Utilization Of Institutional Delivery Research Articles

Determinants of Institutional Delivery in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey

Background: A substantial number of mothers and infants lose their lives due to complications during childbirth. Institutional delivery can lower the number of fatalities. This study aims to explore the prevalence of institutional delivery and its multifaceted associated factors in Bangladesh.
 Methods: The data were extracted from Bangladesh Demographic and Health Survey (BDHS), conducted during the period of 2017-18. Following data preprocessing, a total of 4974 women were included in this study. This study attempts to identify and assess the variables (at the individual and community levels) having the significant impact on the institutional delivery by using a multilevel binary logistic regression model.
 Results: Approximately half of the Bangladeshi women's deliveries were done at the medical center. The study found that women aged 20 or older had a 1.53 times greater likelihood of using healthcare facilities during childbirth (OR 1.53, [1.31-1.78]) than those under 20. Women with higher levels of education were more than twice as likely to choose institutional delivery as those with no education, and the women whose husbands had higher education had the same likelihood. The likelihood of using an institutional delivery service was also boosted by women's higher socioeconomic status. Women with exposure to any form of media had a 36% (OR 1.36, [1.16-1.60] higher likelihood of accessing healthcare facilities during childbirth. Rural women had a 20% lower likelihood of receiving institutional delivery. The utilization of institutional delivery was positively correlated with religion, geographical region, child ever born, and antenatal care visits (ANC). This study discovered significant variations at the community level.
 Conclusion: In order to increase the prevalence of institutional delivery in Bangladesh, the study findings suggest that policymakers should focus on addressing socioeconomic and demographic factors, particularly on women's education, husbands' education, age at first delivery and frequency of ANC visits.

Institutional delivery utilization and associated factors among delivered women in Dawuro Zone, Southern Nation Nationalities Peoples Region.

Globally, around 13.6 million maternal deaths occurred in the last 25 years. Ethiopia accounts one of the highest global maternal deaths, with more than 50% of births taking place at home. Hence, the aim of this study was to determine institutional delivery utilization in Waka town. Community based cross sectional study is the study design chosen. The study was conducted, on mothers having a history of at least 1 birth within the last 2 years, who were selected by a systemic random sampling (K=2), from both kebeles, which is selected by a simple random sampling from the 2 kebeles in the study area. For data collection, an interview with questionnaire containing both closed and open-ended questions, along with non-participant observation method was employed. For analysis, descriptive statistics, along with bivariate and multivariate analytical method was computed. Statistical significance was considered at p < 0.05, and the strength of statistical association was assessed by odds ratio (OR) with 95% confidence interval. The prevalence of institutional delivery service utilization in Waka town was found to be 89.4%. Educational status, marital status, intention of the pregnancy, ANC follows up, and Knowledge of birth complications have shown significant association.

Factors influencing the utilization of institutional delivery services by Chepang women in Chitwan district of Nepal

Factors influencing the utilization of instituional delivery services by Chepang women in Chitwan district of Nepal Background To reduce the maternal death rates, a safe motherhood program has been implemented across Nepal to provide pregnant women with free delivery care in a healthcare facility, as well as transportation incentives promoting institutional delivery. Being a marginalized group of people residing in hilly slope areas, the Chepang population lacks significant usage of healthcare services. Objective This study aimed to assess the incidence of delivery complications, and to investigate the factors associated with the utilization of institutional delivery of the Chepang women in the Chitwan district. Methods A cross-sectional study was conducted with a proportional random sample of 557 mothers. A face-to-face interview was performed to collect the data. Using stepwise logistic regression analysis, the data were analyzed. Results The results showed low incidence of delivery complications among those who utilized an institutional delivery. The literate parents were strongly associated with the increased usage of an institutional delivery (OR=12.08, 95%CI=6.32-23.06, and OR=5.45, 95%CI=2.82-10.51 for literate mothers and literate spouses, respectively). Other significant factors were older ages at delivery of mothers as compared to younger ages mothers (OR= 3.28, 95%CI=1.83-5.90 for ages 20-29 yr.; OR=3.75, 95%CI=1.80-7.83) for ages ≥30 yr.), and engagement in business and services occupation of mothers (OR=2.01, 95%CI=1.01-4.01). The associations were observed for vehicle transportation to the delivery facility (OR =1.99, 95% CI =1.28-3.11) and travel time ≤30 minutes to the delivery facility (OR=2.80, 95%CI=1.58-4.96). Conclusions The results revealed a lower incidence of delivery complications among those who utilized the institutional delivery. The analysis also demonstrated that age, education, income, and convenient access to an institutional delivery facility were associated with the utilization of institutional delivery. Keywords: Institutional delivery, Multilevel analysis, Chepang Women, Chitwan District, Nepal

Institutional delivery knowledge, attitude, and practice among mothers of childbearing age with one or more children, Ethiopia.

Institutional delivery is Giving birth in medical institution under the care and Supervision of trained health care providers which promotes newborn survival and reduces maternal mortality. The objective of the study was to assess Knowledge, Attitude and Practice towards institutional delivery among mothers of child bearing age who have one or more child and visit MCH clinic Adaba health center, West Arsi zone, South East Ethiopia.Institutional based cross sectional study design was conducted. The study was conducted starting from May 1-30, 2021 at Adaba health center, West Arsi zone, South East Ethiopia. Our study sample size is 250 mothers who have at least one birth and visiting MCH at Adaba health center. Systematic random sampling was used to select mothers, Data was collected by using structured questionnaire. Finally, data was analyzed by SPSS version 21.Out of 250 women during our data collection time 246 (98.4%) were our respondents and 4 (1.6%) were non respondents. Among 246 women 213 (86.6%) had good knowledge and 33 (13.4%) had poor knowledge. While 212 (86.2%) had good attitude and 34(13.8%) had poor attitude and 179 (72.8%) had good practice but 67 (27.2%) had poor practice.Increasing knowledge, attitude and practice of mothers towards institutional delivery plays a key role in reducing maternal mortality and morbidity. However, the prevailing level of KAP towards institutional delivery is not satisfactory. Increasing utilization of institutional delivery by increasing awareness of each community through health information dissemination on importance of institutional delivery is needed.

Determinants of potentially harmful traditional cord care practices among mothers in Ethiopia.

BackgroundGlobally, newborn deaths have declined from 5 million in 1990 to 2.4 million in 2019; however, the risk of death in the first 28 days is high. Harmful umbilical cord care contributes to neonatal infection, which accounts for millions of neonatal deaths. This study assessed determinants of potentially harmful traditional cord care practices in Ethiopia using data from a nationally representative survey.Materials and methodsSecondary data analyses were employed using data from the 2016 Ethiopian Demographic and Health Survey. Weighted samples of 4,402 mothers who gave birth in the last 3 years prior to the survey were included in the analysis. Binary logistic regression was fitted to identify associations of outcome variables with explanatory variable analysis, and the results were presented with an adjusted odds ratio (AOR) at a 95% confidence interval (CI), declaring statistical significance at a p-value < 0.05 in all analyses.ResultsAbout 13.70% (95% CI: 12.7%, 14.7%) of mothers practice harmful traditional umbilical cord care. Maternal age (25–34 years, AOR = 1.77, 95% CI: 1.36, 2.31, 35–49 years, AOR = 1.53, 95% CI: 1.07, 2.19), maternal education (primary: AOR = 0.54, 95% CI: 0.41, 0.70 and secondary and above: AOR = 0.61, 95% CI: 0.40, 0.94), parity (para two, AOR = 0.71, 95% CI: 0.55, 0.92), and place of delivery (home delivery, AOR = 1.96, 95% CI: 1.51, 2.56) were factors associated with potentially harmful traditional umbilical cord care practices.ConclusionMaternal educational status, parity, maternal age, and place of delivery were associated with harmful traditional cord care practices. Thus, improving mothers’ education, strengthening antenatal and postnatal care (PNC), and utilization of institutional delivery would help to reduce harmful traditional cord care practices.

Factors Associated With Utilization of Institutional Delivery Service during Covid-19 Pandemic.

The utilization of institutional delivery services is pivotal to improve maternal health and reducing maternal mortality amid childbirth. But COVID-19 pandemic is posturing considerable challenges to maintain essential maternal and newborn health services. So study aims to assess the factors associated with the utilization of institutional delivery during the COVID -19 pandemic. Data was collected from the 116 mothers of Kalika Municipality, Chitwan. The total enumerative sampling technique was used to include mothers who delivered a baby during lockdown (March 21 to August 21, 2020). Collected data were analysed by using descriptive and inferential statistics like chi-square test, logistic regression analysis. Out of 116 mothers, 76.6% had their delivery in the health facilities. Logistic regression analysis showed several factors associated with utilization of institutional delivery such as ethnicity, respondents education status, distance to the nearest health facility, fear of traveling, fear to visit health facility (AOR= 4.923; 95% CI =1.475-16.432, p=0.001),perception on the risk of covid-19 to mother, and intrauterine transmission of COVID-19 (AOR= 19 5.472;95% CI 1.35-22.175;p= 0.017) was found to be statistically significant with the utilization of institutional delivery during COVID-19 pandemic. Several factors have been associated with the utilization of institutional delivery during pandemic. Women preferred not to seek healthcare due to the fear of being infected, lack of awareness, and misperception about COVID-19 and pregnancy. Therefore, the concerned authority should need to deliver a separate message to the pregnant women for a regular check-up and deliver a baby at a hospital.

Determinants of institutional maternity services utilization in Myanmar.

Maternal mortality is a persistent public health problem worldwide. The maternal mortality ratio of Myanmar was 250 deaths per 100,000 live births in 2017 which was the second-highest among ASEAN member countries in that year. Myanmar's infant mortality rate was twice the average of ASEAN member countries in 2020. This study examined factors influencing institutional maternity service utilization and identified the need for improved maternal health outcomes. A cross-sectional study design was used to examine the experience of 3,642 women from the 2015-16 Myanmar Demographic and Health Survey by adapting Andersen's Behavioral Model. Both descriptive and inferential statistics were applied. Adjusted odds ratios and 95% confidence interval were reported in the logistic regression results. The findings illustrate that the proportion of women who delivered their last child in a health/clinical care facility was 39.7%. Women live in rural areas, states/regions with a high levels of poverty, poor households, experience with financial burden and the husband's occupation in agriculture or unskilled labor were negatively associated with institutional delivery. While a greater number of ANC visits and level of the couple's education had a positive association with institutional delivery. The determinants of institutional delivery utilization in this study related to the institutional facilities environment imply an improvement of the institutional availability and accessibility in rural areas, and different states/regions, particularly Chin, Kayah and Kachin States- the poorest states in Myanmar. The poverty reduction strategies are urgently implemented because problems on health care costs and household economic status played important roles in institutional delivery utilization. The ANC visits indicated a significant increase in institutional delivery. The government needs to motivate vulnerable population groups to seek ANC and institutional delivery. Moreover, education is crucial in increasing health knowledge, skills, and capabilities. Thus, improving access to quality, formal, and informal education is necessary.

Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study.

Institutional delivery at birth is an important indicator of improvements in maternal health, which remains one of the targets of sustainable development goals intended to reduce the maternal mortality ratio. The purpose of the present study was to identify the determinants of utilization of institutional delivery in Zambia. A population-based cross-sectional study design was used to examine 9841 women aged 15–49 years from the 2018 Zambia Demographic and Health Survey. A multiple logistic regression was applied to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to identify determinants of utilization of institutional delivery. Sociodemographic factors were significantly associated with institutional delivery: woman’s (OR: 1.76; 95% CI: 1.04–2.99) and husband’s (OR: 1.83; 95% CI: 1.09–3.05) secondary/higher education, higher wealth index (OR: 2.31; 95% CI: 1.27–4.22), and rural place of residence (OR: 0.55; 95% CI: 0.30–0.98). Healthcare-related factors were also significantly associated with institutional delivery: 5–12 visits to antenatal care (OR: 2.33; 95% CI: 1.66–3.26) and measuring blood pressure (OR: 2.15; 95% CI: 1.32–2.66) during pregnancy. To improve institutional delivery and reduce maternal and newborn mortality, policymakers and public health planners should design an effective intervention program targeting these factors.

Effect of checklist based box system interventions on improving institutional delivery among reproductive age women in Northwest Ethiopia: generalized structural equation modeling

BackgroundPrevious studies have shown that there is low utilization of institutional delivery in Ethiopia, as well as various factors contributing to this low utilization. Notably, there is paucity around interventions to improve institutional delivery. Hence, this study examines the effectiveness of checklist-based box system intervention on improving institutional delivery and to investigate the association through which the intervention is linked to institutional delivery.MethodThe study used data from a larger trial, on the effectiveness of checklist-based box system intervention on improving maternal health service utilization. In the intervention arm, mothers received regular community-level pregnancy screening and referral, service utilization monitoring boxes, drop-out tracing mechanisms, regular communication between health centers and health posts, and person-centered health education for mothers. This study used the existing government-led maternal health program as a control arm. A total of 1062 mothers who gave birth one-year before the survey were included in the final analysis. A difference-in-difference estimator was used to test the effectiveness of the intervention. Generalized structural equation modeling was used to examine the direct and/ indirect associations between the intervention and institutional delivery.ResultAmong participants, 403 (79.5%) mothers from intervention and 323 (58.2%) mothers from control clusters gave birth at health facilities. The result of the study revealed a 19% increase in institutional delivery in the intervention arm (19, 95%CI: 11.4-27.3%). In this study the pathway from checklist-based box system intervention to institutional delivery was mainly direct - (AOR = 3.32, 95%CI: 2.36-4.66), however, 33% of the effect was partially mediated by attendance of antenatal care four visits (AOR = 1.39, 95%CI: 1.02-1.92). The influence of significant others (AOR = 0.25, 95%CI: 0.15-0.43) and age (AOR = 0.03, 95%CI: 0.01- 0.09) had an inverse relation with institutional delivery.ConclusionThe implementation of a checklist-based box system significantly increased institutional delivery utilization, both directly and indirectly by improving antenatal care four attendance. A larger-scale implementation of the intervention was recommended, taking the continuum of care approach into account.Trial registrationClinicalTrials.gov, NCT03891030, Retrospectively registered on 26 March, 2019.

Multilevel analysis of factors associated with utilization of institutional delivery in Ethiopia.

Background:The maternal mortality rate in poor nations remains unacceptably high. The purpose of this study was to identify factors associated with institutional delivery usage.Methods:The data came from the Ethiopian mini demographic and health survey, which was conducted in 2019. This study comprised 3978 women of reproductive age who had given birth within the previous 5 years. To uncover significantly linked parameters associated with institutional delivery, we used a multilevel logistic regression model. Statistical significance was declared at p < 0.05, and we assessed the strength of association using adjusted odds ratios with 95% confidence intervals.Results:More than half of the women (53.67%) among 3978 women with last birth had their babies delivered in a health facility. In the multilevel logistic regression analysis, women in age group 45–49 (AOR = 2.43, 95% CI: 1.280, 4.591), primary educational level (AOR = 2.21, 95% CI: 1.864, 2.625, secondary and above education level (AOR = 6.37, 95% CI: 4.600, 8.837), being Muslim (AOR = 2.57, 95% CI: 1.245, 2.166), women who visited ANC service four up to seven times (AOR = 2.75, 95% CI: 2.175, 3.473), women visited ANC service eight times and above (AOR = 3.295% CI: 1.685, 6.050), women who reside in middle wealth index (AOR = 1.57, 95% CI: 1.273, 1.950), and rich wealth index (AOR = 3.43, 95% CI: 2.782, 4.225) were more likely to give birth at health institution compared to their counterparts. Furthermore, women being in rural area (AOR = 0.34, 95% CI:- 0.283, 0.474) and protestant women (AOR = 0.1.57, 95% CI: 0.479, 0.852) were less likely to deliver at health institution.Conclusions:Ethiopia still has a low level of institutionalized delivery. Institutional delivery in Ethiopia should be improved through context-specific and personalized programs, such as educating women and enhancing access to ANC services.

Statistical study for utilization of institutional delivery: An evidences from NFHS data

Objectives: The health of women during pregnancy and child birth is crucial for the mother and her children. The purpose of this study is to examine the determinants and current status of institutional deliveries in Uttar Pradesh on NFHS-4 data. Materials and Methods:The information collected from women who had a live birth in the five years preceding the survey. The study used bivariate analysis and logistic regression to examine the individual and household characteristics of women utilizing institutional delivery. Results: Findings reveal that 70 percent of women go for institutional delivery in Uttar Pradesh. Women’s education, parity, exposure of mass media, ANC visits, wealth index and place of residence were found to be most significant predictor of institutional delivery. Highly educated women were 3.85 times and lower parity women were 2.38 times significantly more likely to prefer institutional delivery. Urban women were slightly in better position to prefer (1.23 times) to deliver child at institution than rural women. Conclusions: The logistic regression results reveal that utilization of institutional delivery is influenced by maternal age, women’s educational level, birth order, mass media exposure, ANC visits, religion, caste, wealth index and type of residence. This study specified the need for an adequate health strategy for the target population and policy implementation to improve maternal healthcare.

Choice of Place of Delivery during COVID-19 Pandemic: Observation from a Community-Based Survey in Rural India

For the past two decades, India has made considerable improvement in health indicators and the country was on the right track toward achieving sustainable development goal-3 by 2030. However, the COVID-19 pandemic has disrupted the health-care system including the essential health services for mother and child. This study was carried out to understand the barriers for utilization of institutional delivery and its prevalence during the pandemic in rural West Bengal. A total of 318 number of women from 18 sampled villages of Canning II block of South 24 Parganas district were interviewed face to face using a semi-structured interview schedule between October and November 2020. The data were analyzed using Stata and NVivo 12 Pro software. Findings show that more than one-fourth (27.3%) of the deliveries took place at home without any assistance of medical professionals. Fear and anxiety related to COVID-19, uncertain service availability, poor service quality during the pandemic, and lack of supporting hands at households compelled women to choose home delivery instead of institutional delivery. Those delivered at institutions, many of them were released on the day of delivery itself, which resulted poor perinatal care even in the cases of institutional delivery. The findings recommend that in addition to COVID-19 related health services, essential maternal and child health services should be continued with the quality to achieve Sustainable Development Goal 3.

Institutional Delivery Service Utilization and Associated Factors Among Women Who Delivered within the Last 2 Years in Waka Town, Maraka Woreda, Dawuro Zone, Southern Nation Nationalities Peoples Region, 2020

Background: Globally, around 13.6 million maternal deaths occurred in the last 25 years. Ethiopia accounts one of the highest global maternal deaths, with more than 50% of births taking place at home. Hence, the aim of this study was to determine institutional delivery utilization in Waka town. Objective: To determine the prevalence of institutional delivery and understand the factors associated with it in Waka town, Maraka wereda, Dawuro zone SNNPR. Methodology: A community based cross sectional study is the study design chosen. The study was conducted, on mothers having a history of at least 1 birth within the last 2 years, who was selected by a systemic random sampling (K=2), from both Waka kebeles, which is selected by a simple random sampling from the 2 kebeles in the study area. For data collection, an interview with questioner containing both closed and open ended questions, along with non-participant observation method was employed. For analysis, Descriptive statistics, along with bivariate and multivariate analytical method was computed. Statistical significance was considered at p &lt; 0.05, and the strength of statistical association was assessed by odds ratio (OR) with 95% confidence interval. Result and Conclusion: The prevalence of institutional delivery service utilization in Waka town was found to be 89.4%. Educational, economic and marital status of the mother, distance, health education provision, intendedness of the pregnancy, ANC follow up, and Knowledge of birth complications have shown significant association. Keywords: Waka town, institutional delivery DOI: 10.7176/JHMN/93-01 Publication date: September 30 th 2021

Levels, Trends, and Inequalities in Using Institutional Delivery Services in Low- and Middle-Income Countries: A Stratified Analysis by Facility Type.

To ensure equitable and accessible services and improved utilization of institutional delivery it is important to identify what progress has been achieved, whether there are vulnerable and disadvantaged groups that need specific attention and what are the key factors affecting the utilization of institutional delivery services. In this study, we examined levels, trends, and inequalities in the utilization of institutional delivery services in low- and middle-income countries. We used nationally representative cross-sectional data from Demographic and Health Surveys (DHS) conducted during 1990-2018. Bayesian linear regression analysis was performed. Among 74 countries, the utilization of institutional delivery services ranged from 23.7% in Chad to 100% in Ukraine and Armenia (with >90% in 19 countries and <50% in 13 countries) during the latest DHS rounds. Trend analysis in 63 countries with at least 2 surveys showed that the utilization of institutional delivery services increased in 60 countries during 1990-2018, with the highest increase being in Cambodia (18.3%). During this period, the utilization of institutional delivery services increased in 90.3% of countries among the richest, 95.2% of countries in urban, and 84.1% of countries among secondary+ educated women. The utilization of institutional delivery services was higher among wealthiest, urban, and secondary+ educated women compared to their counterparts. Greater utilization of private facilities for delivery was observed in women from the highest income group and urban communities, whereas highest utilization of public facilities was observed for women from the lowest income group and rural communities. The utilization of institutional delivery services varied substantially between and within countries over time. Significant disparities in service utilization identified in this study highlight the need for tailored support for women from disadvantaged and vulnerable groups.

Determinants of pre-lacteal feeding practices among mothers having children aged less than 36 months in Ethiopia: Evidence from 2016 Ethiopian demographic and health survey.

Background:Pre-lacteal feeding is associated with infant morbidity and mortality especially during the neonatal period. About 96% infant deaths in developing countries are attributable to inappropriate feeding practice during the first 6 months of life. This study assessed determinants of pre-lacteal feeding practices in Ethiopia using the data from nationally representative survey.Methods:Data were extracted from the 2016 Ethiopian Demographic and Health Survey to assess determinants of pre-lacteal feeding practices in Ethiopia. The analysis included a weighted sample of 5303 mothers having children aged 0–36 months. A multivariable logistic regression analysis was conducted and the results were presented with adjusted odds ratio at 95% confidence interval, declaring statistical significance at a p-value < 0.05 in all analyses.Results:From a total of 5303 mothers having children aged 0–36 months, 423 (8%, 95% confidence interval, 7.06%, 8.99%) had given pre-lacteal foods to their newborn baby. Being from agrarian region (adjusted odds ratio = 0.15, 95% confidence interval, 0.11, 0.20), poorest wealth status (adjusted odds ratio = 1.50, 95% confidence interval, 1.02, 2.22), home delivery (adjusted odds ratio = 1.35, 95% confidence interval, 1.01, 1.79), late initiation of breast feeding (adjusted odds ratio = 4.52, 95% confidence interval, 3.62, 5.64), having no counseling on breast feeding (adjusted odds ratio = 1.33, 95% confidence interval, 1.01, 1.75), and cesarean delivery (adjusted odds ratio = 2.47, 95% confidence interval, 1.45, 4.20) were factors significantly associated with pre-lacteal feeding practice.Conclusion:A significant proportion of Ethiopian mothers had given pre-lacteal foods to their newborn babies. Poorest wealth index, region, late initiation of breast feeding, not counseled on breast feeding, home delivery, and cesarean delivery were identified as determinants of pre-lacteal feeding. Thus, emphasis should be given to improve mothers’ Infant and Young Child Feeding practice through counseling and utilization of institutional delivery. Moreover, special attention should be given to mothers from pastoralist regions and poor socio-economic status to reduce pre-lacteal feeding practice.

Institutional Delivery Among Young Women in Ethiopia: Further Analysis of Trends and Determinants, from the Four Consecutive Ethiopia Demographic and Health Survey.

PurposeAlthough young people have a right to sexual and reproductive health, they are facing inadequate access to information and services. The Ethiopian government has started implementing policies and strategies to eliminate inequalities in reproductive health service use. However, there are huge disparities in institutional delivery utilization between different age groups. Therefore, this study aimed to explore trends and factors associated with institutional childbirth among young women in Ethiopia.MethodsEthiopian demographic and health survey data (EDHS) from 2000 to 2016 surveys were used. Data on the most recent births to women aged 15–24 years that occurred in the 5 years preceding the survey period were extracted. All the four EDHS data were used to examine trends of institutional delivery, whereas determinants for institutional delivery were analyzed from a 2016 dataset by using multivariable logistic regression analysis.FindingsBetween 2000 and 2016, the proportion of institutional delivery among young women increased from 6% (95% CI=3.7–6.5%) to 40.1% (95% CI=30.6–44.3%). The odds of institutional delivery increased for young women who had attended secondary and above education (AOR=2.68; 95% CI=1.559–4.607), started ANC visits early (AOR=1.518; 95% CI=1.095–2.105) and received four or more ANC visits (AOR=1.87; 95% CI=1.370–2.561). However, the odds were lower among young women who had two (AOR=0.31; 95% CI=0.185–0.514), and three or more children (AOR=0.62; 95% CI=0.452–0.849).ConclusionThere is an increase in trend of institutional delivery among young women during the 2000 to 2016 EDHS. Having higher educational levels, early ANC booking, and attending four or more ANC visits were positively associated with institutional delivery. Increased number of children is negatively associated with institutional delivery. Strengthening strategies for improving girls’ education and addressing their socioeconomic and demographic vulnerabilities, and strengthening strategies being implemented for encouraging early and recommended ANC visits is crucial.

Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study

BackgroundThe incidence of maternal mortality remains unacceptably high in developing countries. Ethiopia has developed many strategies to reduce maternal and child mortality by encouraging institutional delivery services. However, only one-fourth of women gave birth at health facility, in the country. This, this study aimed to identify individual level factors and to assess the regional variation of institutional delivery utilization in Ethiopia.MethodsData were obtained from the 2016 Ethiopian demographic and health survey. In this study, a total of 7174 reproductive age women who had birth within five years were included. We fitted multilevel logistic regression model to identify significantly associated factors associated with institutional delivery. A mixture chi-square test was used to test random effects. Statistical significance was declared at p < 0.05, and we assessed the strength of association using odds ratios with 95% confidence intervals.ResultThe level of institutional delivery was 38.9%. Women’s who had focused antenatal care (FANC) visit (AOR = 3.12, 95% CI: 2.73–3.56), multiple gestations (AOR = 2.06, 95% CI: 1.32–3.21, and being urban residence (AOR = 7.18, 95% CI: 5.10–10.12) were more likely to give birth at health facility compared to its counterpart. Compared to women’s without formal education, giving birth at health facility was more likely for women’s who had primary education level (AOR = 1.77, 95% CI: 1.49–2.10), secondary education level (AOR = 3.79, 95% CI: 2.72–5.30), and higher education level (AOR = 5.86, 95% CI: 3.25–10.58). Furthermore, women who reside in rich (AOR = 2.39, 95% CI: 1.86–3.06) and middle (AOR = 1.66, 95% CI: 1.36–2.03) household wealth index were more likely to deliver at health facility compared to women’s who reside poor household wealth index. Moreover, this study revealed that 34% of the total variation in the odds of women delivered at health institution accounted by regional level.ConclusionThe level of institutional delivery in Ethiopia remains low. Context specific and tailored programs that includes educating women and improving access to ANC services has a potential to improve institutional delivery in Ethiopia.

A qualitative study of factors influencing the utilization of institutional delivery: Insights from pastoral communities, Southwest Ethiopia

Background & aim: The practice of institutional delivery services utilization is reported to be very low in Ethiopian pastoral community. In this regard, health programmers should gain an insight into factors influencing the utilization of institutional delivery to improve health facility delivery among these women. Methods: A qualitative study was conducted in pastoralist communities of Bench-Maji zone, southwest Ethiopia within September-October 2017. The data were collected through in-depth interviews and focus-group discussions with women, health extension workers, traditional birth attendants, and supervisors of health extension workers. After transcription and translation, the data were thematically analyzed using Open Code software (version 3.6). Results: As evidenced by the results of the current study, poor risk awareness, inadequate infrastructure and transport, poor quality of care, and lack of financial independence hinder easy access to obstetric care. In this regard, readily available traditional birth attendants become the best alternative to the non-responsive health system. These communities were also marginalized since they receive less health education due to their long distances to healthcare facilities. Consequently, they are encouraged to deliver at home in the belief that only complications require medical attention. Conclusion: In order to design interventions to support pastoral women’s use of obstetric services, existing barriers need to be addressed together since they jointly hinder women’s access to institutional delivery.

Institutional Delivery Service Utilization and Its Association in Gambella Region, Ethiopia

Home delivery is common in sub Saharan states including Ethiopia leading to cause morbidity and mortality of maternal and child health. This study aims to determine factors affecting utilization of institutional delivery among mothers of under two-year-old children in Gambella regional state, Ethiopia. Methods: A cross sectional study which approach 404 mothers of under two years old children by using multistage and purposive sampling technique. Data was collected by self-administer questionaire to examine the prevalence of institutional delivery and factors affecting. Descriptive statistic and Pearson’s Chi-square were performed to describe and determine the associations. Results: The study shows that 69.3% of respondent’s delivery in the health facility, whereas, 26.7% delivery at home and those deliveries on the road and ambulance was 4%. This study disclosed that most of respondents had low level of knowledge on pregnancy complications (65.6%). Education of the mother, ethnicity, attitude, transport accessibility, availability of maternal source of health information, availability of female skilled birth personnel, Antenatal Care visit, and accessibility to 24 hours’ service were significantly associated to institutional delivery. Conclusion: Institutional delivery is affected by many factors. The government and health professionals should promote education regarding the danger signs of pregnancy, pregnancy complications, and benefits of institutional delivery. &nbsp

Determinants of Skilled Birth Attendant Utilization at Chelia District, West Ethiopia.

Background An estimated 303,000 maternal deaths occurred globally in 2015 from which sub-Saharan Africa alone accounted for 201,000 (66%) of the maternal deaths, and most of these are attributed to complications of pregnancy and childbirth due to the absence of institutional delivery by skilled attendants. Objective The aim of this study was to assess institutional delivery utilization and associated factors among mothers who gave birth in the last one year in Chelia District. Methodology. A community-based cross-sectional study design supplemented by a qualitative method was employed from March 15 to 30, 2018. A multistage sampling technique was used to select 475 study participants. Quantitative data were collected using structured questionnaires, and focus group discussions were employed to get qualitative data. The data were entered to EpiData version 3.1 and exported to the statistical package version 21 for analysis. Descriptive statistics and bivariate and multivariate logistic regression analysis were computed to measure the strength of association between dependent and independent variables at a p value of <0.05. Results Among the respondents, 216 (46.2%) utilized institutional delivery service. Monthly income (AOR = 4.465, 95%CI = 1.729, 11.527), antenatal care attendance (AOR = 0.077, 95%CI = 0.008, 0.73), knowledge of mothers about their expected date of delivery (AOR = 0.297, 95%CI = 0.179, 4.93), intended pregnancy (AOR = 0.326, 95%CI = 0.162, 0.654), discussion with health extension workers about the place of delivery at home visit (AOR = 0.11, 95%CI = 0.023, 0.523), knowledge of mothers about the existence of the waiting area in health facilities (AOR = 0.14, 95%CI = 0.023, 0.84), and number of children (AOR = 0.119, 95%CI = 0.029, 0.485) had a significant association with institutional delivery utilization. Conclusion Utilization of institutional delivery was low and far away from the expected country target in the district. The health sector should strive to increase proportion of institutional delivery by reaching pregnant mothers with timely antenatal care service provision and enhancing family planning provision.