Factors influencing the utilization of institutional delivery services by Chepang women in Chitwan district of Nepal

Abstract

Factors influencing the utilization of instituional delivery services by Chepang women in Chitwan district of Nepal Background To reduce the maternal death rates, a safe motherhood program has been implemented across Nepal to provide pregnant women with free delivery care in a healthcare facility, as well as transportation incentives promoting institutional delivery. Being a marginalized group of people residing in hilly slope areas, the Chepang population lacks significant usage of healthcare services. Objective This study aimed to assess the incidence of delivery complications, and to investigate the factors associated with the utilization of institutional delivery of the Chepang women in the Chitwan district. Methods A cross-sectional study was conducted with a proportional random sample of 557 mothers. A face-to-face interview was performed to collect the data. Using stepwise logistic regression analysis, the data were analyzed. Results The results showed low incidence of delivery complications among those who utilized an institutional delivery. The literate parents were strongly associated with the increased usage of an institutional delivery (OR=12.08, 95%CI=6.32-23.06, and OR=5.45, 95%CI=2.82-10.51 for literate mothers and literate spouses, respectively). Other significant factors were older ages at delivery of mothers as compared to younger ages mothers (OR= 3.28, 95%CI=1.83-5.90 for ages 20-29 yr.; OR=3.75, 95%CI=1.80-7.83) for ages ≥30 yr.), and engagement in business and services occupation of mothers (OR=2.01, 95%CI=1.01-4.01). The associations were observed for vehicle transportation to the delivery facility (OR =1.99, 95% CI =1.28-3.11) and travel time ≤30 minutes to the delivery facility (OR=2.80, 95%CI=1.58-4.96). Conclusions The results revealed a lower incidence of delivery complications among those who utilized the institutional delivery. The analysis also demonstrated that age, education, income, and convenient access to an institutional delivery facility were associated with the utilization of institutional delivery. Keywords: Institutional delivery, Multilevel analysis, Chepang Women, Chitwan District, Nepal