Determinants of Skilled Institutional Delivery Service Utilization among Women Who Gave Birth in the Last 12 Months in Bako District, Oromia, Ethiopia, 2012/13 (Case-Control Study Design)

Abstract

Background: High maternal mortality is a continued challenge for the achievement of millennium development goal in sub-Saharan African countries including Ethiopia. Although institutional delivery services utilization ensures safe birth and a key to reduce maternal mortality, interventions at the community or institutions were unsatisfactorily reduced maternal mortality. Institutional delivery service utilization is affected by the interaction of personal, socio-cultural, behavioral and institutional factors. Methods: A community based un-matched Case Control study was conducted in Bako district, West shoa, Ethiopia. Three hundred eighty mothers were included in the study. Data were collected by trained female data collectors via face to face interview and pretested structured questionnaire was used to collect data on different variables. Descriptive statistics, binary and multivariable logistic regression analyses were computed by SPSS version 16. Statistical significance was considered at p<0.05 and the strength of statistical association were assessed by odds ratio (OR) with 95% confidence intervals. Result: In this study, a total of 380 mothers (130 cases and 250 controls) were included in the analysis. Majority (77%) of respondents were Oromo. Ninety four percent (94%) of mothers were married where as 2.4% were singles (never married). Ten percent (10%) of mothers have attended secondary and above grade. Secondary and above education (AOR: 2.754, 95%CI: 1.51–8.91), house wife (AOR: 23, 95% CI: 2.0-25.0), private employee (AOR: 14, 95% CI: 1.04-19.0) were significantly associated with utilization of skilled institutional delivery. Similarly, ANC visit (AOR=0.19[95% CI: 0.086-0.42], joint (husband and wife) final decision where to give birth (AOR=0.25[95% CI: 0.08-0.75], access to transport (AOR=0.53[95% CI: 0.30-0.94] were independently factors affecting institutional delivery service. Conclusion: Women’s education, occupation, ANC visit, joint(husband and wife) final decision making on place of delivery and access to transport service were found to be determinant of skilled institutional delivery service utilization. Hence, intensifying education for women and strengthen decision making power of women, enhance transport accessing of women and well communicating benefit of ANC use were recommended.