Abstract
BackgroundThere is wide variation in the utilization of institutional delivery service in Ethiopia. Various socioeconomic and cultural factors affect the decision where to give birth. Although there has been a growing interest in the assessment of institutional delivery service utilization and its predictors, nationally representative evidence is scarce. This study was aimed to estimate the pooled national prevalence of institutional delivery service utilization and associated factors in Ethiopia.MethodsStudies were accessed through PubMed, Cochrane library, Web of Science, and Google Scholar. The funnel plot and Egger’s regression test were used to see publication bias, and I-squared statistic was applied to check heterogeneity of studies. A weighted Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of institutional delivery service utilization and associated factors.ResultTwenty four studies were included in this review. The pooled prevalence of institutional delivery service utilization was 31% (95% Confidence interval (CI): 30, 31.2%; I2 = 0.00%). Attitude towards institutional delivery (Adjusted Odd Ratio (AOR) = 2.83; 95% CI 1.35,5.92) in 3 studies, maternal age at first pregnancy (AOR = 3.59; 95% CI 2.27,5.69) in 4 studies, residence setting (AOR = 3.84; 95% CI 1.31, 11.25) in 7 studies, educational status (AOR = 2.91;95% 1.88,4.52) in 5 studies, availability of information source (AOR = 1.80;95% CI 1.16,2.78) in 6 studies, ANC follow-up (AOR = 2.57 95% CI 1.46,4.54) in 13 studies, frequency of ANC follow up (AOR = 4.04;95% CI 1.21,13.46) in 4 studies, knowledge on danger signs during pregnancy and benefits of institutional delivery (AOR = 3.04;95% CI 1.76,5.24) in 11 studies and place of birth of the elder child (AOR = 8.44;95% CI 5.75,12.39) in 4 studies were the significant predictors of institutional delivery service utilization.ConclusionThis review found that there are several modifiable factors such as empowering women through education; promoting antenatal care to prevent home delivery; increasing awareness of women through mass media and making services more accessible would likely increase utilization of institutional delivery.
Highlights
There is wide variation in the utilization of institutional delivery service in Ethiopia
Seven studies were found in Amhara region [24,25,26,27,28,29,30], Nine in Oromia [31,32,33,34,35,36,37,38,39], two in Afar [40, 41], one in Bienishangul-Gumuz [42],three in Southern Nation Nationalities and Peoples region (SNNPR) [43,44,45],one in Gambiela [46], and one in Tigray and Oromiya [47]
This systematic review and Meta-analysis revealed institutional delivery service utilization remains low in Ethiopia
Summary
There is wide variation in the utilization of institutional delivery service in Ethiopia. This study was aimed to estimate the pooled national prevalence of institutional delivery service utilization and associated factors in Ethiopia. Institutional delivery service utilization ensures safe birth, reduces both actual and potential complications and maternal death, and increases the survivalof mothers and newborns. Intention of pregnant women to utilize institutional delivery service is affected by socio-demographic variables, household monthly income, health institution, mother’s occupation and husband’s occupation. Psychosocial variables such as perceived susceptibility to pregnancy and birth complications, perceived barriers to utilize institutional delivery service, self-efficacy, being able to make decision, and, being informed where to deliver are predictors of the probability of giving birth at health institution [9]. In 2014, about 71% of women delivered with the support of a skilled birth attendant which is better as compared to 59% in 1990 worldwide
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