Abstract
Institutional delivery is one of the key interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries like Ethiopia are home deliveries and are not attended by skilled birth attendants. We investigated the prevalence and determinants of home delivery in three districts in Sidama administration, Southern Ethiopia. Between 15-29 October 2018, a cross sectional survey of 507 women who gave birth within the past 12 months was conducted using multi-stage sampling. Sociodemographic and childbirth related data were collected using structured, interviewer administered tools. Univariate and backward stepwise multivariate logistic regression models were run to assess independent predictors of home delivery. The response rate was 97.6% (495). In the past year, 22.8% (113), 95% confidence interval (CI) (19%, 27%) gave birth at home. Rural residence, adjusted odds ratio (aOR) = 13.68 (95%CI:4.29-43.68); no maternal education, aOR = 20.73(95%CI:6.56-65.54) or completed only elementary school, aOR = 7.62(95% CI: 2.58-22.51); unknown expected date of delivery, aOR = 1.81(95% CI: 1.03-3.18); being employed women (those working for wage and self-employed), aOR = 2.79 (95%CI:1.41-5.52) and not planning place of delivery, aOR = 26.27, (95%CI: 2.59-266.89) were independently associated with place of delivery. The prevalence of institutional delivery in the study area has improved from the 2016 Ethiopian Demography Health Survey report of 26%. Uneducated, rural and employed women were more likely to deliver at home. Strategies should be designed to expand access to and utilization of institutional delivery services among the risky groups.
Highlights
Maternal mortality is a major public health problem in developing countries in sub–Saharan Africa (SSA) [1]
Rural residence, adjusted odds ratio = 13.68 (95%confidence interval (CI):4.29–43.68); no maternal education, aOR = 20.73(95%CI:6.56–65.54) or completed only elementary school, aOR = 7.62(95% CI: 2.58–22.51); unknown expected date of delivery, aOR = 1.81(95% CI: 1.03–3.18); being employed women, aOR = 2.79 (95%CI:1.41–5.52) and not planning place of delivery, aOR = 26.27, (95%CI: 2.59–266.89) were independently associated with place of delivery
Home delivery practice survey was supported by Hawassa University through its Kangaroo Mother Care (KMC) Projects in the form of funds awarded to HT
Summary
Maternal mortality is a major public health problem in developing countries in sub–Saharan Africa (SSA) [1]. Nearly half a million women and girls needlessly die from complications of pregnancy and childbirth, and 99% of these deaths occur in developing countries [1]. According to the joint World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) 2015 estimate, the global maternal mortality rate was 216/100,000 live births (LBs), while 436/100,000 LBs and 546/100,000 LBs were reported for the least developed and SSA countries, respectively [2]. Institutional delivery is one of the key interventions to reduce maternal death It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. A significant proportion of deliveries in developing countries like Ethiopia are home deliveries and are not attended by skilled birth attendants. We investigated the prevalence and determinants of home delivery in three districts in Sidama administration, Southern Ethiopia
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