Abstract:Background: In spite of the promotion of institutional delivery in Ethiopia, home delivery is still common primarily in hard-to-reach areas. Institutional delivery supported to achieve the goal of reducing maternal and neonatal mortality in Ethiopia. The objective of this study is to assess the determinants of institutional delivery in Ethiopia. Methods: Cross sectional survey was conducted in 11 administrative regions of Ethiopia. The Ethiopian demographic and health survey data collection took place from Jan… Show more
“…Our study also showed that wealth status is signi cant predicator of institutional delivery both with and without controlling other variables. The result are similar with the study conducted in Bangladesh 21 Gambila 22 , Southwest Ethiopia 23 ,and Mozambique 24 . The nding is also consistent with other studies Pakistan 25 , Eastern Nepal 26 and other different low income countries [27][28][29][30] .Despite of the Nepal's national agship programs (Aama) since 2005 which promoting safe motherhood through initiatives such as providing free delivery care and transportation incentive schemes to women delivering in a health facility, it is discouraging that poor women are less likely to deliver their recent child in the health facilities.…”
Background The huge discrepancy in health statistics between developed and developing countries occur in the area of maternal mortality, with developing countries contributing most of the figures. Nepal has higher maternal mortality ratio than its South Asian neighbors.This study assesses the trend of institutional delivery of recent birth and compared the inequalities with associated factors that affect institutional delivery in Nepal.Methods The data for this study was obtained from three sequential Nepal Demographic and Health Surveys [NDHS] of 2006, 2011, and 2016. The information was collected from mothers having a child within last five years preceding the survey years.The total number of such mothers was 4066, 4148, and 3998 respectively in the survey of 2006, 2011, and 2016.The association between institutional delivery and the explanatory variables was assessed via bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression).Results The utilization of health service during delivery stepped up from 21% in 2006 to 62% in 2016.Although the proportion of delivery in health facility increased among poorest over the period of 10 years, the disparity between richest and poorest still persisted from 2006 to 2016 and the association was highly significant in all the surveys. Although, government of Nepal has launched the maternity incentive scheme through safe delivery incentive program in 2005, poor women are still deprived from utilizing the service. Poorest and poorer women were 78 percent (aOR = 0.22, 95% CI 0.17–0.27) and 71 Percent (aOR = 0.23, 95%CI 0.23–0.35) respectively less likely to have institutional delivery than the richest women after controlling the other socio-demographic and culture factors. Furthermore, this study found that education, place of residence, women’s autonomy, religion, number of ANC visits, exposure to newspaper and TV were significant predicators for place of delivery.Conclusion Although there has been three-fold increment in utilization of health services during delivery over the period of 10 years, the discrepancy between rich and poor, educated and uneducated and urban and rural area is highly evident. Overall, our study highlights the necessity of interventions to promote institutional delivery with greater focus on poor, uneducated, and rural women.
“…Our study also showed that wealth status is signi cant predicator of institutional delivery both with and without controlling other variables. The result are similar with the study conducted in Bangladesh 21 Gambila 22 , Southwest Ethiopia 23 ,and Mozambique 24 . The nding is also consistent with other studies Pakistan 25 , Eastern Nepal 26 and other different low income countries [27][28][29][30] .Despite of the Nepal's national agship programs (Aama) since 2005 which promoting safe motherhood through initiatives such as providing free delivery care and transportation incentive schemes to women delivering in a health facility, it is discouraging that poor women are less likely to deliver their recent child in the health facilities.…”
Background The huge discrepancy in health statistics between developed and developing countries occur in the area of maternal mortality, with developing countries contributing most of the figures. Nepal has higher maternal mortality ratio than its South Asian neighbors.This study assesses the trend of institutional delivery of recent birth and compared the inequalities with associated factors that affect institutional delivery in Nepal.Methods The data for this study was obtained from three sequential Nepal Demographic and Health Surveys [NDHS] of 2006, 2011, and 2016. The information was collected from mothers having a child within last five years preceding the survey years.The total number of such mothers was 4066, 4148, and 3998 respectively in the survey of 2006, 2011, and 2016.The association between institutional delivery and the explanatory variables was assessed via bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression).Results The utilization of health service during delivery stepped up from 21% in 2006 to 62% in 2016.Although the proportion of delivery in health facility increased among poorest over the period of 10 years, the disparity between richest and poorest still persisted from 2006 to 2016 and the association was highly significant in all the surveys. Although, government of Nepal has launched the maternity incentive scheme through safe delivery incentive program in 2005, poor women are still deprived from utilizing the service. Poorest and poorer women were 78 percent (aOR = 0.22, 95% CI 0.17–0.27) and 71 Percent (aOR = 0.23, 95%CI 0.23–0.35) respectively less likely to have institutional delivery than the richest women after controlling the other socio-demographic and culture factors. Furthermore, this study found that education, place of residence, women’s autonomy, religion, number of ANC visits, exposure to newspaper and TV were significant predicators for place of delivery.Conclusion Although there has been three-fold increment in utilization of health services during delivery over the period of 10 years, the discrepancy between rich and poor, educated and uneducated and urban and rural area is highly evident. Overall, our study highlights the necessity of interventions to promote institutional delivery with greater focus on poor, uneducated, and rural women.
“…This finding was in line with 74%, 15 74.4%, 22 78.3%, 2 78.8% 16 studies conducted in Ethiopia and 78.1% in Gambia. 20 It was higher than 12.3%, 8 16.9% 29 24.8%, 5 26.2%, 19 31.0%, 9 32.8%, 30 47.3%, 18 63.1%, 31 64.62%, 14 64.8%, 21 71.2% 13 studies conducted in Ethiopia and 67.3% in Tanzania. 32 The variation observed could be due to socio-economic; educational and sociocultural profiles.…”
Section: Discussionmentioning
confidence: 89%
“…This finding was supported by several studies conducted previously. 1,2,[19][20][21]29,30,32 This is due to the better affordability of the cost incurred from the transportation and the service itself.…”
Section: Discussionmentioning
confidence: 99%
“…8,[10][11][12][13] The factors associated with institutional delivery are multiple and include age, income status, education, occupation, religion, residence, attending ANC, frequency of ANC visit, age at first marriage, age at first pregnancy, types of pregnancy (planned/unplanned), gravidity, parity, owing radio and/or television, knowledge, and occurrence of pregnancy danger signs. 1,2,5,8,9,[14][15][16][17][18][19][20][21][22][23] Ethiopia is one of the six countries that contribute to more than 50% of global maternal deaths. 24 Despite it is known that delivery attended by a skilled provider at a health facility reduced maternal deaths, but more than half of all births in Ethiopia take place at home.…”
Section: Introductionmentioning
confidence: 99%
“…This finding was supported by several studies done previously. 2,5,8,10,13,14,19,22,29 The reason why ANC visit increased institutional delivery use is because of counseling of birth preparedness and place of delivery by the health care workers at ANC follow up clinic in every visit during pregnancy.…”
Background: Despite the global maternal mortality ratio (MMR) fallen by nearly 44% from 1990 to 2015, however, maternal mortality remains a global problem. Reducing maternal morbidity and mortality is a global priority, which is particularly relevant for developing countries like Ethiopia. A good strategy for reducing maternal morbidity and mortality is increasing institutional delivery service utilization. This study aimed to assess the magnitude and associated factors of institutional delivery among reproductive-age women in southwest Ethiopia. Methods: A community-based cross-sectional study was conducted among 526 women at Mizan-Aman town from January 1 to 30, 2019. The data were collected through face-to-face interviews, and a structured questionnaire was used to assess the prevalence and associated factors of institutional delivery among reproductive-age women who delivered in the past one year. The collected data were entered into the Epi Data manager and analyzed using SPSS version 21. Binary logistic regression was done to determine the association between dependent and expected independent variables. Statistical significance was declared at p < 0.05 in the multivariable logistic regression analysis. Results: Of the 526 mothers interviewed, the proportion of institutional delivery was 76%, 95% CI (72.4%-79.7%). The study also found maternal age 25-34 years (AOR=1.89, 95% CI [1.42-3.26]) and 35 years and above (AOR=3.51, 95% CI [1.52-7.85]), monthly income ≥36 USD (AOR=2.22, 95% CI [1.12-4.13]), being multiparity (AOR=1.98, 95% CI [1.08-3.62]), having ANC visit (AOR=10.5, 95% CI [6.76-28.3]), knowledge of pregnancy danger signs (AOR=5.51, 95% CI [3.46-10.2]) and experience of pregnancy danger signs (AOR=3.86, 95% CI [2.67-7.29]) were significantly associated with institutional delivery. Conclusion: The utilization of institutional delivery service among mothers in the study area was good. But, more effort is needed to increase service utilization to 100%. The provision of the continuous house to house health education regarding institutional delivery is an important segment of intervention that can be done through health extension workers. Besides, counseling mothers on the importance of institutional delivery by health professionals at each ANC follow-up visit plays paramount importance.
The study analysed antenatal care (ANC) services usage trends related to exposure to mass media based upon data from three Nepal Demographic and Health Surveys [NDHS] conducted in 2006, 2011, and 2016. Total 12,212 women aged 15‐49 having live births within five years preceding each survey included in the study. Most independent variables were found to be associated with utilisation of ANC services. For example, exposure to TV illustrated an increasing services trend. Seventy‐three percent of the women had exposure to Radio followed by TV (65%), and newspaper (25%). All three media were significantly associated with ANC services in all surveys (p < 0.05). High exposure to Newspapers were (2.5 times, 95%CI: 1.93–3.19), Radio (1.3 times, 95%CI: 1.13–1.46), and TV (1.6 times, 95%CI: 1.36–1.76) more likely to result in adequate (≥4) ANC visits. Age and age at marriage; caste and educational status of women; place of residence; wealth status; and women's decision‐making autonomy were significant predictors for adequate ANC visits. ANC services utilisation trends increased gradually, but not satisfactory. Most socio‐demographic variables were also significant predictors for utilizing ANC services. All these predictors should be used to guide ANC services promotion policies and interventions.
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