Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state, Ethiopia

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Abstract

Background

Giving birth in a medical institution under the care and supervision of trained health-care providers promotes child survival and reduces the risk of maternal mortality. According to Ethiopian Demographic and Health Survey (EDHS) 2005 and 2011, the proportion of women utilizing safe delivery service in the country in general and in Oromia region in particular is very low. About 30% of the eligible mothers received Ante Natal Care (ANC) service and only 8% of the mothers sought care for delivery in the region. The aim of this study is to determine the prevalence of institutional delivery and understand the factors associated with institutional delivery in Dodota, Woreda, Oromia Region.

Methods

A community based cross sectional study that employed both quantitative and a supplementary qualitative method was conducted from Jan 10–30, 2011 in Dodota Woreda. Multi stage sampling method was used in selection of study participants and total of 506 women who gave birth in the last two years were interviewed. Qualitative data was collected through focus group discussions (FGDs). Data was entered and analyzed using EPI info 3.5.1 and SPSS version 16.0. Frequencies, binary and multiple logistic regression analysis were done, OR and 95% confidence interval were calculated.

Results

Only 18.2% of the mothers gave birth to their last baby in health facilities. Urban residence, educational level of mothers, pregnancy related health problems, previous history of prolonged labour, and decision made by husbands or relatives showed significant positive association with utilization of institutional delivery services (P < 0.05). While ANC attendance during the index pregnancy did not show any association.

Conclusion

Institutional Delivery is low. Increasing accessibility of the delivery services and educating husbands not only mothers appear very important factors in improving institutional delivery. Health education on the importance of institutional delivery should also address the general population. The quality and content of the ANC services need to be investigated.

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Most cited references 6

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Factors affecting home delivery in rural Tanzania.

Mwifadhi Mrisho, Joanna A Schellenberg, Adiel K Mushi … (2007)

Studies of factors affecting place of delivery have rarely considered the influence of gender roles and relations within the household. This study combines an understanding of gender issues relating to health and help-seeking behaviour with epidemiological knowledge concerning place of delivery. In-depth interviews, focus group discussions and participant observation were used to explore determinants of home delivery in southern Tanzania. Quantitative data were collected in a cross-sectional survey of 21,600 randomly chosen households. Issues of risk and vulnerability, such as lack of money, lack of transport, sudden onset of labour, short labour, staff attitudes, lack of privacy, tradition and cultures and the pattern of decision-making power within the household were perceived as key determinants of the place of delivery. More than 9000 women were interviewed about their most recent delivery in the quantitative survey. There were substantial variations between ethnic groups with respect to place of delivery (P<0.0001). Women who lived in male-headed households were less likely to deliver in a health facility than women in female-headed households (RR 0.86, 95% CI 0.80-0.91). Mothers with primary and higher education were more likely to deliver at a health facility (RR 1.30, 95% CI 1.23-1.38). Younger mothers and the least poor women were also more likely to deliver in a health facility compared with the older and the poorest women, respectively. To address neonatal mortality, special attention should be paid to neonatal health in both maternal and child health programmes. The findings emphasize the need for a systematic approach to overcome health-system constraints, community based programmes and scale-up effective low-cost interventions which are already available.

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Accessibility and utilisation of delivery care within a Skilled Care Initiative in rural Burkina Faso.

Tim Ensor, Nicolas Meda, Sennen Hounton … (2008)

The Skilled Care Initiative (SCI) was a comprehensive skilled attendance at delivery strategy implemented by the Ministry of Health and Family Care International in Ouargaye district (Burkina Faso) from 2002 to 2005. We aimed to evaluate the relationships between accessibility, functioning of health centres and utilisation of delivery care in the SCI intervention district (Ouargaye) and compare this with another district (Diapaga). Data were collected on staffing, equipment, water and energy supply for all health centres and a functionality index for health centres were constructed. A household census was carried out in 2006 to assess assets of all household members, and document pregnancies lasting more than 6 months between 2001 and 2005, with place of delivery and delivery attendant. Utilisation of delivery care was defined as birth in a health institution or birth by Caesarean section. Analyses included univariate and multivariate logistic regression. Distance to health facility, education and asset ownership were major determinants of delivery care utilisation, but no association was found between the functioning of health centres (as measured by infrastructure, energy supply and equipment) and institutional birth rates or births by Caesarean section. The proportion of births in an institution increased more substantially in the SCI district over time but no changes were seen in Caesarean section rates. The SCI has increased uptake of institutional deliveries but there is little evidence that it has increased access to emergency obstetric care, at least in terms of uptake of Caesarean sections. Its success is contingent on large-scale coverage and 24-h availability of referral for life saving drugs, skilled personnel and surgery for pregnant women.

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The Safe Motherhood Initiative: why has it stalled?

D Maine, A Rosenfield (1999)

Complications of pregnancy and childbirth are still the leading cause of death and disability among women of reproductive age in developing countries. After decades of neglect, the founding of the Safe Motherhood Initiative in 1987 promised action on this problem. A dozen years later, there is no evidence that maternal mortality has declined and there are still few sizeable programs. A major reason for this disappointing record is that the initiative lacks a clear, concise, feasible strategy. This article reviews the available options and proposes a strategy based on improving the availability and quality of medical treatment of obstetric complications. Once district hospitals and health centers provide such needed care, community mobilization to improve prove utilization may be beneficial. Substantial reductions in maternal deaths would be possible in a relatively short period of time if this strategy were embraced.

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Author and article information

Journal

Journal ID (nlm-ta): Reprod Health

Journal ID (iso-abbrev): Reprod Health

Title: Reproductive Health

Publisher: BioMed Central

ISSN (Electronic): 1742-4755

Publication date Collection: 2012

Publication date (Electronic): 15 December 2012

Volume: 9

Page: 33

Affiliations

[1 ]Clear Impact Consult (CIC), P.O.Box: 876, Addis Ababa, Ethiopia

[2 ]Addis Continental Institute of Public Health, Addis Ababa, Ethiopia

Article

Publisher ID: 1742-4755-9-33

DOI: 10.1186/1742-4755-9-33

PMC ID: 3546055

PubMed ID: 23241397

SO-VID: f1037bad-fc01-4e1c-bb1c-49d3ad7772af

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state, Ethiopia

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Abstract

Background

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Conclusion

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Advocacy for Maternal and Women’s Health

Most cited references 6

Factors affecting home delivery in rural Tanzania.

Accessibility and utilisation of delivery care within a Skilled Care Initiative in rural Burkina Faso.

The Safe Motherhood Initiative: why has it stalled?

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