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      Factors associated with Institutional delivery service utilization among mothers in Bahir Dar City administration, Amhara region: a community based cross sectional study

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      Reproductive Health
      BioMed Central

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          Abstract

          Background

          High maternal mortality is a continued challenge for the achievement of the fifth millennium development goal in Sub-Saharan African countries including Ethiopia. Although institutional delivery service utilization ensures safe birth and a key to reduce maternal mortality, interventions at the community and/or institutions were unsatisfactorily reduced maternal mortality. Institutional delivery service utilization is affected by the interaction of personal, socio-cultural, behavioral and institutional factors. Therefore this study was designed to assess factors associated with institutional delivery service use among mothers in Bahir Dar city administration.

          Methods

          A community based cross sectional study was conducted in Bahir Dar City administration Northwest of Addis Ababa, Ethiopia. Four hundred eighty four mothers were included in the study. Data were collected by trained female data collectors. Descriptive statistics, binary and multivariable logistic regression analyses were computed. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by odds ratios (OR) with 95% confidence intervals.

          Result

          In this study, 78.8% of women gave birth to their current child at health institution. The multivariable logistic regression showed that, attending primary education (AOR = 4.7[95% CI:1.3-16.7], secondary education (AOR = 3.5[95% CI:1.1-10.7]), age at first marriage; first time marriage at 15–19 years (AOR = 5.4[95% CI:2.0-15.0]) and first time marriage at 20–24 years (AOR = 5.0[95% CI:1.5-16.8] and gestational age at first ANC visit (first trimester) (AOR = 5.3[1.3-22.2]) and second trimester (AOR = 2.8[95% CI:0.7-11.]) were independent factors affecting institutional delivery service utilization.

          Conclusion

          In this study, institutional delivery service utilization is optimal, urban mothers were more likely to practice institutional delivery. This study indicated that age at first marriage, educational status of the women and gestational age at first ANC visit are independent predictors of delivery service utilization. Hence, intensifying education for women and behavior change communication (BCC) interventions to increase early initiation and up-take of ANC service use in the first trimester and delaying marriage are recommended to promote institutional delivery service utilization.

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          Most cited references7

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          Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state, Ethiopia

          Background Giving birth in a medical institution under the care and supervision of trained health-care providers promotes child survival and reduces the risk of maternal mortality. According to Ethiopian Demographic and Health Survey (EDHS) 2005 and 2011, the proportion of women utilizing safe delivery service in the country in general and in Oromia region in particular is very low. About 30% of the eligible mothers received Ante Natal Care (ANC) service and only 8% of the mothers sought care for delivery in the region. The aim of this study is to determine the prevalence of institutional delivery and understand the factors associated with institutional delivery in Dodota, Woreda, Oromia Region. Methods A community based cross sectional study that employed both quantitative and a supplementary qualitative method was conducted from Jan 10–30, 2011 in Dodota Woreda. Multi stage sampling method was used in selection of study participants and total of 506 women who gave birth in the last two years were interviewed. Qualitative data was collected through focus group discussions (FGDs). Data was entered and analyzed using EPI info 3.5.1 and SPSS version 16.0. Frequencies, binary and multiple logistic regression analysis were done, OR and 95% confidence interval were calculated. Results Only 18.2% of the mothers gave birth to their last baby in health facilities. Urban residence, educational level of mothers, pregnancy related health problems, previous history of prolonged labour, and decision made by husbands or relatives showed significant positive association with utilization of institutional delivery services (P < 0.05). While ANC attendance during the index pregnancy did not show any association. Conclusion Institutional Delivery is low. Increasing accessibility of the delivery services and educating husbands not only mothers appear very important factors in improving institutional delivery. Health education on the importance of institutional delivery should also address the general population. The quality and content of the ANC services need to be investigated.
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            Perinatal mortality in developing countries.

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              Factors associated with home delivery in Bahirdar, Ethiopia: A case control study

              Background In Ethiopia although pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. The individual or health system factors that affect women’s preferences for delivery places are not well known. Method A case control study was conducted in July 2010 to assess factors associated with utilization of institutional delivery service. A total of 324 mothers who recently delivered and visited either postnatal care or sought immunization services were included. Cases (n = 108) were mothers who gave birth at home and controls (n = 216) were those who delivered at health facility. Pre-tested and standardized questionnaires were used to collect relevant data by trained data collectors. Logistic regression model was used to control for confounding. Result The likelihood of delivering at home was greater among mothers with inadequate knowledge of pregnancy related services (AOR = 62, 95% CI: 3, 128.4), those who started attending ANC after 24 weeks of gestation (AOR 8.7, 95% CI: 2.2, 33.3), mothers having no formal education (Adjusted OR 4.2, 95% CI 1.63, 11.27) and rural residents (AOR = 3.6, 95%CI: 1.4, 9.0). Conclusion The predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC) follow up, having, Illiteracy and rural residence. Audience specific behavioral change communication should be designed to improve the demand for delivery services. Health professionals should take the opportunity to encourage mothers attend delivery services during ANC follow up. Improvements should be made in social conditions including literacy and major social mobilization endeavors.
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                Author and article information

                Contributors
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central
                1742-4755
                2014
                14 March 2014
                : 11
                : 22
                Affiliations
                [1 ]Public Health Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
                Article
                1742-4755-11-22
                10.1186/1742-4755-11-22
                3986471
                24629278
                e96af9bb-25d2-46d8-9004-7bd4db942800
                Copyright © 2014 Abeje et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 October 2013
                : 9 March 2014
                Categories
                Research

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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