title: Maternal health care service seeking behaviors and associated factors among women in rural Haramaya District, Eastern Ethiopia: a triangulated community-based cross-sectional study.
abstract: BACKGROUND
  Regular utilization of maternal health care services reduces maternal morbidity and mortality. This study assessed the maternal health care seeking behavior and associated factors of reproductive age women in rural villages of Haramaya district, East Ethiopia.
  
  
  METHODS
  Community based cross sectional study supplemented with qualitative data was conducted in Haramaya district from November 15 to Decemeber 30, 2015. A total of 561 women in reproductive age group and who gave birth in the last 2 years were randomly included. Bivariate and multivariate logistic regressions model was used to identify the associated factors. Odds ratios with 95% CI were used to measure the strength of association.
  
  
  RESULTS
  Maternal health care service seeking of women was found as; antenatal care 74.3% (95% CI; 72.5, 76.14), attending institutional delivery 28.7% (95% CI; 26.8, 30.6) and postnatal care 22.6% (95% CI; 20.84, 24.36). Knowledge of pregnancy complications, Educational status, and religion of women were found to be significantly associated with antenatal health care, delivery and postnatal health care service seeking behaviours triangulated with individual, institutional and socio-cultural qualitative data.
  
  
  CONCLUSIONS
  The maternal health care service seeking behavior of women in the study area was low. Educational status of the women, birth order and knowledge about pregnancy complications were the major factors associated with maternal health care service seeking behavior Focused health education with kind and supportive health care provider counseling will improve the maternal health care seeking behaviors of women.
authors.affiliation: Department of Health Education, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
authors.forename: Dereje
authors.initials: D
authors.lastname: Kifle
authors.affiliation: Department of Health Education, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
authors.forename: Telake
authors.initials: T
authors.lastname: Azale
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
authors.forename: Yalemzewod Assefa
authors.initials: YA
authors.lastname: Gelaw
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia. 078yayu@gmail.com.
authors.forename: Yayehirad Alemu
authors.initials: YA
authors.lastname: Melsew
mesh_terms: D000293:Adolescent; D000328:Adult; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D000068097:Maternal Health; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Antenatal care; Delivery; Health care seeking; Northeast Ethiopia; Postnatal care; Women