Determinants of Home Delivery among Mothers in Abobo District, Gambella Region, Ethiopia: A Case Control Study

Abstract

Introduction. Home delivery is one of the major reasons for high maternal mortality ratio in sub-Saharan Africa. Sub-Saharan Africa and South Asia together contribute over 85% of maternal deaths, of which, only half of deliveries are institutional. However, data are scarce on the availability of information with regard to the determinant factors for this high prevalence of home delivery in the study area. Objective. This study is aimed at determining factors associated with home delivery, among mothers in Abobo Woreda, Gambella region, Southwest Ethiopia, 2019. Methods. A case control study conducted from 12 March 2019 up to 2 April 2019 on 88 cases and 176 controls. Cases include mothers who gave birth at home and those mothers who gave birth at health facility in the last one year preceding the study included as controls. Data entry was made using Epi-Data version 3.1, and analysis was made using SPSS version 20. A binary logistic regression analysis was conducted to assess candidate variables and subsequently a multivariable regression to determine the statistical associations. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was calculated to determine strength of association, and p value <0.05 was used to establish significant associations. Results. No formal education (AOR: 5.07; 95% CI: 2.18-11.50), poor knowledge on obstetric complications (AOR: 3.83; 95% CI: 1.98-7.40), negative attitude towards delivery service (AOR: 3.25; 95% CI: 1.70-6.19), poor household wealth index (AOR: 4.55; 95% CI: 2.01-10.31), and no antenatal care visit (AOR: 3.29; 95% CI: 1.63-6.63) were found to be significantly associated with home delivery. Conclusions. The findings do support that no formal education, poor knowledge on obstetric complications, negative attitude towards delivery service, poor household wealth index, and no antenatal care visit showed a significant association with home delivery.

Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data

“…In compared with women with poorest wealth status, the odds of home delivery were decreased by 26%, 40%, 55% and 73% among women with poorer, middle, richer and richest wealth status, respectively. This result was in agreement with the previous studies [26][27][28]31]. Financial capability of families and costs related to transportation may determine the place of delivery.…”

“…Educated women had less likelihood of home deliver as compared to uneducated women. The result was in line with the individual studies conducted in rural Ethiopia [26][27][28], Zimbabwe [29], Nigeria [30], Ghana [31,32], Guinea [23] and Nepal [33]. The reason for this might be due the fact that when mothers are educated it is more is likely to enhance female self-determination, positive attitude, and nancial freedom [34,35].…”

Cultural malpractices during labor/delivery and associated factors among women who had at least one history of delivery in selected Zones of Amhara region, North West Ethiopia: community based cross-sectional study

“…Respondents who had no ANC follow-up were 34.94 times more likely to deliver at home as compared with women who had ANC follow-up (AOR = 34.94,95% CI: 19.74:61.86). This result is in concurred with studies conducted in Gambella Region, Ethiopia [ 32 ], South Sudan [ 33 ], Zambia [ 34 ] and Malaysia [ 35 ]. The possible justification for this could be women who have visited a health facility for ANC service, will have awareness of the risks and complications of home delivery.…”

Spatial variation and factors associated with home delivery after ANC visit in Ethiopia; spatial and multilevel analysis

“…This could be due to the inequality in the distribution of maternal health services and the inaccessibility of infrastructure [ 28 , 29 ]. Besides, the mobile lifestyle of nomads, negative Attitude toward skilled birth attendants and low perception of institutional delivery could be potential resons that might reduce maternal health care service utilization [ 30 , 31 ].…”

“…The odds of having home delivery after ANC visit was about two times higher for women within a community with the poor wealth status as compared to those from communities with rich wealth status.This finding was in line with studies done in Ethiopia [ 33 , 39 ], Tanzania [ 22 ] and Nepal [ 40 ]. This might be due to the demand for different costs related to transportation and food that might not be afforded by the mother’s in low level of income [ 31 , 41 ]. Possibly it might be due to that mostly poor women live in rural areas in Ethiopia in the absence of transportation and long-distance travel and access to health facilities which may lead to home delivery [ 42 – 45 ].…”