Predictors of Delay for Institutional Delivery among Pregnant Mothers in Gamo Zone of Southern Ethiopia: The Generalized Estimating Equations (GEE)

Abstract

Background: Delay in institutional delivery refers to the time interval from the first onset of labour to start receiving the first healthcare. This study aimed to assess the associated factors of the maternal delays for institutional delivery service utilization in Selected Gamo Zone Health Centres, Southern Ethiopia in 2019. Methods: A retrospective study was conducted in rural districts of the Gamo zone. A total of 394 postnatal mothers were selected by simple random sampling. The Generalized Estimating Equations (GEE) was used to examine associations between outcome maternal delay time and independent variables. Results: The mean age of respondents was 29 years (range from 19 to 40 years). Out of the total 391 mothers, 266 (68.03%) were unemployed and 125 (31.97%) were employed. The unemployed mother had Exp (0.5572) = 1.75 times higher odds of being maternal delay compared to employed. Similarly, mothers whose poor knowledge on danger signs of labor and childbirth had Exp (0.5216) = 1.68 times higher odds of being maternal delay as compared to whose good knowledge. The odds of being the husband decision maker for institutional delivery service utilization (Exp (0.8006) =2.23) times higher odds of being maternal delay compared to jointly. Conclusions: The maternal delay time is significantly determined by the mother’s occupation, number of children, final decision maker for institutional delivery service utilization, mother’s knowledge on danger signs of labor and childbirth and delay time. However, variables religion, residence, mother’s education, previous pregnancy related problem, ANC follow-up, and birth preparedness had no significant effect on maternal delay. Therefore, due attention needs to be given to encourage unemployed mothers, promoting couples in involvement in decision making for institutional delivery service utilization, enhancing education on family planning and creating awareness on danger signs of labor and childbirth.