Assessment of equity in provision and utilization of maternal and child health programs in butajira, southern ethiopia

5.3. Socio-demographic and socio-economic determinants of health service utilization

For logistic regression factors were categorized into two categories as follows:

Sex household head, Male=1,else=0; Mother’s age 35 and above =1,else=0; Occupation, non-farmer =1,else=0; Mother’s educational status, Some school =1,else=0; Father’s Education, Some schooling=1,else=0; Annual Income (above 75%ile), 1000 or more birr=1,else=0; Private house ownership, own house=1,else=0; Private land ownership, own land=1,else=0; place of residence, urban=1,else=0.
It can be seen from table 3 that significant differences exist between cases and controls with respect to place of residence, mothers education, fathers education, occupation of heads of households, annual household income, possession of land and house. Mothers who used the service were more likely to be an urban resident with the odds of being to an urban resident to be 3.86 times higher for cases than controls (X²=18.71, p<0.001), have mothers and fathers with some schooling with the odds of mothers and fathers having some schooling to be 2.81 and 1.99 times higher for cases than controls (X²=12.41, p<0.001 and X²=10.14, p<0.01). The heads of households being non-farmer (X²=13.22, p<0.001), having higher annual household income (X²=10.33, p<0.01), not having land (X²=10.42, p<0.01) and not owning house (X²=6.58, p<0. 05) were also shown to be associated with service use.
To calibrate households with respect to their wealth relative to other households, a composite 'index' of assets was developed. It was assumed that a household that possesses its own house, own private farm land, cattle, radio, coffee, 'chat', and pepper is relatively better off in rural areas. In urban areas, one that possesses a radio, a television, pipe water, its own house and electrification of house is thought of as relatively better off.
The score of assets for urban 'kebeles' was based on possession of radio, television, pipe water, own house and electrification of house. These five indicators (0 or 1) were added to an index from 0 to 5, where 0-1 and 2-5 were interpreted as worse off and better off households, respectively. For rural households, the indicators used were possession of radio, own house, farm land, cattle and backyard plantations (coffee, 'chat', and pepper). These seven indicators were added to an index from 0 to 7, where 0-3 and 4-7 were interpreted as worse off and better off households, respectively (Table 3).
Bivariate analysis showed the difference in wealth score detected between cases and controls households was not statistically significant in rural 'kebeles' (OR=1.58, 95% CI=0.97-2.57) and in urban 'kebeles' (OR=2.06, 95% CI=0.63-6.79).

Table 3. Association of Socio-demographic and socio-economic factors with utilization of health services, Meskan and Mareko Districts, Ethiopia, 2004.

Male 183 183

Female 7 8 1.14 (0.41, 3.22)

Mother’s age

Below 35 yrs. 129 133

35 and above 34 43 1.23(0.74, 2.04)

Place of residence

Urban 47 15

Rural 143 176 3.86 (2.07, 7.19) ^***

Mother’s Educational status

Some schooling^ 47 20

No school 143 171 2.81 (1.59, 4.96) ^***

Father’s Educational status

Some schooling^ 91 60

No schooling 99 130 1.99 (1.31, 3.02) ^**

Occupation

Non-farmer 47 18

Farmer 142 171 2.89 (1.64, 5.1^{) ***}

Annual Income

1000 or more 63 35

Less than 1000 78 102 2.35 (1.42, 3.91) ^**

Own house

Has own house 166 182

No own house 24 9 0.34 (0.15, 0.76) ^*

Own land

Has own land 151 175

No own land 39 16 0.35 (0.19, 0.65) ^**

­Wealth score rural HH out of seven

Mean SD, range 4.38 (1.33);0-7 4.16 (1.3);0-7

0-3 37 (24) 59 (33)

4-7 116 (76) 117 (67) 1.58 (0.97, 2.57)

Wealth score urban HH out of 5

Mean SD, range 2.98 (1.2);0-5 2.47 (1.06); 0-5

0-2 14 (30) 7 (47)

3-5 33 (70) 8 (53) 2.06 (0.63, 6.79)

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Note - Some schooling^- those who have formal education

*-Significant at p<0.05, **- significant at p<0.01, *** significant at p<0.001

5.4. Type and access to nearest HFs and family decision making pattern

Table 4. Type and distance of health facility, Source of information and Pattern of family decision making, Meskan and Mareko District, Ethiopia 2004.

Health center 104 (55) 100 (52)

Health post/station 69 (36) 83 (43.5)

Hospital 15 (8) 3 (1.5)

Drug vendor/phar. 2 (1) 5 (2.5)

Walking distance of nearest HI

Mean (SD), 49.24 (40.3), 60.13 (50.5)

>1hour 62 (32) 98 (51)

Walking 150 (79) 164 (86)

Public trans 11 (6) 10 (5)

Health W 148 (78) 160 (84)

Radio&/or TV 31 (16) 12 (6)

Others 11 (6) 19 (10)

Self 16 (8.4) 20 (10.5)

Husband 81 (43) 92 (48)

Both 91 (48) 78 (41)

Others. 2 (1) 1 (0.5)

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