Midwives' willingness to provide home-based maternity and child health care, along with the associated factors and barriers, in Gondar, Ethiopia

埃塞俄比亚贡德尔市助产士提供居家孕产妇和儿童保健服务的意愿及其相关因素和障碍

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Abstract

INTRODUCTION: Many Ethiopian mothers and their infants do not have access to maternity and child health care during the first week after birth, increasing their risk of becoming ill or dying. Midwives doing maternity and child health care home visits could improve the overall maternity and child health care experience. There is inadequate empirical evidence to show the desire of midwives to implement home-based maternity and child health care in low-income countries like Ethiopia. METHODS: Between February 27 and October 27, 2023, 423 midwives participated in an institutional-based mixed methods, cross-sectional study. For the quantitative study, data were collected using a standardized self-administered questionnaire, whereas for the qualitative study, we conducted in-depth interviews with 12 midwives'. Bivariate and multivariable logistic regression analyses were performed. The adjusted odds ratio with confidence intervals at P-value 0.05 was used to identify a statistically significant relationship between the independent and outcome variables. Thematic analysis was used to interpret qualitative data. RESULT: The percentage of midwives' who would be willing to offer child health care and home-based maternity care was 74.3%, with a 95% confidence interval between 74% and 77.4%. A strong correlation was found between midwives' high level of willingness to Implement home-based maternity and child health care and their history of obstetrics-related family loss (aOR: 2.2 with CI (1.04-4.8), P = 0.036. organizational factor (aOR: 0.087 CI (0.034-0.22), P = 0.000 individual beliefs factor (aOR: 0.19 CI (0.07-0.48), P = 0.000 and attitudes (aOR: .22 CI (0.08-0.61), P = 0.004. Based on the qualitative findings, the main obstacles to home-based maternity and child health care were found to be infrastructures, finances, and implement burden. CONCLUSION AND RECOMMENDATION: This study found that many midwives were willing to offer child health care and home-based maternity services. Establishing and implementing a home-based maternity and child healthcare service requires sufficient manpower, facility equipment, and access infrastructure.

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