Abstract:
Introduction: Bypassing primary health facilities is an observable fact where individuals choose
to obtain care from a health facility that is not nearest to them. One of the devastating effects of
bypassing on higher level health care system is compromising the quality of care rendering to the
clients because of overcrowding and minimizing the contact time between clients and health care
professionals. Similarly Bypassing lower level facilities result in underutilization of the facility too,
because of the loss of skills required to provide obstetric care
Objective: The objective of this study was to assess the magnitude and associated factors of
bypassing childbirth services at the nearby health centers among postnatal women who gave birth
at University of Gondar comprehensive specialized hospital.
Method: Facility based cross sectional study was conducted from August 1-30/2018. A pretested
and structured interviewer administered questionnaire was used to collect 391 data. Systematic
random sampling technique was used to select study participants. Data were coded and entered
into Epi Info version-7 and exported to SPSS version 20 for further analysis. Bivariable and
multivariable logistic regression analyses were done to assess the association between
dependent and explanatory variables.
Results: Overall 62.9% with [95% CI:
Conclusions and recommendations: The proportion of women bypassing health centers is high.
Preference of hospital childbirth service is associated with bypassing nearest health center.
Investing and improving quality of care in primary care facilities may reduce bypassing and
improve the efficiency and effectiveness of the health system.
Key words: bypass, Health center, nearest, childbirth, north Gondar, and Comprehensive
Specialized Referral Hospital.
