Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study

Abstract

Background: The incidence of maternal mortality remains unacceptably high in developing countries. Ethiopia has developed many strategies to reduce maternal and child mortality by encouraging institutional delivery services. However, only one-fourth of women gave birth at health facility, in the country. This, this study aimed to identify individual level factors and to assess the regional variation of institutional delivery utilization in Ethiopia. Methods: Data were obtained from the 2016 Ethiopian demographic and health survey. In this study, a total of 7174 reproductive age women who had birth within five years were included. We fitted multilevel logistic regression model to identify significantly associated factors associated with institutional delivery. A mixture chisquare test was used to test random effects. Statistical significance was declared at p < 0.05, and we assessed the strength of association using odds ratios with 95% confidence intervals. Result: The level of institutional delivery was 38.9%. Women's who had focused antenatal care (FANC) visit (AOR = 3.12, 95% CI: 2.73-3.56), multiple gestations (AOR = 2.06, 95% CI: 1.32-3.21, and being urban residence (AOR = 7.18, 95% CI: 5.10-10.12) were more likely to give birth at health facility compared to its counterpart. Compared to women's without formal education, giving birth at health facility was more likely for women's who had primary education level (AOR = 1.77, 95% CI: 1.49-2.10), secondary education level (AOR = 3.79, 95% CI: 2.72-5.30), and higher education level (AOR = 5.86, 95% CI: 3.25-10.58). Furthermore, women who reside in rich (AOR = 2.39, 95% CI: 1.86-3.06) and middle (AOR = 1.66, 95% CI: 1.36-2.03) household wealth index were more likely to deliver at health facility compared to women's who reside poor household wealth index. Moreover, this study revealed that 34% of the total variation in the odds of women delivered at health institution accounted by regional level. Conclusion: The level of institutional delivery in Ethiopia remains low. Context specific and tailored programs that includes educating women and improving access to ANC services has a potential to improve institutional delivery in Ethiopia.

Maternity Care Services Utilization and Factors Associated with Institutional Delivery Among Postpartum Women in Dabat Demographic and Health Survey Site, Northwest Ethiopia: A Community Based Baseline Survey for MNCH Surveillance

“…Furthermore, their autonomy to decide on place of delivery is better in educated women than non-educated ones. A similar nding was also observed in different studies conducted in Ethiopia [44,45] and Bangladish [48].…”

“…Additionally, physical accessibility of health facility is better in urban than rural. The same nding was also observed in a national level study conducted in Ethiopia [44,45], lay Gayint district, Ethiopia[46], and studies conducted in Bangladish [47,48].…”

Determinants of Health Facility Delivery in Northwest Ethiopia: A Community-Based Case-Control Study

“…This result is supported by other studies done in Ethiopia and abroad. 29,[39][40][41][42] Mothers whose age range from 18 to 25 years at first pregnancy were two times more likely to use health facility delivery as compared to those mothers whose age was less than 18 years of age. This finding is not supported by other local studies done in Ethiopia [43][44][45] and Nepal 46 which revealed that younger…”

Determinants and spatial distribution of institutional delivery in Ethiopia: evidence from Ethiopian Mini Demographic and Health Surveys 2019

“…The increased log-likelihood and decreased deviance were an indication of good model fitness (Table 4). (13). There was a high variation from pocket studies but it showed good improvement from EDHS 2016.…”

“…Family size, accessibility of transportation, planned pregnancy, information about the place of delivery, participation of women in monthly health conference (PWMHC), information about exempted service, and having antenatal care (ANC) follow up during their last pregnancy were predictors (11,12). In other studies, institutional delivery was 38.9% and influenced by focused antenatal care, multiple gestations, urban residence, and formal education of the women (13,14).…”