Discussion
LICs
DELIVERY COMPLICATION
The trial evaluated the effectiveness of a set of community-based interventions to reduce delays in accessing skilled care in rural Gamo zone. Accordingly, the results showed that the interventions were effective in improving women's knowledge of obstetric danger signs, birth preparedness practices, and use of skilled care services in the study area. Our findings are consistent with the findings of several community-based interventions conducted in LICs [Despite efforts to address the barriers to accessing skilled care, only a small number of rural women give birth in health facilities in rural Ethiopia [Poor awareness of health and obstetric danger signs was common in rural communities where only 30% of women received formal education [Improved awareness alone cannot lead to increased utilization of existing services, especially skilled care utilization, which is significantly affected by financial, logistical, and sociocultural and perception about the quality of care related barriers [We found that the proportion of women who prepared for childbirth increased significantly (by 32.5%), as did the proportion of women who gave birth in healthcare facilities (by 16.1%). This finding highlights the gaps in routine care and the importance of integrated community-based packages of interventions for improving maternal health. However, it also suggests that not all women who are prepared for childbirth will actually give birth in healthcare facilities or receive postnatal care. Therefore, actions aimed at creating demand for existing services should be accompanied by community-level efforts to follow up on pregnant women to ensure they implement the message and create supportive environments that promote positive behaviour [We implemented MWHs as part of our interventions to address the second delay in the study area and improved the MWHs in the intervention arm to make them comfortable places for women to stay during the last few weeks of their pregnancy. Although we found that a higher proportion of women in the intervention arm were aware of MWHs, there was no significant difference in staying at MWHs between the two arms. Thus, in addition to addressing the awareness gap, it is important to consider barriers to stay MWHs, such as the support system at the family level, the willingness of husbands to allow their wives to stay in MWHs and cultural restrictions [Through its HEP, the Ethiopian government has recognized that community-based interventions are essential to improving maternal health. There is strong evidence that the HEP has achieved much regarding maternal health, especially in rural areas [The primary aim of our study was to increase demand among pregnant women and their male partners, as this can lead to better and more sustainable changes. However, since most men were farmers and the intervention occurred during the harvest season, only pregnant women attended the intervention sessions. Women also emphasized the importance of including men, who are typically the decision-makers regarding healthcare services. Several studies have shown that males with knowledge of pregnancy and delivery complications are more likely to advocate for professional care [