Statistical Analysis of Determinants of Institutional Delivery Service among Reproductive Age Women in Ethiopia

Health care services during pregnancy and during delivery are important for the survival and wellbeing of both the mother and the infant so that increasing institutional deliveries is a basic concern for reducing maternal and neonatal mortality. This article was focused on assessing the trend of institutional delivery service and identifying associated factors using basic statistical tools. The analysis was based on the hypothetical data of 5753 women in reproductive age carefully managed from Ethiopian Mini Demographic and Health Survey (EMDHS) 2019. The trend of institutional delivery revealed a sharp increase from 26% in 2016 to 49.92% in 2019 based on DHS data of the respective years. The study identified variables such as region, place of residence, education level, sex of household head, wealth index, number of living children and antenatal care as highly significant determinants of institutional delivery service in Ethiopia. Institutional delivery service increases with better access to education, living in urban, being in better off wealth category, and following antenatal care visit. The study recommended that there should be well equipped health facilities for pregnant women at each stage.

Health Institutional Delivery Service Utilization and Associated Factors Among Mothers Who Gave Birth in the Last Year in Dembecha Zaria Woreda, Northwest Ethiopia: A Community Based Cross-Sectional Study

Background: The morbidity and mortality of women is a worldwide challenge and the current global maternal death is more than 800 per day; ninety-nine percent of maternal death occurs in developing countries and in Ethiopia about 30% of all ladies’ death is identified with pregnancy-related causes. We, therefore, did this study to assess the magnitude and associated factors of institutional delivery service utilization among mothers who gave birth in the last year in Dembecha Zuria woreda, Northwest Ethiopia.Methods: A community-based cross-sectional study design was employed, and multistage sampling technique was used. Data were collected through face-to-face interviews with pre-tested structured questionnaires among mothers who gave birth in the last year in Dembecha zuria woreda, Northwest Ethiopia from November 23, 2020 to January 16, 2021. After data collection, data were coded and entered using EPI info version 7 and analyzed using SPSS version 25 statistical software. Binary logistic regression analysis was used to ascertain the association between explanatory variables and the outcome variable. Variables with P value less than 0.25 in the Bivariable analysis and P-value < 0.05 in the multivariable analysis and corresponding 95% CI of odds ratio were considered to declare a result as statistically significant. Result: In this study, the magnitude of institution delivery service utilization among mothers who gave birth in the last year was 179 (42.4%) with 95% CI [37.7, 46.9]. type of pregnancy [AOR: 1.906, (95%CI: 1.017,3.57)]), gravidity [AOR: 1.899 (95% CI: 1.244, 2.898)], ANC follow up [AOR: 2.079 (95% CI: 1.242, 3.482)], husband preference on place of delivery [AOR: 2.036) (95% CI: 1.291. 3.211)] and decision-maker on place of delivery [AOR: 2.853 (95% CI: 1.321, 6.160)] were significantly associated with health institution delivery service utilization.Conclusion: In this study, the magnitude of health institution delivery service utilization was low as compared to the national expectation. The concerned bodies need to create awareness on the function of antenatal care follow-up and empower the mothers to decide on the place of delivery and give counseling for husbands about the importance of health institution delivery.

Intention to use institutional delivery service and its predictors among pregnant women, North West Ethiopia: Using theory of planned behavior

Background Improving institutional delivery service is the most crucial strategies to reduce maternal and neonatal mortalities. In developing countries, only 50% of pregnant women deliver in health facilities and in Ethiopia only 48% of pregnant women deliver in health facilities. Maternal mortality remains the highest in Ethiopia. This study assessed intention to use institutional delivery service and its predictors among pregnant women using theory of planned behavior. Methods Community-based cross-sectional study was conducted among 645 Yilmana Densa District Pregnant women using multi-stage followed by cluster sampling technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with STATA version 14. Binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors. Results Intention of pregnant women to use institutional delivery service was 74.3% (CI; 70.71%, 77.6%). In the multivariable logistic regression; those who had 1–3 and 4 &above antenatal care 2.85(1.41, 5.75) and 3.14(1.16, 8.45) respectively, those who had past experience of institutional delivery (AOR = 3.39, 95%CI: 1.72, 6.71), parity of 1–3 and 4 & above % (AOR = 0.37, 0.19, 0.71) and (AOR = 0.25, 95%CI: 0.12, 0.55) respectively, rural residence (AOR = 0.51, 95%CI: 0.27, 0.96), favorable attitude (AOR = 2.93, 95%CI: 1.56, 5.50), favorable perceived behavioral control (AOR = 2.60, 95%CI: 1.44, 4.69) were factors significantly associated with intention to use institutional delivery service. Conclusion and recommendation Majority of the pregnant women were intended to deliver in the institution. Good Knowledge on institutional delivery, antenatal care visit, past experience of institutional delivery, rural residence, parity, attitude and perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation and behavioral change communication programs are required at all levels of health system to raise intention of residents towards institutional delivery.

Knowledge on Intrapartum Danger Sign Influences Place of Delivery: The Case of Raya Kobo District, Northeastern Ethiopia

Background: A skilled birth attendance for every pregnant woman during childbirth is the most crucial intervention for improving maternal health. This study aimed to assess institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Raya Kobo district, Ethiopia. Methods: A community-based cross-sectional study was carried out in the Raya Kobo district of Amhara Regional State during March 2016. Logistic regression analysis was performed to assess the association between each independent variable and the outcome variable. Variables with a p-value <0.05 were considered significant. Results: A total of 493 mothers were included in the study, with a response rate of 95.4%. The mean (+SD) age of the study participants was 29.13 (±6.93) years. About 73% of the study participants had attended at least one antenatal care follow up for their last pregnancy, and 56.6% (95% CI: 52.0, 61.0%) gave birth at health institutions. Travelling for 30 minutes and less [AOR=2.95(1.89, 4.58)], attending antenatal care [AOR=6.0(3.55, 10.13)], having knowledge about intrapartum danger signs [AOR=2.48(1.44, 4.24)] and getting information from health extension workers (HEWs) regarding maternal health services were positively associated. Conclusion: The district health office should strengthen its effort to provide free ambulance accessibility and provide information on danger signs of intrapartum complications and the importance of using institutional delivery service to every mother who came to the antenatal clinic. Furthermore, the district health officials should focus on strengthening the capacity of HEWs in relation to maternal health services.

Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia

Background The risk of death from complications relating to pregnancy and childbirth for women’s lifetime is higher in developing countries. Improving maternal and child health through a well-organized institutional delivery service is central to achieving reduced maternal and child mortality. Despite the efforts that have been made to improve maternal health outcomes in Ethiopia, institutional delivery is still unacceptably low. Objective This study was conducted to assess institutional delivery service utilization and associated factors in the study area. Methods A Community-based cross-sectional study was conducted. A multi-stage sampling technique was used to employ a total of 546 women. Data were collected using an interviewer-administered questionnaire and entered into EpiData version 3.1 and then exported to SPSS version 23.0. for analysis. Logistic regression models were used to determine factors associated with the outcome variable. Adjusted Odds ratios with 95% CI were computed to measure the strength of association and statistical significance was declared at p-value <0.05. Results The Prevalence of institutional delivery in the study area was 38% (34%-42%). Factors significantly associated with institutional delivery were ANC visit 1.80 (1.12–2.91), knowledge of danger sign during pregnancy 3.60 (2.25–5.76), urban residency 2.09 (1.15–3.81), Parity 0.49 (0.25–0.95) accessibility of health facility 4.60 (2.01–10.89), husbands educational level: primary 2.50 (1.27–4.91), secondary and above 2.36 (1.24–4.48), mothers occupation: governmental employee 2.05 (1.00–4.18), and Private employee 2.42 (1.09–5.35). Conclusions The prevalence of institutional delivery in the District was low. Antenatal visits, residency, knowledge of pregnancy danger signs, parity, and accessibility of health facilities, maternal occupation, and husband education were factors significantly associated with institutional delivery.

Institutional Delivery Services Utilization and Associated Factors Among Mothers Who Gave Birth in The Last Year in Mandura District, North West Ethiopia, 2019.

Background: The risk of death from complications relating to pregnancy and childbirth for women’s lifetime is higher in developing countries. Improving maternal and child health through a well-organized institutional delivery service is central to achieve reduced maternal and child mortality. Despite the efforts that have been made to improve maternal health outcomes in Ethiopia, institutional delivery is still unacceptably low. This study was aimed to assess institutional delivery service utilization and associated factors in the study area. Methods: Community-based cross-sectional study was conducted. A multi-stage sampling technique was used to employ a total of 546 women. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to determine factors associated with the outcome variable. Adjusted Odds ratios with 95% CI were computed to measure the strength of association and statistical significance was declared at p-value <0.05.Results: The Prevalence of institutional delivery in the study area was 38% (34%-42%). Factors significantly associated with institutional delivery were ANC visit 1.80(1.12-2.91), knowledge on danger sign 3.60(2.25-5.76), urban residency 2.09(1.15-3.81), Parity 0.49(0.25-0.95) accessibility of health facility 4.60(2.01-10.89), husbands educational level: primary 2.50(1.27-4.91), secondary and above 2.36(1.24-4.48), mothers occupation: governmental employee 2.05(1.00-4.18), and Private employee 2.42 (1.09-5.35). Conclusions: The prevalence of institutional delivery in the District was low. Antenatal visits, residency, knowledge on pregnancy danger signs, parity, accessibility of health facilities, maternal occupation, and husband education were significantly associated with institutional delivery. Strengthen the community-based awareness creation program regarding the danger signs of pregnancy and benefits of institutional delivery through the health developmental army, health extension workers, and local health care service providers; empowering women to get a job access, advocating education in the community, and improving antenatal care utilization would be among important measures to improve institutional delivery utilization.

Prevalence and associated factors of home delivery among women at Jimma town, Jimma Zone, Southwest Ethiopia

Background: Maternal and child mortality and morbidity are higher during childbirth in developing countries compared to developed countries. Institutional delivery service utilization is indispensable to improve maternal and child health.However, the proportion of women utilizing institutional delivery service in Ethiopia is very low. In addition, little is known about factors contributing to home delivery. Objectives: To assess the prevalence of home delivery and associated risk factors at Jimma Town, Southwest Ethiopia. Methods: A community-based cross-sectional study was employed on 423 study participants. Data were collected by semi-structured questionnaire through face to face interview. A systematic sampling technique was used to select study participants. After cleaning and checking completeness of collected data, data was entered into Epi data version 3.3.1 software and exported to Statistical Package for the Social Science (SPSS) version 21.0 for analysis. Logistic regression was used to find out the association between explanatory and response variables. Explanatory variables which fulfill the assumption of logistic regression and had a P-value less than 0.25 from bi-variable logistic regression were considered for the multivariable logistic regression model. The strength of association was evaluated using odds ratio at 95% confidence interval (CI) and P-value < 0.05 was considered to declare significant associations. Results: The prevalence of home delivery in this study was 36.64% (n=155/423 and it had significant association with illiteracy AOR=2.7 [(95%CI); (1.37-5.43)], multi-gravida AOR=2.12 [(95%CI); (1.09-4.10)], history of antenatal care (ANC) follow up AOR=4.15 [(95%CI); (2.57-6.70)] and husband educational status AOR=13.5 [(95%CI); (2.86-63.62)]. Conclusion: The prevalence of home delivery in this study was high compared to world health organizational recommendation. Educational status of the mother, gravida, antenatal care follow up and husband educational status were factors that had a significant association. Women empowerment through educational opportunities, increase antenatal care follow up and male involvement in maternal health service are recommended

Institutional Delivery Service Utilization and Associated Factors in Rural Communities of Central Gondar zone, Northwest Ethiopia

Introduction: Institutional delivery has been considered as one of the important strategies to improve maternal and child health, and significantly reduces birth related complications however it is still low in developing countries though there are some improvements. Hence, the aim of this study was to assess the prevalence of institutional delivery service utilization and associated factors among women who gave birth in Central Gondar zone, North West Ethiopia. Methods: A community-based cross-sectional study was conducted from September to December 2019. A multistage systematic sampling technique was used to select a total of 1,394 study participants. Data were collected from women who gave birth during the past one year by using structured and pretested questionnaire. Binary logistic regression was performed to identify factors at 95% confidence level. Results: The prevalence of institutional delivery service utilization was 58.17 % (95%CI: 55.57%, 60.77%). Multivariable logistic regression showed that women age ( ≥35years) (AOR= 1.43; 95% CI 1.04,1.96), having a family size of less than five (AOR= 4.61; 95% CI 3.34,6.34), husbands educational status of primary school (AOR= 1.64; 95% CI 1.19,2.24), middle level household wealth index (AOR= 1.78; 95% CI 1.25,2.54), rich level household wealth index (AOR= 2.01; 95% CI 1.42,2.86), having family discussion (AOR= 4.05; 95% CI 2.74,5.97), antenatal care visit during their recent pregnancy (AOR= 1.86;95% CI 1.16,2.97),distance from the nearby clinic(≤30min) (AOR= 2.92; 95% CI 1.53,5.58), decision power about place of delivery (AOR= 2.50; 95% CI 1.56,4.01) and bad behavior of health workers (AOR= 0.27; 95% CI 0.19,0.39) were significantly associated with utilization of institutional delivery service. Conclusion: Institutional delivery service utilization was low in the study area. Women age (≥35years), having a family size of less than five, educational status of husband (primary), household wealth index (middle and rich), family discussion, antenatal care visit, distance from the nearby clinic (≤30min), decision power about place of delivery and bad behavior of health workers were predictors of institutional delivery. This study implies that strengthening family discussion and up taking antenatal Care services in regular ways are few of the suggested recommendations.