Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study

BMC Pregnancy and Childbirth

Meaza Demissie²  Feleke Habte¹ 

[1] Johns Hopkins University – Technical Support for the Ethiopian HIV/AIDS ART Initiative project, Addis Ababa, Ethiopia;Addis Continental Institute of Public Health, Addis Ababa, Ethiopia

关键词: Ethiopia;    Cheha district;    Skilled attendant;    Institutional delivery;   

Others  :  1233191
DOI  :  10.1186/s12884-015-0716-8

 received in 2014-11-30, accepted in 2015-10-22,  发布年份 2015

【 摘 要 】

Background

Ethiopia is one of the six countries that contributes’ to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia.

Methods

A community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression.

Results

A total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband’s attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2 ^ndyoungest child were found to have statistically significant association with institutional delivery.

Conclusion

Institutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service; working to improve women’s economic status; counseling women to give birth at health institution during their ANC visit and exploring the overall quality of ANC service are some of the areas where much work is needed to improve institutional delivery.

【 授权许可】

   
2015 Habte and Demissie.

【 图 表 】

Fig. 1.

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【 参考文献 】

• [1]Trends in maternal mortality: 1990 to 2008. WHO, Geneva; 2010.
• [2]Trends in maternal mortality: 1990 to 2010. WHO, Geneva; 2012.
• [3]Ronsmans C, Graham WJ. Maternal mortality: who, when, where and why. Lancet. 2006; 368:1189-200.
• [4]Campbell OM, Graham WJ. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006; 368(9543):1284-99.
• [5]United Nations. The Millennium Development Goals report: Statistical annex. New York; 2007. http://www. un.org/millenniumgoals/pdf/mdg2007
• [6]Family Care International: Safe Motherhood A Review; 2007. http://www. familycareintl.org/UserFiles/File/SM_A Review_Exec_Sum_Final_1.pdf
• [7]Graham W, Bell JS, Bullough C. Can skilled attendance at delivery reduce maternal mortality in developing countries? Lancet. 2001; 17:97-129.
• [8]Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L et al.. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet. 2005; 365(9463):977-88.
• [9]Kabir M. Safe delivery practices in rural bangladesh and its associated factors: evidence from bangladesh demographic and health survey-2004. East Afr J Public Health. 2007; 4(2):67-72.
• [10]Kesterton AJ, Cleland J, Sloggett A, Ronsmans C. Institutional delivery in rural India: the relative importance of accessibility and economic status. BMC Pregnancy Childbirth. 2010; 10:30. BioMed Central Full Text
• [11]Montagu D, Yamey G, Visconti A, Harding A, Yoong J. Where Do poor women in developing countries give birth? a multi-country analysis of demographic and health survey data. PLoS One. 2011; 6(2):e17155.
• [12]Proportion of births attended by a skilled health worker, 2008 updates. WHO, Geneva; 2008. http://whqlibdoc. who.int/hq/2008/WHO_RHR_08.22_eng.pdf
• [13]The millennium development goals report. New York: United Nations; 2009. http://www. un.org/millenniumgoals/pdf/MDG_Report_2009_ENG.pdf
• [14]Gabrysch S, Campbell OMR. Still too far to walk: literature review of the determinants of delivery services use. BMC Pregnancy Childbirth. 2009; 9(34):1-18.
• [15]Barbour V, Clark J, Jones S, Peiperl L, Veitch E. Maternal Health: Time to Deliver. PLoS Med. 2010;7(6):e1000300. doi:10.1371/journal.pmed.1000300.
• [16]Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994; 38(8):1089-110.
• [17]Onah HE, Ikeako LC, Iloabachie GC. Factors associated with the use of maternity services in Enugu, southeastern Nigeria. Soc Sci Med. 2006; 63:1870-8.
• [18]Chowdhury M, Ronsmans C, Killewo J, Anwar I, Gausia K, Das-Gupta S et al.. Equity in use of home-based or facility-based skilled obstetric care in rural Bangladesh: an observational study. Lancet. 2006; 367(9507):327-32.
• [19]Abera M, Gebremariam A, Belachew T. Predictors of safe delivery service utilization in arsi zone South-East Ethiopia. Ethiop J Health Sci. 2011; 21:95-106.
• [20]Nigusse M, HaileMarian D, Mitike G. Assessment of safe delivery service utilization among women of childbearing age in North Gondor Zone. Ethiop J Health Dev. 2004; 18(3):145-52.
• [21]Teferra AS, Alemu FM, Woldeyohannes SM. Institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Sekela district, north west of Ethiopia: a community - based cross sectional study. BMC Pregnancy Childbirth. 2012; 12:74. BioMed Central Full Text
• [22]Amano A, Gebeyehu A, Birhanu Z. Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross sectional study. BMC Pregnancy Childbirth. 2012; 12:105. BioMed Central Full Text
• [23]Mekonnen Y. Patterns of maternity care service utilization in southern Ethiopia: evidence from a community and family survey. Ethiop Health Dev. 2003; 17(1):27-33.
• [24]Charlotte W. Care seeking for maternal health: challenges remain for poor women. Ethiop J Health Dev. 2010;24(Special Issue 1):100–4.
• [25]Central Statistical Agency [Ethiopia] and ICF International. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.
• [26]Dhakal S, Teijlingen EV, Raja EA, Dhakal KB. Skilled Care at Birth among Rural Women in Nepal: Practice and Challenges. J Health Popul Nutr. 2011; 29(4):371–8.
• [27]Thind A, Mohani A, Banergee K, Hagigi F. Where to deliver? analysis of choice of delivery location from a national survey in India. BMC Public Health. 2008; 8:29. BioMed Central Full Text
• [28]Hazemba AN, Siziya S. Choice of place for childbirth: prevalence and correlates of utilization of health facilities in Chongwe district, Zambia. Med J Zambia. 2008; 35(2):53-7.
• [29]Lwelamira J, Safari J. Tanzania choice of place for childbirth: prevalence and determinants of health facility delivery among women in Bahi district, central Tanzania. Asian J Med Sci. 2012; 4(3):105-12.
• [30]Tura G, G/Mariam G. Safe delivery service utilization in Metekel Zone, northern Ethiopia. Ethiop J Health Sci. 2008; 17(4):213-22.
• [31]Mekonnen Y. Utilization of maternal health care services in Ethiopia. Ethiopian Health and Nutrition Research Institute, November; 2002.
• [32]Thind A, Mohani A, Banerjee K, Hagigi F. Where to deliver? Analysis of choice of delivery location from a national survey in India. BMC Public Health. 2008; 8:29. BioMed Central Full Text
• [33]Crowe S, Utley M, Costello A, Pagel C. How many births in sub-Saharan Africa and South Asia will not be attended by a skilled birth attendant between 2011 and 2015? BMC Pregnancy Childbirth. 2012; 12:4. BioMed Central Full Text
• [34]Kwat BE, Kidane, Mariam W, Yosef M, Fowkes FG. Epidemiology of maternal mortality in Addis Ababa: a community study. Eth Med J. 1985; 23(7):7-16.
• [35]Paxton A, Maine D, Freedman L, Fry D, Lobis S. The evidence for emergency obstetric care. Int J Gynecol Obstet. 2005; 88:181-93.
• [36]Mayhew M, Hansen PM, Peters DH et al.. Determinants of skilled birth attendant utilization in Afghanistan: a cross-sectional study. Am J Public Health. 2008; 98(10):1849-56.
• [37]Titalay CR, Hunter CL, Dibley MJ, Heywood P. Why do some women still prefer traditional birth attendants and home delivery? A qualitative study on delivery care services in West Java Province, Indonesia. BMC Pregnancy Childbirth. 2010;10.