Factors associated with institutional delivery service utilization in Ethiopia

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Abstract

Background

Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home.

Objective

The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia.

Methods

The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I ² test.

Results

People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization.

Conclusion and recommendation

Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended.

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Why do women prefer home births in Ethiopia?

Solomon Shiferaw, Mark Spigt, Merijn Godefrooij … (2013)

Background Skilled attendants during labor, delivery, and in the early postpartum period, can prevent up to 75% or more of maternal death. However, in many developing countries, very few mothers make at least one antenatal visit and even less receive delivery care from skilled professionals. The present study reports findings from a region where key challenges related to transportation and availability of obstetric services were addressed by an ongoing project, giving a unique opportunity to understand why women might continue to prefer home delivery even when facility based delivery is available at minimal cost. Methods The study took place in Ethiopia using a mixed study design employing a cross sectional household survey among 15–49 year old women combined with in-depth interviews and focus group discussions. Results Seventy one percent of mothers received antenatal care from a health professional (doctor, health officer, nurse, or midwife) for their most recent birth in the one year preceding the survey. Overall only 16% of deliveries were assisted by health professionals, while a significant majority (78%) was attended by traditional birth attendants. The most important reasons for not seeking institutional delivery were the belief that it is not necessary (42%) and not customary (36%), followed by high cost (22%) and distance or lack of transportation (8%). The group discussions and interviews identified several reasons for the preference of traditional birth attendants over health facilities. Traditional birth attendants were seen as culturally acceptable and competent health workers. Women reported poor quality of care and previous negative experiences with health facilities. In addition, women’s low awareness on the advantages of skilled attendance at delivery, little role in making decisions (even when they want), and economic constraints during referral contribute to the low level of service utilization. Conclusions The study indicated the crucial role of proper health care provider-client communication and providing a more client centered and culturally sensitive care if utilization of existing health facilities is to be maximized. Implications of findings for maternal health programs and further research are discussed.

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Ethiopia Demographic and Health Survey 2011

(2012)

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Towards elimination of maternal deaths: maternal deaths surveillance and response

Sennen Hounton, Luc de Bernis, Julia Hussein … (2013)

Current methods for estimating maternal mortality lack precision, and are not suitable for monitoring progress in the short run. In addition, national maternal mortality ratios (MMRs) alone do not provide useful information on where the greatest burden of mortality is located, who is concerned, what are the causes, and more importantly what sub-national variations occur. This paper discusses a maternal death surveillance and response (MDSR) system. MDSR systems are not yet established in most countries and have potential added value for policy making and accountability and can build on existing efforts to conduct maternal death reviews, verbal autopsies and confidential enquiries. Accountability at national and sub-national levels cannot rely on global, regional and national retrospective estimates periodically generated from academia or United Nations organizations but on routine counting, investigation, sub national data analysis, long term investments in vital registration and national health information systems. Establishing effective maternal death surveillance and response will help achieve MDG 5, improve quality of maternity care and eliminate maternal mortality (MMR ≤ 30 per 100,000 by 2030).

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Author and article information

Journal

Journal ID (nlm-ta): Int J Womens Health

Journal ID (iso-abbrev): Int J Womens Health

Journal ID (publisher-id): International Journal of Women’s Health

Title: International Journal of Women's Health

Publisher: Dove Medical Press

ISSN (Electronic): 1179-1411

Publication date Collection: 2016

Publication date (Electronic): 12 September 2016

Volume: 8

Pages: 463-475

Affiliations

[1 ]Department of Population and Family Health

[2 ]College of Health Sciences, Jimma University, Ethiopia

Author notes

Correspondence: Aderajew Nigussie Teklehaymanot, Department of Population and Family Health, College of Health Sciences, Old Registrar Building, Room Number 5, Jimma University, Ethiopia, Tel +251 912914777, Email aderajewnu@ 123456gmail.com

Article

Publisher ID: ijwh-8-463

DOI: 10.2147/IJWH.S109498

PMC ID: 5026219

PubMed ID: 27672342

SO-VID: 291cb083-a288-4c5c-8639-52f67f2dadf8

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Factors associated with institutional delivery service utilization in Ethiopia

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Abstract

Background

Objective

Methods

Results

Conclusion and recommendation

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Advocacy for Maternal and Women’s Health

Most cited references 57

Why do women prefer home births in Ethiopia?

Ethiopia Demographic and Health Survey 2011

Towards elimination of maternal deaths: maternal deaths surveillance and response

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