Determinants of institutional delivery in Sub-Saharan Africa: findings from Demographic and Health Survey (2013–2017) from nine countries

Gebremichael, Shewayiref Geremew; Fenta, Setegn Muche

doi:10.1186/s41182-021-00335-x

Cited by 23 publications

(29 citation statements)

References 20 publications

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“…Women who did not make ANC visits were more likely to give birth at home; the more ANC visits a woman makes during her pregnancy, the less likely she is to give birth outside a health facility. This result confirms those found by Gebremichael et al in nine sub-Saharan countries (32), Kimario et al in Tanzania (39), Sangho et al in Mali (40), and Paraiso et al (41) in Benin. The significant effect of ANC underscores the role that pregnancy care plays in informing women of the benefits of institutional delivery and linking them to appropriate services (42).…”

Section: Discussionsupporting

confidence: 92%

Factors Associated With Home Births in Benin and Mali: Evidence From the Recent Demographic and Health Surveys

Bado

Brenner

Johnson

et al. 2022

Front. Reprod. Health

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IntroductionIdentifying and understanding the factors associated with homebirths can contribute to improving maternal and child health and achieving the Sustainable Development Goals (SDGs). This study aimed to perform a comparative analysis of the factors associated with homebirths in Benin and Mali.MethodThis study is based on the most recent data from the Demographic Health Surveys conducted in Mali and Benin in 2018. The dependent variable was homebirth, and the explanatory variables were the individual characteristics of the woman, the distance to the health center, the place of residence, the number of prenatal consultations had, the frequency of media exposure, and the use of the Internet. The primary survey unit (PSU) was considered in the analysis to measure the effect of context on the choice of the place of delivery. Further, descriptive statistics and multilevel logistic regression analysis were used in the study.ResultsEducational level was associated with homebirth in Benin and Mali; Women with either no education or primary education are more likely to give birth at home. Women who didn't live close to a health facility were more likely to give birth at home than those who didn't face this problem in both countries. Not making visits for antenatal care (ANC) increases the odds of having a homebirth by 31.3 times (CI = 24.10–40.70) in Benin and 12.91 times (CI = 10.21–16.33) in Mali. Similarly, women who went on 1–2 ANC visits were more likely to give birth at home compared with women who made five or more ANC visits in both countries. The number of children per woman was also a significant factor in both countries. Women who often or regularly paid attention to the media messages were less likely to give birth at home compared with those who did not follow relevant media inputs (aOR = 0.42 [CI = 0.26–0.67] in Benin and aOR = 0.65 [CI = 0.50–0.85] in Mali).ConclusionIncreasing the demand and uptake of women's health services by improving the availability and quality of services and establishing community health centers could help reduce the incidence of homebirths that can be risky and, thus, combat maternal and infant mortality.

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Section: Discussionsupporting

confidence: 92%

Factors Associated With Home Births in Benin and Mali: Evidence From the Recent Demographic and Health Surveys

Bado

Brenner

Johnson

et al. 2022

Front. Reprod. Health

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“…The safety of the mother and newborn is always the target during delivery and can be improved by institutional delivery. Developing countries have many constraints in reducing maternal and newborn problems due to access, availability, and awareness [ 1 ]. As a country in the Sub-Saharan region, Ethiopia got similar limitations regarding maternal and child cares.…”

Section: Introductionmentioning

confidence: 99%

Determinants and spatial distribution of institutional delivery in Ethiopia: evidence from Ethiopian Mini Demographic and Health Surveys 2019

2022

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Background Over the past few decades, maternal and child mortality had drawn the attention of governments and policymakers. Institutional delivery has been among the implementations needed to reduce maternal and child mortality. The fact that the problem was persisted intensified studies to research for more factors. Thus, the current study was intended for further analyses of EMDHS to identify the magnitude, spatial patterns, and predictors of institutional delivery. Methods A cross-sectional survey data from EMDHS 2019 was analyzed involving 5488 reproductive-age women regarding institutional deliveries. We presented descriptive statistics using mean, standard deviations, and proportions. To check the nature of the distribution of institutional delivery, we applied the global Moran’s I statistics. Getis-Ord Gi statistics was applied to detect spatial locations, and we applied spatial interpolation to predict unknown locations of institutional delivery using the Ordinary Kriging method. Kulldorff’s SatScan was also applied to identify the specific local clustering nature of institutional delivery using the Bernoulli method. We applied multilevel binary logistic regression for the scrutiny of individual and community-level factors. We applied P < 0.25 to include variables in the model and P < 0.05 to declare associations. AOR with 95% CI was used to describe variables. Results The prevalence of institution/facility delivery was 2666.45(48.58%) in the survey. The average number of children was 4.03 ± 2.47, and most women in this survey were in the age range of the 25-29 years (31.84%) and 30–34 years (21.61%). Women who learned primary education (AOR = 1.52; 95% CI 1.20–1.95), secondary education (AOR = 1.77; 95% CI 1.03–3.07), and higher education (AOR = 5.41; 95% 1.91–15.25), while those who can read and write sentences (AOR = 1.94; 95% 1.28–2.94), Rich (AOR = 2.40 95% CI 1.82–3.16), and those followed 1–2 ANC (AOR = 2.08; 95% CI 1.57–2.76), 3 ANCs (AOR = 3.24; 95% CI 2.51–418), and ≥ 4 ANCs (AOR = 4.91; 95% CI 3.93–6.15) had higher odds of delivering at health institutions. Conclusion The institutional delivery was unsatisfactory in Ethiopia, and there were various factors associated differently across the different regions. Pastoralist regions showed high home delivery than institutions which invites further interventions specific to those regions. Factors like age, highest education level achieved, preceding birth interval, literacy status, wealth status, birth order, regions, and rural residences were all affected institutional delivery so that interventions considering awareness, access, and availability of the services are vital.

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“…Prior studies on healthcare use and a subsequent health facility delivery, have highlighted a range of potential influences on a woman's tendency to seek care at a health facility, which include younger maternal age, a woman and husband's education, employed, contraception use, previous delivery at a health facility and the utilization of antenatal care (10)(11)(12). Despite this knowledge, the use of institutional healthcare delivery is failing in Sub-Saharan Africa due to a lack of access, distance and insufficient equipment (5,13).…”

Section: Introductionmentioning

confidence: 99%

“…More than 70% of all maternal deaths are due to preventable conditions such as hemorrhage, infection, unsafe abortion, hypertensive disorders of pregnancy and obstructed labor (3, 4). To help improve maternal health, adequate access to healthcare during and after pregnancy is necessary (5). However, access to these services is not possible for some women due to underlying causes, such as poverty, inadequate, inaccessible or unaffordable healthcare, unequal access to resources, the low status of women and illiteracy (3).…”

Section: Introductionmentioning

confidence: 99%

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Does living in major towns favor institutional delivery in Somalia?

Sheikh

Hussein

Mohamed

et al. 2022

Preprint

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BackgroundAn institutional delivery is a childbirth that takes place at a health facility in which the birth is assisted by a skilled healthcare provider. Institutional delivery could reduce approximately 33% of maternal deaths. However, the use of institutional healthcare is failing in many Sub-Saharan African countries because of many factors, including poverty, a lack of access, distance, a lack of transport and other socio-cultural factors. In Somalia, only 32% of births are delivered in a health facility with the assistance of a skilled healthcare provider. We aim to investigate the factors hindering women from giving birth at health facilities in major towns in Somalia, where most of the health facilities in the country are concentrated.MethodsA community-based health survey was carried out from 11 major towns in Somalia between October and December 2021. A structured and pretested questionnaire was used to collect data from 430 women who gave birth last five years. A logistic regression analysis was carried out to establish the association between the covariates of interest and the outcome variable.ResultsThe overall prevalence of institutional delivery was 57%. Approximately 38% of women who live in Mogadishu and 53% of women living in another ten towns give birth at home. Women who had a poor knowledge of the importance of health facility delivery had nearly four times higher odds of delivering at home (OR 3.645 CI: 1.488-8.928). Similarly, those who did not receive antenatal care (OR 2.551, CI: 1.017-6.399), and those who did not receive a consultation on the place of delivery (OR 2.145, CI: 1.167-3.942) were more likely to give birth at home. The reasons for home delivery included financial reasons, must use transport to reach the nearest health facility and it is easier to deliver at home.ConclusionThe study shows that home delivery is high in major towns in Somalia. It is important for health providers to communicate with women and men about the risks related to pregnancy and educate them about the importance of a health facility delivery. Antenatal care should be considered universal for pregnant women, while central and federal governments should guarantee access to free and within-reach ANC for women and girls. In conflict settings in Somalia, this should be done by training community health workers and auxiliary nurses who provide ANC for women through home visits.

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Determinants of institutional delivery in Sub-Saharan Africa: findings from Demographic and Health Survey (2013–2017) from nine countries

Cited by 23 publications

References 20 publications

Factors Associated With Home Births in Benin and Mali: Evidence From the Recent Demographic and Health Surveys

Factors Associated With Home Births in Benin and Mali: Evidence From the Recent Demographic and Health Surveys

Determinants and spatial distribution of institutional delivery in Ethiopia: evidence from Ethiopian Mini Demographic and Health Surveys 2019

Does living in major towns favor institutional delivery in Somalia?

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