered babies during three months prior to the survey. Determinants of birth attendant choice were identified based on the choice of delivery place (facility vs. non-facility), choice of birth attendant in home births (skilled vs. unskilled) and change of birth attendant during delivery (changed vs. unchanged). The analyses were performed by logistic regression. Results: Of the 980 women included in the analyses, 19.8% had skilled attendants present at the birth. The determinants of facility delivery choice were different from skilled attendant choice in home births, and contact with birth attendant worked differently on the choices. For facility delivery choice, contact with skilled attendant through antenatal care was a significant determinant. However, for home births, the choice of skilled and unskilled attendants at the preceding delivery was a significant determinant. For community-based programs, women who once chose unskilled attendants were five to seven times less likely to choose skilled attendant in the following delivery than primiparas. Conclusion: Caution should be employed in planning a hospital-based or a community-based skilled attendance promotion, because different determinants support the choice of birth attendant in each program.

Learning Objectives:

• Identify determinants of birth attendant choice of women in a country where the utilisation of skilled attendants is low.
• Discuss that the determinants of skilled birth attendant choice during home births are different from those of facility delivery choice.

Keywords: Safe Mother Program, Health Behavior

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.