Determinants of utilisation of intrapartum obstetric care services in Cambodia, and gaps in coverage

Anne Chomat, John Grundy, Sophal Oum, Odilia Bermudez

    Research output: Contribution to journalArticlepeer-review

    11 Citations (Scopus)

    Abstract

    Background. Facility delivery and skilled birth attendance are two of the most effective strategies for decreasing maternal mortality. The objectives of this study were to further define utilisation of these services in Cambodia and to uncover socio-economic or location-specific coverage gaps that may exist. Methods. We performed a cross-sectional analysis of the 2005 Cambodia Demographic Health Survey (CDHS) to determine prevalence, and determinants, of service utilisation. Results. Out of 6069 women aged 15-49 years, 77% delivered at home, three-fourths without a skilled birth attendant. Poverty, lower education and rural residence were associated with the highest likelihood of poor utilisation of services. Discussion. While there has been an overall increase in facility deliveries and skilled birth attendance since 2000, improvements have been spread unevenly across the population, benefiting mostly urban, wealthier and better educated women. While recent financing initiatives and health system developments appear to have further increased service utilisation since 2005, the extent of their reach to the most vulnerable populations, and their ultimate impact on maternal mortality reduction, remain to be elucidated. Conclusion. Further expanding successful initiatives, particularly among vulnerable populations, is essential. Longitudinal evaluation of ongoing strategies and their impact remains critical.

    Original languageEnglish
    Pages (from-to)890-905
    Number of pages16
    JournalGlobal Public Health: An International Journal for Research, Policy and Practice
    Volume6
    Issue number8
    DOIs
    Publication statusPublished - Dec 2011

    Keywords

    • birth attendance
    • Cambodia
    • Demographic Health Survey
    • facility delivery
    • health care disparity
    • maternal mortality

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