Abstract
BackgroundPlace of delivery is a crucial factor which affects the health and wellbeing of the mother and newborn. Institutional delivery helps the women to access skilled assistance, drugs, equipment, and referral transport. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia.MethodsRetrospective unmatched case control study design was used to assess determinants of institutional delivery in Western Ethiopia from September to October 2013. A total of 320 respondents from six districts of East Wollega zone, West Ethiopia were included. Data were collected using pretested and structured questionnaires. Data were entered and cleaned by Epi-info then exported and analyzed using SPSS software. Statistical significance was determined through a 95% confidence level.ResultsEducation [Adjusted Odds Ratio (AOR) (95% Confidence Interval (CI)) = 2.754(1.510–8.911)], family size [AOR (95% CI) = .454(.209–.984)], residence [AOR (95% CI) = 3.822 (1.766–8.272)] were important predictors of place of delivery. Four or more antenatal care [(ANC) (AOR (95% CI) = 2.914(1.105–7.682)], birth order [(AOR (95% CI) = .136(.054–.344), age at last delivery [(AOR (95% CI) = 9.995(2.101–47.556)], birth preparedness [AOR (95% CI) = 6.957(2.422–19.987)], duration of labour [AOR (95% CI) = 3.541(1.732–7.239)] were significantly associated with institutional delivery. Moreover service related factors such as distance from health institutions [AOR (95% CI) = .665(.173–.954)], respondents’ awareness of skill of health care professionals [AOR (95% CI) = 2.454 (1.663–6.255)], mode of transportations [AOR (95% CI) = .258(.122–.549)] were significantly associated with institutional delivery.Conclusions and RecommendationsPolicy makers, health service organizations, community leaders and other concerned bodies have to consider the predictors of institutional delivery like education, birth order, antenatal care utilization and residence to improve institutional delivery in the area.
Highlights
The fifth Millennium Development Goal (MDG) was to reduce maternal mortality ratio (MMR) by 3/4th between 1990 and 2015
Four or more antenatal care [(ANC) (AOR = 2.914(1.105–7.682)], birth order [(AOR = .136(.054–.344), age at last delivery [(AOR = 9.995(2.101–47.556)], birth preparedness [above duration of labour (AOR) = 6.957(2.422–19.987)], duration of labour [AOR = 3.541(1.732–7.239)] were significantly associated with institutional delivery
Policy makers, health service organizations, community leaders and other concerned bodies have to consider the predictors of institutional delivery like education, birth order, antenatal care utilization and residence to improve institutional delivery in the area
Summary
The fifth Millennium Development Goal (MDG) was to reduce maternal mortality ratio (MMR) by 3/4th between 1990 and 2015. The maternal mortality ratio of Ethiopia was 676 deaths per 100,000 live births by 2011 compared to 673 deaths per 100,000 live births by 2005. Skilled birth attendance is correlated with lower MMR. At least 15% of all births in the population should take place in basic or comprehensive emergency obstetrics facilities. The proportion of births with a skilled attendant is 10% in Ethiopia. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia
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