Trends and factors associated with skilled birth attendance in a post-Ebola context: DHS Guinea 2018.

Abstract

Background: In Guinea, the 2013-2015 Ebola epidemic profoundly affected maternal health service use. The frequency of births attended by skilled health professionals in the post-Ebola context remains under-documented.

Aim: The aim of this study was to analyze the trend and factors associated with skilled births among women aged 15-49 between 2016 and 2018 in Guinea.

Setting: The Republic of Guinea was the setting for this study.

Methods: Data from 3018 women aged 15-49 years who had at least one live birth over the period 2016-2018 were analysed. The simple binary logistic regression model was used to analyse factors associated with skilled births using Stata software version 16.1. The significance level was set at 5%.

Results: Our study found that 57.3% of deliveries were skilled births. This proportion showed a remarkable variation with a trend in assisted deliveries from 61% in 2016 to 59% in 2017 and then to 50% (p = 0.003) in 2018. Factors associated with skilled birth attendance in post-Ebola were: having no level of education (odds ratio [OR] = 0.39; confidence interval [CI]: 0.31-0.77), performing four or more antenatal care (ANC) (OR = 12.10; CI: 8.24-17.77), residing in a rural area (OR = 0.25 [0.17-0.37]), having a spouse who was a trader or manual worker, belonging to a household with an intermediate or poor wealth index and residing in the Labé region.

Conclusion: This study showed that the proportion of assisted births showed a downward trend between 2016-2018.

Contribution: The interventions undertaken to strengthen the maternal health system in the aftermath of the Ebola epidemic should be reinforced and maintained, in particular the retention of health providers deployed in rural areas and capacity building (training, equipment) for community health workers would help to improve this indicator.