Abstract

Background: Bypassing primary health care facilities is “a delivery that takes place in the health facility that is not the closest to mothers’ home”. Bypassing imposes financial hardship to women, inefficient use of resources within health care system, inadequate and low quality of services, and high out-of-pocket expenditure Objective: This study aims to assess bypassing primary health care facility and associated factors among women seeking delivery service in Nigist Eleni Mohammed Memorial Comprehensive Specialized (NEMMCS) hospital. Method: Facility based cross sectional study design was employed from February to March 2023. Systematic random sampling was used to choose participants. Bivariate and multivariable logistic regression model were applied to determine the association between dependent and independent variables. The strength of association was determined using odds ratio with 95% confidence interval. Statistical significance was declared at a P-value less than 0.05. Result: This study indicated that 68.5% participants bypassed the nearest PHC facility. Educational status of respondents Adjusted Odds Ratio (AOR) 4.1(95% CI: 1.55 -11.10), perceived service quality AOR 0.37(95% CI: 0.16-0.85, availability of drugs and supplies AOR 0.32(95% CI: 0.13 -0.75), and information on the need to have referral letter AOR 0.20(95% CI: 0.09-0.47) were factors that affect bypassing. Conclusion: Given more specialist care at tertiary hospitals, the proportion of bypassers in current study seems
significantly high. Recommendation: Ministry of health should strengthen and improve primary health care facilities giving special emphasis on provision of adequate human power and medical supplies.

Keywords: Bypassing, PHC facilities, Delivery service, NEMMCS hospital, Ethiopia