Determinants of home delivery in Nepal – A disaggregated analysis of marginalised and non-marginalised women from the 2016 Nepal Demographic and Health Survey

Devkota, Bikash; Maskey, Jasmine; Pandey, Achyut Raj; Karki, Deepak Kumar; Godwin, Peter; Gartoulla, Pragya; Mehata, Suresh; Aryal, Krishna Kumar

doi:10.1371/journal.pone.0228440

Cited by 47 publications

(66 citation statements)

References 35 publications

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“…Women who had access to health facilities were more likely to utilize institutional delivery service. This finding is in line with studies [ 18 , 28 , 29 ]. This could be explained by an increased distance from the health facility, transport cost, and lost production time, as well as possible lower exposure to health information.…”

Section: Discussionsupporting

confidence: 94%

Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia

Mitikie¹,

Wassie

Beyene

2020

PLoS ONE

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Background The risk of death from complications relating to pregnancy and childbirth for women’s lifetime is higher in developing countries. Improving maternal and child health through a well-organized institutional delivery service is central to achieving reduced maternal and child mortality. Despite the efforts that have been made to improve maternal health outcomes in Ethiopia, institutional delivery is still unacceptably low. Objective This study was conducted to assess institutional delivery service utilization and associated factors in the study area. Methods A Community-based cross-sectional study was conducted. A multi-stage sampling technique was used to employ a total of 546 women. Data were collected using an interviewer-administered questionnaire and entered into EpiData version 3.1 and then exported to SPSS version 23.0. for analysis. Logistic regression models were used to determine factors associated with the outcome variable. Adjusted Odds ratios with 95% CI were computed to measure the strength of association and statistical significance was declared at p-value <0.05. Results The Prevalence of institutional delivery in the study area was 38% (34%-42%). Factors significantly associated with institutional delivery were ANC visit 1.80 (1.12–2.91), knowledge of danger sign during pregnancy 3.60 (2.25–5.76), urban residency 2.09 (1.15–3.81), Parity 0.49 (0.25–0.95) accessibility of health facility 4.60 (2.01–10.89), husbands educational level: primary 2.50 (1.27–4.91), secondary and above 2.36 (1.24–4.48), mothers occupation: governmental employee 2.05 (1.00–4.18), and Private employee 2.42 (1.09–5.35). Conclusions The prevalence of institutional delivery in the District was low. Antenatal visits, residency, knowledge of pregnancy danger signs, parity, and accessibility of health facilities, maternal occupation, and husband education were factors significantly associated with institutional delivery.

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Section: Discussionsupporting

confidence: 94%

Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia

Mitikie¹,

Wassie

Beyene

2020

PLoS ONE

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“…Muslim women were more likely to deliver at home in this study, compared to women who belonged to other religions. Similar to the findings of this study, a study in Nepal, identified that Muslim women were more likely to deliver at home compared to women of other religions [ 33 ]. A study in Ghana also identified low utilization of maternal healthcare skilled service among Muslim women [ 56 ].…”

Section: Discussionsupporting

confidence: 87%

Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

Ahinkorah

2020

BMC Health Serv Res

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Background Many childbearing women in sub-Saharan African countries like Guinea still face challenges accessing and utilizing health facility delivery services and opt to deliver at home. This study examined the non-utilization of health facility delivery and its associated factors among childbearing women in Guinea. Methods Data from the 2018 Guinea Demographic and Health Survey was used in this study. Data of 5406 childbearing women were analysed using STATA version 14.2 by employing a multilevel logistic regression approach. The results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results More than three-quarters (47.6%) of childbearing women in Guinea did not deliver at health facilities. Women who had no formal education (aOR = 1.52, 95% CI = 1.09–2.12), those whose partners had no formal education (aOR = 1.25, 95% CI =1.01–1.56), those whose pregnancies were unintended (aOR = 1.40, 95% CI =1.13–1.74) and those who were Muslims (aOR = 2.87, 95% CI =1.17–7.08) were more likely to deliver at home. Furthermore, women with parity four or more (aOR = 1.78, 95% CI =1.34–2.37), those who listened to radio less than once a week (aOR = 5.05, 95% CI =1.83–13.89), those who never watched television (aOR = 1.46, 95% CI =1.12–1.91), those with poorest wealth quintile (aOR = 4.29, 95% CI =2.79–6.60), women in female-headed households (aOR = 1.38, 95% CI =1.08–1.78) and rural dwellers (aOR = 3.86, 95% CI =2.66–5.60) were more likely to deliver at home. Conclusion This study has identified low socio-economic status, inadequate exposure to media, having an unplanned pregnancy and religious disparities as key predictors of home delivery among childbearing women in Guinea. The findings call for the need to enhance advocacy and educational strategies like focus group discussions, peer teaching, mentor-mentee programmes at both national and community levels for women to encourage health facility delivery. There is also the need to improve maternal healthcare services utilization policies to promote access to health facility delivery by reducing costs and making health facilities available in communities.

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“…These findings could be explained by older women or health personnel placing greater emphasis on the benefits of childbirth in health facilities by skilled health personnel due to the increased risk of complications due to the mother's older age. However, a study in Nepal reported that older pregnant women had a higher probability of home births given the association between higher maternal age with multiparity and precipitous childbirth [ 36 ]. Nonetheless, in our study, women in the age group of young adolescents presented the highest probability of having a home birth.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with home births in Peru 2015–2017: A cross-sectional population-based study

Hernández-Vasquéz

Chacón-Torrico

Vargas-Fernández

et al. 2021

Heliyon

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Background Higher rates of maternal complications and deaths have been described in home births. However, few local studies have evaluated factors associated with home births in Peru. The study aims to determine the prevalence and factors associated with home birth in the Peruvian population. Methods A population-based analytical cross-sectional study was conducted using pooled data from the 2015–2017 Peruvian Demographic and Health Surveys. A logistic regression model was performed to calculate crude and adjusted odds ratios (aOR) for the association between sociodemographic and mother-related factors and home births. Results Seven out of every 100 births were home births. Living in a rural area (aOR = 3.10; 95% CI: 2.52–3.81), having a primary or secondary educational level, belonging to a medium or low wealth tertile, being from the rest of the Coast, Andean or Amazon regions, the second or greater number of birth order and considering the distance to the health center as problematic (aOR: 1.32; 95% CI: 1.17–1.48) were found to be associated with a higher probability of home births. Contrarily, being in the age groups of 25–34 and 35–39 years old, having a multiple pregnancy and giving birth to a medium (aOR: 0.88; 95% CI: 0.78–1.00) or large-sized newborn (aOR = 0.81; 95% CI: 0.72–0.93) were associated with a lower probability of presenting home births. Conclusions Sociodemographic factors are associated with home births in Peru. Further study of these factors is required to develop strategies specific to the needs of the population of childbearing age.

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Determinants of home delivery in Nepal – A disaggregated analysis of marginalised and non-marginalised women from the 2016 Nepal Demographic and Health Survey

Cited by 47 publications

References 35 publications

Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia

Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia

Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

Factors associated with home births in Peru 2015–2017: A cross-sectional population-based study

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