Spatial variations of women\u2019s home delivery after antenatal care visits at lay Gayint District, Northwest Ethiopia

Araya Mesfin Nigatu,Degefie Tibebe Degefie,Abraham Yeneneh Birhanu,Kassahun Alemu Gelaye

doi:10.1186/s12889-019-7050-4

Araya Mesfin Nigatu, Degefie Tibebe Degefie + Show 2 more

Open Access

https://doi.org/10.1186/s12889-019-7050-4

Copy DOI

Abstract

BackgroundHome delivery is the most frequent childbirth practice in Ethiopia and brings health risks for many mothers and their babies which in turn affecting the whole families. Characterizing the spatial variations and the associated factors of home deliveries after antenatal care visit is necessary to prioritize risks and facilitate geographically based interventions.MethodA community-based cross-sectional study design was carried out between February and March 2016. A total of 528 women who had just given birth were interviewed face-to-face using a questionnaire. Geo-referenced data were collected using a handheld global positioning system (GPS). The Bernoulli model was applied using the SatScan ™ software to analyze the purely spatial clusters of home deliveries. ArcGIS version 10.1 was used to visualize clusters of home delivery.ResultsThe overall proportion of home deliveries was 278(52.7%), and home deliveries had spatial variations. A primary cluster [LLR = 14.54, p < 0.001] was detected in village of Safida Giorgis. Secondary clusters were detected in Checheho [LLR = 9.17, p < 0.05] and ZurAmba [LLR = 8.51, p < 0.05]. Predictors for home delivery included the distance between the health extension worker’s and mother’s house [AOR = 2.2, 95% CI: 1.1, 4.3], residence [AOR = 3.8, 95% CI: 1.3, 10.9], source of information for ANC [AOR = 0.3, 95% CI: 0.13, 0.7], ANC visits [AOR = 6.1, 95% CI:1.9, 19.3], health education [AOR = 3.4, 95% CI: 1.5, 7.4], decision on place of delivery [AOR = 0.3, 95% CI: 0.1, 0.8], and knowledge on place of delivery [AOR = 0.04, 95% CI: 0.0, 0.1].ConclusionThe proportion of home delivery after ANC visit was decreasing compared to other studies conducted in the region. In addition, spatial variations of home delivery were observed in the study area. Promoting women’s education and behavioral change communication at the grass root level, provision of the services both at home and health facilities and improving the quality and capacity of the health providers are some of the recommendations forwarded.

Highlights

Home delivery is the most frequent childbirth practice in Ethiopia and brings health risks for many mothers and their babies which in turn affecting the whole families
Predictors for home delivery included the distance between the health extension worker’s and mother’s house [AOR = 2.2, 95% CI: 1.1, 4.3], residence [AOR = 3.8, 95% CI: 1.3, 10.9], source of information for Antenatal care (ANC) [AOR = 0.3, 95% CI: 0.13, 0.7], ANC visits [AOR = 6.1, 95% CI:1.9, 19.3], health education [AOR = 3.4, 95% CI: 1.5, 7.4], decision on place of delivery [AOR = 0.3, 95% CI: 0.1, 0.8], and knowledge on place of delivery [AOR = 0.04, 95% CI: 0.0, 0.1]
The proportion of home delivery after ANC visit was decreasing compared to other studies conducted in the region

Summary

Introduction

Home delivery is the most frequent childbirth practice in Ethiopia and brings health risks for many mothers and their babies which in turn affecting the whole families. Though the majority of maternal deaths are preventable, every minute of every day, somewhere in the world, women lose their life due to complications related to pregnancy and childbirth [1]. Of the globally estimated 289,000 maternal deaths in 2013, a decline of 45% from 1990, the sub-Saharan Africa region alone accounted for 62% (179000) of global deaths followed by Southern Asia at 24% (69000) [2]. Developing regions account for approximately 99% (302000) of the global maternal deaths in 2015, with sub-Saharan Africa alone accounting for roughly 66% (201000), followed by Southern Asia (66000) [1]

Methods

Results

Discussion

Conclusion