Abstract
BackgroundEthiopia is one of the six countries that contributes’ to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia.MethodsA community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression.ResultsA total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband’s attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2nd youngest child were found to have statistically significant association with institutional delivery.ConclusionInstitutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service; working to improve women’s economic status; counseling women to give birth at health institution during their ANC visit and exploring the overall quality of ANC service are some of the areas where much work is needed to improve institutional delivery.
Highlights
Ethiopia is one of the six countries that contributes’ to more than 50 % of worldwide maternal deaths
The major predictors of using health facility for delivery service were found to be place of residence, ability to afford for the whole process of getting delivery service at health facility including transportation cost and delivery service fee at health facility, husbands attitude towards institutional delivery, place of birth of the second youngest child, provision of counseling service at antenatal care (ANC) clinic about where to give birth during ANC visit for the last child pregnancy, and traveling time needed to reach to nearest health facility where women can find safe delivery service
This study demonstrates that institutional delivery service utilization in the district is low
Summary
Ethiopia is one of the six countries that contributes’ to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. The safe motherhood initiative strongly emphasizes ensuring the availability and accessibility of skilled care at the time of childbirth, of which institutional delivery is one element where emergency obstetric care could be found to handle complicated cases. This is critical intervention to avoid most maternal deaths occurring from preventable obstetric complications [6]
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