Knowledge Attitude and Practice Towards Skilled Care Attendance among Women of Reproductive Age Group in Eritrea

Introduction: Maternal Mortality Ratio (MMR) in Eritrea is one of the highest in the world. According to the EDHS of 1995, the MMR in Eritrea was 998 per 100,000. The MMR estimation of WHO/UNFPA/UNICEF for Eritrea is 630/100,000 live births. The Government of Eritrea in collaboration with its partners are implementing the Road Map for accelerating the reduction of maternal and neonatal mortality in Eritrea. Objective: To assess the Knowledge, Attitude and Practice (KAP) on the utilization of maternal and child health information and services among women of reproductive age group. Methods: A cross sectional community based study using standard questionnaire was conducted in three zones of Eritrea in April 2006 on 851 women in reproductive age group residing in 33 villages randomly selected. At 28% skilled care attendance rate and 95% confidence interval, the sample size was calculated to be 927. The response rate was 851 (91.8%) of the sample size. Results: A total of 851 (92%) women were interviewed and majority 652 (76.9%) were Moslems and the rest were Christians. About two-third (59.3%) of the women had no formal education. 88.7% of the respondents were housewives. 13.6% of the total 788 respondents had at least one abortion. Excessive bleeding was one of the leading causes of maternal death. The symptoms of mothers at the time of death as mentioned by the interviewed women were excessive bleeding for 18.8%, fast breathing for 12.5%, fever for 6.3% and others for 62.5%. Gash Barka zone hah the lowest skilled care attendance (SCA) (23.6%) as compared to the other two zones Northern Red Sea 39.3% and Southern Red sea (47.2%). Orthodox Christians had a higher level of SCA at birth (58.0%) as compared to (30.4%). Unmarried women have a higher level of SCA (66.0%) as compared to married women (35.3%). The study also elucidated that as educational level increases the SCA at birth also increases from 24.3% among uneducated women to 83.9% among those with grade 10-12. There was no significant change of SCA by age. Conclusion: The study revealed that skilled care attendance at birth is still very low as compared to other countries and bleeding is the major cause of maternal death. Education of women is crucial for service utilization. It is recommended that husbands should be targeted for Behavioral Change Communication and women to be empowered to make a decision of their destiny