Abstract
Background: In this study, we expected to evaluate the utilization rate of institutional delivery services in Eastern Nepal. We also analyzed the socio-economic factors associated with institutional delivery and assessed the reason for their utilization.Methods: A cross-sectional quantitative study was conducted in Sunsari district of Eastern Nepal. Three hundred and seventy two women, who delivered their baby within period of one year preceding this study, were interviewed through household visit. Focus group discussions (FGDs) were also done to gather qualitative data.Results: We interviewed 368 women. The prevalence of institutional delivery was 55.1%. Logistic regression analyses revealed that women having good knowledge about importance of SBA utilized institutional delivery services more than nine times than women having poor knowledge (AOR=9.02, 95% CI: 2.61-31.09). Similarly, women exposed to media (AOR=6.56, 95% CI: 2.10-21.21), women from advantaged ethnicity (AOR=5.85, 95% CI: 1.78-19.74), women having higher level of autonomy (AOR= 5.93, 95%CI: 1.18- 29.53) and richer women (AOR=3.30, 95% CI: 1.24-8.72) were more likely to have institutional delivery than women unexposed to media, women from relatively disadvantaged ethnicity, women having low level of autonomy and poorer women respectively.Conclusions: Good knowledge on importance of SBA, completion of 4 ANC service, media exposure with maternal health service related massages, relatively advantaged ethnicity, higher rank of women’s autonomy and higher wealth rank were found significantly associated with institutional delivery service utilization. Provisions of community ambulance system can also be helpful to address the transportation problem. Encouraging women to complete their schooling and teaching/encouraging women to have antenatal care frequently are also important to increase institutional delivery services. Med Phoenix. Vol. 3, Issue. 1, 2018, Page: 6-15
Highlights
Improvement of maternal health is one of the eight millennium development goals (MDGs) adopted by United Nations in September 2000 and it calls for reducing maternal mortality
Logistic regression analyses revealed that women having good knowledge about importance of SBA utilized institutional delivery services more than nine times than women having poor knowledge (AOR=9.02, 95% confidence interval (95% CI): 2.61-31.09)
Women exposed to media (AOR=6.56, 95% CI: 2.10-21.21), women from advantaged ethnicity (AOR=5.85, 95% CI: 1.78-19.74), women having higher level of autonomy (AOR= 5.93, 95%CI: 1.1829.53) and richer women (AOR=3.30, 95% CI: 1.24-8.72) were more likely to have institutional delivery than women unexposed to media, women from relatively disadvantaged ethnicity, women having low level of autonomy and poorer women respectively
Summary
Improvement of maternal health is one of the eight millennium development goals (MDGs) adopted by United Nations in September 2000 and it calls for reducing maternal mortality. In 2008, developing countries encountered 99% (355 000) of the estimated 358 000 maternal deaths worldwide. Nepal has been working for improving maternal health and dropping maternal mortality for years. Regardless of remarkable progress in last 15 years, Nepal still has high maternal mortality ratio (MMR) compared to many developed countries.[2] The MMR represents the number of maternal deaths per 100 000 live births. The Nepal demographic and health survey (NDHS) 2006 showed that the MMR was 281 per hundred thousand live births. In Nepal, maternal mortality accounts for 11 percent of deaths among women of reproductive Age, 15-49 years.[3]. We expected to evaluate the utilization rate of institutional delivery services in Eastern Nepal. We analyzed the socio-economic factors associated with institutional delivery and assessed the reason for their utilization
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