Home delivery practice and its predictors in South Ethiopia

Abstract

Background Institutional delivery is one of the key interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries like Ethiopia are home deliveries and are not attended by skilled birth attendants. We investigated the prevalence and determinants of home delivery in three districts in Sidama administration, Southern Ethiopia. Methods Between 15–29 October 2018, a cross sectional survey of 507 women who gave birth within the past 12 months was conducted using multi-stage sampling. Sociodemographic and childbirth related data were collected using structured, interviewer administered tools. Univariate and backward stepwise multivariate logistic regression models were run to assess independent predictors of home delivery. Results The response rate was 97.6% (495). In the past year, 22.8% (113), 95% confidence interval (CI) (19%, 27%) gave birth at home. Rural residence, adjusted odds ratio (aOR) = 13.68 (95%CI:4.29–43.68); no maternal education, aOR = 20.73(95%CI:6.56–65.54) or completed only elementary school, aOR = 7.62(95% CI: 2.58–22.51); unknown expected date of delivery, aOR = 1.81(95% CI: 1.03–3.18); being employed women (those working for wage and self-employed), aOR = 2.79 (95%CI:1.41–5.52) and not planning place of delivery, aOR = 26.27, (95%CI: 2.59–266.89) were independently associated with place of delivery. Conclusion The prevalence of institutional delivery in the study area has improved from the 2016 Ethiopian Demography Health Survey report of 26%. Uneducated, rural and employed women were more likely to deliver at home. Strategies should be designed to expand access to and utilization of institutional delivery services among the risky groups.

Prevalence of cultural malpractice during the perinatal period and its determinants among reproductive age women in southwest Ethiopia: A community-based cross-sectional study

“…Our study also found that the prevalence of home delivery was 31.88% (95% CI: 27.42, 36.61%). This result was higher than previous reports in Ethiopia (13,15,32). This might be due to the difference in the study setting; the previous studies were institutional based while our study was community-based.…”

“…Similarly, women with no formal education were more likely to practice food taboos, home delivery, and pre-lacteal feeding than women with primary and above education. This association was documented elsewhere (5,10,13,15,29), and could be related to the lack of awareness about the harmful effect of cultural malpractices on the health of the mother and her offspring among women without formal education.…”

“…Bench Maji Zone is also a home for such malpractices where home delivery, food prohibition, pre-lacteal feeding, and abdominal massage are commonly exercised (8,12). These malpractices were found to have a significant association with residence, educational status, antenatal care (ANC) follow-up, gravidity, and distance from the health facility (5,10,(13)(14)(15).…”

Determinants of place birth: a multinomial logistic regression and spatial analysis of the Ethiopian mini demographic and health survey data, 2019

“…Rural residence, distance to health facility, low antenatal care coverage, and economic status are common societal factors. Also, low education, not planning for place birth, and unknown due date [10][11][12] were significant predictors. Moreover, socio-cultural factors such as assuming labor and delivery as a natural process, presence of enjoyable rituals during and after delivery, perceived friendly care by traditional attendants, and unavailability, inaccessibility, and perceived poor quality of modern services were qualitatively extracted factors [13][14][15] for home delivery in Ethiopia.…”

Predictors of homebirth amidst COVID-19 pandemic among women attending health facilities in Wondo Genet, Sidama Region, Ethiopia: A case control study

“…Most rural women in Sidama Region (formerly known as Sidama Zone) face difficulty in accessing distant health facilities to use maternal health services [ 18 , 19 ]. In addition, poor landscape and topography make institutional delivery less reliable in this region.…”