Multilevel analysis of skilled birth attendance and associated factors among reproductive age women in Ethiopia: Data from EDHS 2016

Abstract

IntroductionThe evaluation of factors on the utilization of skilled birth attendance is crucial for Ethiopia where the utilization of skilled birth attendance (SBA) is low. The study was aimed to assess the influence of individual and community-level factors on women's utilization of SBA at delivery in Ethiopia. MethodsData for this study was obtained from the fourth national representative 2016 Ethiopian Demographic and Health Survey (EDHS 2016) sampled from 645 communities of 7193 women age 15–49 who had the most recent childbirth in the survey. In this study, a two-level multilevel logistic regression model was used to identify individual and community-level factors associated with the utilization of SBA. ResultApproximately 37.75% of women were utilized skilled birth attendance by a skilled provider during their delivery of most recent childbirth. Significant heterogeneity was observed among the community in the utilization of SBA at the delivery of their most recent childbirth. At the individual level, factors such as mother’s education, antenatal care, exposure to media, wealth index, wantedness of pregnancy, and birth order were found to be predictors of SBA. At the communal level, place of residence and region were predictors of SBA utilization of mothers. ConclusionThis study found a significant variation in the utilization of skilled birth attendance during delivery at the individual level, with the most prominent factors such as socio-economic status and educational level. Thus, we recommend the concerned body in empowering women economically and educationally through community and individual-based intervention to improve utilization of SBA during delivery.