Prevalence and predictors of institutional delivery in Lumjung, Tanahun and Gorkha district of Nepal: a community-based cross-sectional study

Abstract

Background: The Maternal mortality rate (MMR) in Nepal had dropped from 444 per 1, 00,000 live births in 2005 to 239 per 1, 00,000 live births in 2016. However, the MMR of Nepal is still highest in the South Asian countries except Afghanistan. Although maternal mortality has declined noticeably in Nepal, there still persists a low proportion of institutional deliveries. The aim of the study was to assess the factors influencing the utilization rate of institutional delivery.Methods: A cross-sectional study was conducted in selected village development committee of Lamjung, Tanahun and Gorkha district using semi-structured interview schedule. A random sample of 1410 married women who gave birth in the last two years were included in the study. Multiple logistic regression analysis was carried out to identify the factors associated with institutional delivery. Results: The prevalence of institutional delivery in three districts was 73.1%, highest in Lamjung (78.8%) and lowest in Gorkha (67.8%). Employed women (aoR=1.7, CI=1.05-2.80), seeking antenatal check-up (aoR=5.8, CI=3.00-11.16), secondary (SLC) or above education (aoR= 3.3, CI=1.93-5.54), more than 20 years of age at marriage (aoR=1.5, CI=1.02-2.04), Kshetri by cast (aoR=1.7, CI=1.11-2.64) were statistically significant and associated with an increased rate of institutional delivery.Conclusions: Occupation, education, antenatal check-up, age at marriage, and ethnicity/cast are major factors for determining institutional delivery. The concerned authorities have to consider the predictors of institutional delivery in formulating the policy and plan for implementing safe motherhood delivery.