Factors associated with home delivery in Bahirdar, Ethiopia: a case control study.

Fantu Abebe,Yemane Berhane,Belaineh Girma

doi:10.1186/1756-0500-5-653

Abstract

BackgroundIn Ethiopia although pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. The individual or health system factors that affect women’s preferences for delivery places are not well known.MethodA case control study was conducted in July 2010 to assess factors associated with utilization of institutional delivery service. A total of 324 mothers who recently delivered and visited either postnatal care or sought immunization services were included. Cases (n = 108) were mothers who gave birth at home and controls (n = 216) were those who delivered at health facility. Pre-tested and standardized questionnaires were used to collect relevant data by trained data collectors. Logistic regression model was used to control for confounding.ResultThe likelihood of delivering at home was greater among mothers with inadequate knowledge of pregnancy related services (AOR = 62, 95% CI: 3, 128.4), those who started attending ANC after 24 weeks of gestation (AOR 8.7, 95% CI: 2.2, 33.3), mothers having no formal education (Adjusted OR 4.2, 95% CI 1.63, 11.27) and rural residents (AOR = 3.6, 95%CI: 1.4, 9.0).ConclusionThe predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC) follow up, having, Illiteracy and rural residence. Audience specific behavioral change communication should be designed to improve the demand for delivery services. Health professionals should take the opportunity to encourage mothers attend delivery services during ANC follow up. Improvements should be made in social conditions including literacy and major social mobilization endeavors.

Highlights

In Ethiopia pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low
The predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC) follow up, having, Illiteracy and rural residence
Improvements should be made in social conditions including literacy and major social mobilization endeavors

Summary

Introduction

In Ethiopia pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. In Ethiopia, the majority of births occur without the help of a skilled assistant (defined as a midwife, nurse trained, or a doctor) and mainly at home [1]. Home deliveries are bound to be un-hygienic, unsupervised and when intervention is required it usually late [2,3]. Despite skilled delivery is one of the most tracked Millennium Development Goals (MDG) indicators, the proportion of births attended by skilled health personnel in Ethiopia and in the region at present is about 6% and 4% respectively [2]. The presence of skilled delivery service utilization at each birth can significantly reduce the maternal mortality and morbidity [10,14]

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