Use Of Institutional Delivery Services Research Articles

Institutional delivery service utilization and associated factors in fragile and conflict-affected situations in Sekota town, Northern Ethiopia, 2022: A community-based cross-sectional study

BackgroundConflict-affected areas are considered to contribute a substantial proportion of worldwide maternal deaths. However, research on maternal health care in conflict-affected countries is very limited. In the absence of recent data, it is impossible to monitor progress made in mitigating the effect of conflict on maternal survival. As a result, this study targeted to assess institutional delivery services usage and influencing factors in a fragile and conflict-affected situation in Sekota town, Northern Ethiopia. MethodsA community-based cross-sectional study was employed among 420 mothers in Sekota town, Northern Ethiopia from July 15th to 30th, 2022. The desired sample size was determined using a single population proportion formula. The data were collected by using interviewer administered structured questionnaire; entered via EpiData version 4.6 and analyzed using SPSS version 25 software. To identify the associated factors, a bivariable and multivariable logistic regression model was applied. The level of significance was declared at a p-value of <0.05. An adjusted odds ratio with a 95% confidence interval was considered to see the strength of the association between dependent and independent variables. ResultsOf the total respondent, 202 (48.1%), 95% CI: (43.0%, 53.0%) mothers utilized institutional delivery service. The use of institutional delivery services was associated with the maternal educational level of secondary school and above (AOR = 2.06, 95% CI: 1.08–3.93), antenatal care during the most recent pregnancy (AOR = 5.24, 95% CI: 3.01–9.11), being informed on birth preparedness and complication readiness (AOR = 1.93, 95% CI: 1.23–3.02) and displacement of the respondents from their usual place of residence due to conflict (AOR = 0.41, 95% CI: 0.21–0.68). ConclusionInstitutional delivery service utilization was very low in the study setting. Healthcare for women in conflict-prone areas requires critical attention and should be given priority during the conflict. More prospective research is needed to fully understand and reduce the impact of conflict on maternal and neonatal health care.

Prevalence and determinants of home delivery among reproductive age women, Margibi County, Liberia

BackgroundThe use of institutional delivery services is essential for improving maternal and child health. However, studies in Liberia reveal over 20% of women still deliver at home. We assessed the prevalence and associated factors of home delivery among women of reproductive age in Margibi County, Liberia.MethodsWe conducted a cross-sectional study among 438 women of reproductive age in Margibi County. Data were obtained using a semi-structured questionnaire. A simple random sampling approach was used to select the participants for the study. We performed binary logistic regression to identify factors influencing home delivery. Findings were summarized into tables displaying the frequencies, percentages, crude, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsPrevalence of home delivery in the County was 90.6% (95% CI = 87.5 – 93.0). Women who were ≥ 31 years (aOR = 6.74, 95%CI = 2.86—15.90), women who had two or more children (aOR = 9.68, 95%CI = 4.07—22.99) and those who had rapid onset of labor (aOR = 6.35, 95%CI = 1.59 – 25.27) were associated with increased odds of home delivery. Good attitude of health workers (aOR = 0.01, 95%CI = 0.001 – 0.08) and the availability of transport to the nearest health facility (aOR = 0.01, 95%CI = 0.003 – 0.03) were factors associated with a decreased odds of home delivery among the study participants.ConclusionThe high prevalence of home delivery in the county is a call for urgent interventions by the government of Liberia and various non-governmental organizations. The government may need to supply the county with ambulances and ensure in-service training of health workers on good attitudes.

Institutional delivery service utilisation and associated factors among mothers of childbearing age in Delgi District, Northwest Ethiopia: a community-based cross-sectional study design

ObjectiveThis study aimed to assess the use of institutional delivery services and associated factors among Delgi District mothers of childbearing age.DesignA community-based cross-sectional study design.SettingAt five Kebeles in Delgi District,...

Factors associated with institutional delivery among women in Bule Hora Town, Southern Ethiopia

IntroductionGlobally, approximately 303,000 women died during pregnancy and childbirth in 2015, and 830 women died each day from preventable causes related to pregnancy and childbirth. Although institutional delivery is crucial to save the lives of mothers and infants, many women in Ethiopia give birth at home. Identification of factors that prevent them from giving birth at health facilities is needed to resolve this issue. This study aimed to assess the use of institutional delivery services and associated factors among women of childbearing age in Bule Hora Town, Ethiopia. Materials and methodsA community-based quantitative cross-sectional study was undertaken from 1 February to 30 March 2018. Three hundred and sixty childbearing mothers were involved in the study using a systematic sampling method. The instrument was pre-tested on 5% of the sample in Gerba Town. Data were analysed using bivariate and multi-variate binary logistic regression. ResultsThe prevalence of institutional delivery in Bule Hora Town was 72%. Age at first pregnancy, maternal education, paternal education, use of antenatal care services, parity, spousal communication regarding place of delivery, and paternal occupation were significantly associated with institutional delivery. ConclusionsThe prevalence of institutional delivery in Bule Hora Town is higher than the national average, but lower than the national target. Policy makers and healthcare institutions should strengthen and create awareness on the importance of institutional delivery.

A Multilevel Analysis to Determine the Factors Associated with Institutional Delivery in Nepal: Further Analysis of Nepal Demographic and Health Survey 2016.

Background:One out of two neonatal deaths and 2 out of 5 maternal deaths occur at home in Nepal. An essential intervention in reducing maternal mortality and neonatal death is institutional delivery. The objective of this study was to find out the external environmental, predisposing, and enabling factors associated with the use of institutional delivery care in Nepal.Methods:Data from Nepal Demographic and Health Surveys (NDHS) 2016 was used to estimate socio-economic, provincial, and use of media differentials with institutional delivery under the Andersen behavioral model framework using multilevel regression analysis.Results:More than half of the women (60.9%) among 3899 women with last birth had their babies delivered in a health facility. In the multilevel logistic regression analysis, we found that women from province 2 (OR = 0.47 95%CI: 0.28-0.79) were significantly less likely to deliver in health institutions, and province 7 (OR = 1.76, 95%CI: 1.05-2.94) were significantly more likely deliver in a health institution. Age (OR = 0.94, 95%CI: 0.92-0.95) was also significantly associated with the place of delivery. Women with higher education (OR = 3.17, 95%CI: 2.09-4.81) were most likely to go for institutional delivery. The odds of women opting for institutional delivery were 3 folds more for those who had visited Antenatal Care (ANC) 4 or more times compared to those who did not.Conclusion:The results highlight the need for governments and health care providers to emphasize the promotion of institutional delivery and ANC visits as per protocol with a special focus on underprivileged communities. The use of multi-media is a vital strategy to promote the use of institutional delivery services.

Religion and Use of Institutional Child Delivery Services: Individual and Contextual Pathways in Mozambique

Research on institutional child delivery in Sub-Saharan Africa typically focuses on availability and accessibility of health facilities. Cultural factors, including religion, that may facilitate or hinder the use of such services have not been well examined and remain poorly understood. The relationship between religious affiliation and delivery in a health facility was explored using data from a household survey of 1,297 women aged 18-50 and a census of 825 religious congregations, both conducted in a predominantly Christian district in Mozambique in 2008. Multilevel logistic regression analyses were conducted to predict the likelihood of recent institutional delivery according to both individual religious affiliation and the concentration of religious congregations of certain denominations in the community of residence. Approximately 63% of deliveries occurred in a health facility. The odds of such deliveries were lower among women who belonged to Apostolic churches or had no religious affiliation than among members of Catholic or mainline Protestant churches, net of other factors (odds ratios, 0.5 and 0.6, respectively). In addition, regardless of a woman's religion, the odds that she had an institutional delivery increased by 9% for each additional Catholic or mainline Protestant congregation in her community of residence (1.1). Organized religion is associated with critical health outcomes in Mozambique and, potentially, in other Sub-Saharan African contexts. Policymakers should consider designing programs and interventions that promote the use of institutional delivery services among members of religious groups characterized by low use of these services and in areas where such religious groups have a strong presence.

Predisposing, enabling, and need factors associated with utilization of institutional delivery services: A community-based cross-sectional study in far-western Nepal

ABSTRACTUse of institutional delivery services can be effective in reducing maternal and infant mortality. In Nepal, however, the majority of women deliver at home. Using Andersen’s behavioral model of use of health care services, this cross-sectional study aimed to identify factors associated with use of institutional delivery services in four villages and one municipality in Kailali district, Nepal. Mothers (N = 500) who had given birth in the 5 years preceding the survey (conducted between January and February 2015) were randomly selected by cluster sampling and interviewed using a semi-structured questionnaire. Bivariate analyses and multivariate hierarchical logistic regression analyses were performed. Among the women surveyed, 65.6% had used institutional delivery services for their last delivery, a higher proportion than the national average. Primiparity, having a secondary or higher education level, living in the Durgauli village, having husbands with occupations other than agriculture or professional/technical jobs, and having attended four or more antenatal care (ANC) visits had significantly increased use of institutional deliveries. Also, belonging to the richest 20% of the community and having experienced pregnancy complications were marginally significantly associated. These findings demonstrate the need for improving mother’s education, encouraging them to attend ANC visits and addressing disparities between different regions.

An equity analysis of utilization of health services in Afghanistan using a national household survey.

BackgroundAfghanistan has made great strides in the coverage of health services across the country but coverage of key indicators remains low nationally and whether the poorest households are accessing these services is not well understood.MethodsWe analyzed the Afghanistan Mortality Survey 2010 on utilization of inpatient and outpatient care, institutional delivery and antenatal care by wealth quintiles. Concentration indexes (CIs) were generated to measure the inequality of using the four services. Additional analyses were conducted to examine factors that explain the health inequalities (e.g. age, gender, education and residence).ResultsAmong households reporting utilization of health services, public health facilities were used more often for inpatient care, while they were used less for outpatient care. Overall, the utilization of inpatient and outpatient care, and antenatal care was equally distributed among income groups, with CIs of 0.04, 0.03 and 0.08, respectively. However, the poor used more public facilities while the wealthy used more private facilities. There was a substantial inequality in the use of institutional delivery services, with a CI of 0.31. Poorer women had a lower rate of institutional deliveries overall, in both public and private facilities, compared to the wealthy. Location was an important factor in explaining the inequality in the use of health services.ConclusionsThe large gap between the rich and poor in access to and utilization of key maternal services, such as institutional delivery, may be a central factor to the high rates of maternal mortality and morbidity and impedes efforts to make progress toward universal health coverage. While poorer households use public health services more often, the use of public facilities for outpatient visits remains half that of private facilities. Pro-poor targeting as well as a better understanding of the private sector’s role in increasing equitable coverage of maternal health services is needed. Equity-oriented approaches in health should be prioritized to promote more inclusive health system reforms.

Explaining inequity in the use of institutional delivery services in selected countries.

Wealth-related disparities in the use of reproductive health services remain a substantial problem in many low- and middle-income countries. Very few studies have attempted to explain such inequalities through decomposition of the contributions made by various individual- and household-level factors. This study aims to: (1) assess the degree of wealth-related inequality and inequity in the use of institutional delivery services in selected low- and middle-income countries, and (2) to explain wealth-related inequity through decomposition by the contributions made by various components, including health insurance coverage. Data come from Demographic and Health Surveys in three countries: Ghana, Rwanda, and the Philippines. Concentration indices are used to calculate inequality and horizontal inequity in service utilization. Multivariate methods are used to decompose inequity. Findings indicate a moderate to high degree of inequity in institutional delivery service use in all study countries. The study provides some evidence of the contribution of health insurance to increased wealth-related inequity in the use of institutional delivery services, although having health insurance was also associated with increased utilization of services. Results suggest that increased health insurance coverage does not automatically translate to lower wealth-related inequity in service utilization. Inequities in service utilization exist if there are still inequities in the health insurance status. The study advocates for expanding health insurance coverage, particularly among the poor to reduce inequity in insurance coverage and increase service utilization.

Use of institutional delivery services in the Southern Nations, Nationalities, and People's Region, Ethiopia: a cross-sectional comparative mixed methods study

Background118 000 newborn babies in Ethiopia die each year and 500 000 pregnancy-related complications occur. Maternal mortality in Ethiopia is also very high (676 deaths per 100 000 livebirths); only 34% of mothers receive antenatal care and 10% of births took place in health facilities in 2011. We identified factors contributing to low use of institutional delivery services in the Southern Nations, Nationalities, and People's Region, Ethiopia. MethodsWe interviewed mothers who had given birth within the past year and organised six focus group discussions. We selected participants by multistage sampling proportional to the number of expected pregnancies in the 19 administrative zones in the region. We did univariate, bivariate, and multivariate analyses to assess 24 potential predictors of non-institutional delivery. We analysed focus group discussions with NVivo (version 10). FindingsWe interviewed 502 women from urban areas, 164 from rural pastoral areas, and 2231 from rural agrarian areas. 876 of 2897 (30·2%) births occurred in health institutions—412 of 502 (82·1%) births in urban areas, seven of 164 (4·3%) in rural pastoral areas, and 457 of 2231 (20·5%) in rural agrarian areas. Factors associated with non-institutional delivery include mother's education status (none vs grade 9 or higher: adjusted odds ratio [AOR] 3·91, 95% CI 2·76–5·56), mother's partner's educational status (primary vs none: AOR 0·65, 95% CI 0·49–0·86), occupation (merchant vs farmer: AOR 0·56, 95% CI 0·36–0·87), household financial decision-maker (male partner vs mother: AOR 2·12, 95% CI 1·52–2·95), monthly income (<700 birr vs ≥700 birr: AOR 1·77, 95% CI 1·43–2·18), use of antenatal clinic services (no use vs use: AOR 5·63, 95% CI 3·76–8·43), and knowledge of danger signs during delivery (don't know vs do know: AOR 2·16, 95% CI 1·83–2·55). Mothers with no education and who were aged younger than 18 years at their first marriage were more likely to give birth outside of a health institution compared with mothers who were educated to grade 9 or higher (AOR 3·91, 95% CI 2·76–5·56) and mothers who were aged 18 years and older at their first marriage (crude odds ratio 1·69, 95% CI 1·43–1·99). Mothers who planned their last pregnancy were less likely to give birth outside of a health institution compared with mothers who did not plan (AOR 0·48, 95% CI 0·37–0·63). InterpretationInstitutional delivery is still uncommon in the Southern Nations, Nationalities, and People's Region despite several interventions. Innovative approaches are needed to attract women to health facilities. FundingSave the Children International.

Use of institutional delivery services in the Southern Nations, Nationalities, and People's Region, Ethiopia: a cross-sectional comparative mixed methods study

Use of institutional delivery services in the Southern Nations, Nationalities, and People's Region, Ethiopia: a cross-sectional comparative mixed methods study

Use of institutional delivery services in Kassala, eastern Sudan

International Journal of Gynecology & ObstetricsVolume 123, Issue 1 p. 79-80 Brief communications Use of institutional delivery services in Kassala, eastern Sudan Ameer O. Abbaker, Ameer O. Abbaker Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanSearch for more papers by this authorYasir Salih, Yasir Salih Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanSearch for more papers by this authorAbdelAziem A. Ali, AbdelAziem A. Ali Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Kassala, SudanSearch for more papers by this authorAbdulmutalab M. Imam, Abdulmutalab M. Imam Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanSearch for more papers by this authorElsir A. Abdulla, Elsir A. Abdulla Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Kassala, SudanSearch for more papers by this authorIshag Adam, Corresponding Author Ishag Adam [email protected] Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanCorresponding author at: Faculty of Medicine, University of Khartoum, PO Box 112, 11111 Khartoum, Sudan. Tel.: + 249 912168988; fax: + 249 183771211.Search for more papers by this author Ameer O. Abbaker, Ameer O. Abbaker Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanSearch for more papers by this authorYasir Salih, Yasir Salih Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanSearch for more papers by this authorAbdelAziem A. Ali, AbdelAziem A. Ali Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Kassala, SudanSearch for more papers by this authorAbdulmutalab M. Imam, Abdulmutalab M. Imam Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanSearch for more papers by this authorElsir A. Abdulla, Elsir A. Abdulla Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Kassala, SudanSearch for more papers by this authorIshag Adam, Corresponding Author Ishag Adam [email protected] Department of Obstetrics and Gynaecology, University of Khartoum, Khartoum, SudanCorresponding author at: Faculty of Medicine, University of Khartoum, PO Box 112, 11111 Khartoum, Sudan. Tel.: + 249 912168988; fax: + 249 183771211.Search for more papers by this author First published: 11 July 2013 https://doi.org/10.1016/j.ijgo.2013.04.018Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume123, Issue1October 2013Pages 79-80 RelatedInformation

Low use of skilled attendants' delivery services in rural Kenya.

The aim of the study was to estimate the use of skilled attendants' delivery services among users of antenatal care and the coverage of skilled attendants' delivery services in the general population in Kikoneni location, Kenya. Data collected from the registers at the Kikoneni Health Centre (KHC) from March 2001 through March 2003 were retrospectively reviewed. Antenatal care attendance, deliveries by skilled attendants, and the percentage of antenatal care attendees who delivered in a healthcare facility were assessed. Deliveries at the KHC were compared with expected births in the population to estimate the coverage of deliveries assisted by skilled attendants in the community. Of 994 women who attended the antenatal care clinic, 74 (7.4%) presented for delivery services. 5.4% of expected births in the population occurred in health facilities. The coverage of deliveries assisted by skilled attendants was far below the national and international goals. The use of institutional delivery services was very low even among antenatal care attendees. Targeted programmatic efforts are necessary to increase skilled attendant-assisted births, with the ultimate goal of reducing maternal mortality.