Utilization of Institutional Delivery Service in a Predominantly Pastoralist Community of Northeast Ethiopia

Abstract

BACKGROUND: Maternal mortality is high in sub-SaharanAfrica, and most deaths occur around childbirth. In Ethiopia, mostbirths happen at home without skilled delivery attendants, andparticularly, the least utilization of skilled delivery is recorded inAfar Region. The factors that influence this utilization are not welldocumented in the region where utilization has been low. The aimof this study was to determine the prevalence of utilization ofinstitutional delivery and associated factors.METHODS: A cross-section study with pretested structuralquestionnaire was conducted from August 5 to September 27, 2015,among women who gave birth within 24 months preceding thesurvey. A multivariable logistic regression analysis was done toidentify factors associated with utilization of institutional delivery.RESULTS: Out of the total 1842 women, only 339(18.4%) ofmothers reported having delivered their youngest child at a healthfacility. Home delivery was preferred due to cultural norms, low-risk perception, and distance from a health facility. The odds ofdelivering in a health facility were higher for mothers who attendedat least four antenatal visits during the index pregnancy(AOR=3.08,95%CI=1.91-4.96), those whose husbands wereeducated to secondary school (AOR= 1.86, 95% CI=1.34-2.60), andthose that had at least secondary school level education themselves(AOR=1.52, 95% CI=1.03-2.23).CONCLUSION: Utilization of institution delivery among Afarcommunities is very low, and less educated mothers are laggingbehind. Women’s education and full attendance to antenatal carecan help increase utilization of skilled delivery services. Qualitativestudies to identify socio-cultural barriers are also essential