Abstract
Background Health-care facility delivery was the most critical in ensuring the provision of high-quality care and a distribution location that was ready in the case of an emergency for reproductive women. However, maternal mortality remains high in African nations, and the majority of women were still giving birth at home. This study was aimed to determine whether women's empowerment and community norms, plus other proximate factors, are related to the health facility delivery utilization of women in Ethiopia. Methods The data for this study was taken from the Performance Monitoring for Action (PMA) in Ethiopia of the 2019 cross-sectional survey. A weighted sample of 4864 women with at least one birth history, clustered within 264 clusters was used for this study. The impact of women's empowerment, cultural norms, and other proximate factors on the use of health facility deliveries among reproductive-age women across clusters in Ethiopia was studied using a two-level multilevel logistic regression. Results In Ethiopia, around 51 % of women were delivered their most recent child at the health facility. The use of a health facility delivery was more common among empowered women and those living in where the most people encourage a health facility delivery. Older women were less likely to deliver at a health facility and women from the highest wealth quantile more likely to have a facility delivery. Those women with higher education and living in an urban area were more likely to have a health facility delivery. Women’s chances of giving birth in health facilities vary significantly across the 264 clusters of Ethiopia ( σ_uo^2 =2.49,p.value<0.001). Conclusions This study emphasizes the importance of women's empowerment and cultural norms in enhancing maternal health outcomes of women in Ethiopia. It is more important than ever that the government and development agency should invest more in women's empowerment and raising community consciousness about the benefits of using health facility delivery as part of a strategic intervention to improve maternal health outcomes.
Measuring community norms around women's empowerment in the West Bank: Opportunities and challenges of a novel approach using cultural consensus