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Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study.
BMC Public Health. 2020 Jul 08; 20(1):1077.BP

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 chi-square 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.

Links

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Authors+Show Affiliations

Berelie Y
Department of Statistics, Debre Markos University, Debre Markos, Ethiopia. yebelay.ma@gmail.comc.
Yeshiwas D
Department of Statistics, Debre Markos University, Debre Markos, Ethiopia.
Yismaw L
Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.
Alene M
Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.

MeSH

AdolescentAdultCross-Sectional StudiesDelivery, ObstetricEthiopiaFemaleHealth FacilitiesHealth SurveysHumansLogistic ModelsMiddle AgedMultilevel AnalysisOdds RatioPregnancyPrenatal CareSocioeconomic FactorsUrban PopulationYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32641020

Citation

Berelie, Yebelay, et al. "Determinants of Institutional Delivery Service Utilization in Ethiopia: a Population Based Cross Sectional Study." BMC Public Health, vol. 20, no. 1, 2020, p. 1077.
Berelie Y, Yeshiwas D, Yismaw L, et al. Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study. BMC Public Health. 2020;20(1):1077.
Berelie, Y., Yeshiwas, D., Yismaw, L., & Alene, M. (2020). Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study. BMC Public Health, 20(1), 1077. https://doi.org/10.1186/s12889-020-09125-2
Berelie Y, et al. Determinants of Institutional Delivery Service Utilization in Ethiopia: a Population Based Cross Sectional Study. BMC Public Health. 2020 Jul 8;20(1):1077. PubMed PMID: 32641020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study. AU - Berelie,Yebelay, AU - Yeshiwas,Dawit, AU - Yismaw,Leltework, AU - Alene,Muluneh, Y1 - 2020/07/08/ PY - 2019/02/04/received PY - 2020/06/16/accepted PY - 2020/7/10/entrez PY - 2020/7/10/pubmed PY - 2020/11/26/medline KW - EDHS KW - Ethiopia KW - Institutional delivery KW - Maternal mortality KW - Multilevel SP - 1077 EP - 1077 JF - BMC public health JO - BMC Public Health VL - 20 IS - 1 N2 - 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 chi-square 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. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/32641020/Determinants_of_institutional_delivery_service_utilization_in_Ethiopia:_a_population_based_cross_sectional_study_ DB - PRIME DP - Unbound Medicine ER -