Determinants of skilled birth attendance in rural Cambodia.
OBJECTIVE
To identify the determinants of skilled and unskilled birth attendance.


METHODS
Population-based survey in a rural area in Cambodia, of women aged 15-49 years who had delivered during the previous 3-month period. An analytical framework based on Andersen's behavioural model served to identify determinants according to delivery place (facility vs. non-facility), birth attendant at home births (skilled vs. unskilled), and change of birth attendant during delivery (changed vs. unchanged). We used logistic regression to analyse the data.


RESULTS
Of 980 women included in the analyses, 19.8% had skilled attendants present during delivery. The determinants of facility delivery were different from those for having skilled attendants assisting in home births. In case of facility deliveries, previous contact with a skilled attendant through antenatal care was a significant determinant. In case of home births, the type of birth attendant (i.e. skilled or unskilled) at the preceding delivery was a significant determinant.


CONCLUSIONS
Community-based programmes need to reach primiparas, because once a woman has delivered with the aid of an unskilled attendant, she is five to seven times less likely to seek skilled help than a primipara.
Yanagisawa
Satoko
S
School of Health Sciences, Faculty of Medicine, Shinshu University, Nagano, Japan. sayanag@shinshu-u.ac.jp
Oum
Sophal
S
Wakai
Susumu
S
D000293:Adolescent; D000328:Adult; D002160:Cambodia; D002755:Choice Behavior; D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000379:methods* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006700:Home Childbirth / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000523:psychology; D017060:Patient Satisfaction; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D012423:Rural Health; D012959:Socioeconomic Factors