Factors associated with institutional delivery in Ethiopia: a cross sectional study

Abstract

Background: In spite of the promotion of institutional delivery in Ethiopia, home delivery is still common primarily in hard-to-reach areas. Institutional delivery supported to achieve the goal of reducing maternal and neonatal mortality in Ethiopia. The objective of this study is to assess the determinants of institutional delivery in Ethiopia. Methods: Cross sectional survey was conducted in 11 administrative regions of Ethiopia. The Ethiopian demographic and health survey data collection took place from January 18, 2016, to June 27, 2016. The study subjects were 11,023 women (15-49 years old) who gave birth in the preceding 5 years before 2016 Ethiopian demographic health survey. This representative data was downloaded from Demographic Health Survey after getting permission. The Primary outcome variable was institutional delivery. The data was transferred and analyzed with SPSS Version 20 statistical software package. Results: Of 11,023 mothers, 2892 (26.2%) delivered at a health facility and 8131 (73.8%) at home. Women with secondary education were 4.36 times more likely to have an institutional delivery (OR: 4.36; 95% CI: 3.12-6.09). Institutional delivery was higher among women who were resided in urban areas by three fold (OR: 3.26; 95% CI: 2.19-4.35). Women who visited ANC (Antenatal care) were about two times more likely to choose institutional delivery (OR: 1.81; 95% CI: 1.58-2.07). Respondents who watch television at least once a week was two times more likely to experience institutional delivery than those who did not watch at all (0R: 1.90; 95% CI: 1.35-2.66). The wealthiest women were 2.61 times more likely to deliver in an institution compared with the women in the poorest category (OR: 2.61; 95% CI: 1.95-3.50). Conclusion: Women having higher educational level, being richest, residing in urban area, visiting antenatal care at least once, and frequent exposure to mass media were factors associated with institutional delivery. Improving access to education and health promotion about obstetrics and delivery through mass media will increase the uptake of institutional delivery.

Inequality in institutional delivery of the recent birth among married women in Nepal: a trend analysis

“…Our study also showed that wealth status is signi cant predicator of institutional delivery both with and without controlling other variables. The result are similar with the study conducted in Bangladesh 21 Gambila 22 , Southwest Ethiopia 23 ,and Mozambique 24 . The nding is also consistent with other studies Pakistan 25 , Eastern Nepal 26 and other different low income countries [27][28][29][30] .Despite of the Nepal's national agship programs (Aama) since 2005 which promoting safe motherhood through initiatives such as providing free delivery care and transportation incentive schemes to women delivering in a health facility, it is discouraging that poor women are less likely to deliver their recent child in the health facilities.…”

<p>Magnitude and Associated Factors of Institutional Delivery Among Reproductive Age Women in Southwest Ethiopia</p>

“…This finding was in line with 74%, 15 74.4%, 22 78.3%, 2 78.8% 16 studies conducted in Ethiopia and 78.1% in Gambia. 20 It was higher than 12.3%, 8 16.9% 29 24.8%, 5 26.2%, 19 31.0%, 9 32.8%, 30 47.3%, 18 63.1%, 31 64.62%, 14 64.8%, 21 71.2% 13 studies conducted in Ethiopia and 67.3% in Tanzania. 32 The variation observed could be due to socio-economic; educational and sociocultural profiles.…”

“…This finding was supported by several studies conducted previously. 1,2,[19][20][21]29,30,32 This is due to the better affordability of the cost incurred from the transportation and the service itself.…”

“…8,[10][11][12][13] The factors associated with institutional delivery are multiple and include age, income status, education, occupation, religion, residence, attending ANC, frequency of ANC visit, age at first marriage, age at first pregnancy, types of pregnancy (planned/unplanned), gravidity, parity, owing radio and/or television, knowledge, and occurrence of pregnancy danger signs. 1,2,5,8,9,[14][15][16][17][18][19][20][21][22][23] Ethiopia is one of the six countries that contribute to more than 50% of global maternal deaths. 24 Despite it is known that delivery attended by a skilled provider at a health facility reduced maternal deaths, but more than half of all births in Ethiopia take place at home.…”

“…This finding was supported by several studies done previously. 2,5,8,10,13,14,19,22,29 The reason why ANC visit increased institutional delivery use is because of counseling of birth preparedness and place of delivery by the health care workers at ANC follow up clinic in every visit during pregnancy.…”