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Institutional Delivery Service Utilization and Associated Factors

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Institutional Delivery Service Utilization and Associated Factors omens H f W ea o l l th a n C r a u r e o J Journal of Women's Health Care Shigute et al., J Women's Health Care 2017, 6:5 ISSN: 2167-0420 DOI: 10.4172/2167-0420.1000394 Research Article Open Access Institutional Delivery Service Utilization and Associated Factors among Women of Child Bearing Age at Boset Woreda, Oromia Regional State, Central Ethiopia Taye Shigute, Solomon Tejineh and Legesse Tadesse* Department of Public Health, Arsi University College of Health Sciences, Asella, Ethiopia *Corresponding author: Legesse Tadesse, Department of Public Health, Arsi University, College of Health Sciences, Asella, Ethiopia, Tel: 251-222-308-252; E-mail: [email protected] Received date: August 31, 2017; Accepted date: September 25, 2017; Published date: October 20, 2017 Copyright: © 2017 Shigute T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Evidence has shown access to skilled attendance at birth averting nearly 16-33% maternal deaths. Despite concerted effort to increase access and importance of institutional delivery in preventing maternal death, only 46% and 15% of developing nations and Ethiopian national deliveries, respectively delivered in health facilities that makes assessment of the barriers to health facility delivery important in the study setup. Objective: To assess institutional delivery magnitude and associated factors among mothers delivered in the past 12 months in Boset Woreda, Ethiopia. Methods: A community based cross-sectional study was employed. Systematic random sampling was used to select participants. Data collected using Interviewer administered questionnaire and entered Epi Info 7.1 and analyzed using SPSS version 20.0, p-value 0.05 used to declare statistical significance. Results: A total of 589 women were participated in this study. The mean age of the respondents was 26 years (+5 SD). Educational status of 321 (54.0%) were read and write, while 198 (34.0%) were illiterate. The magnitude of institutional delivery utilization is found 60%. From the study, primary and above educational status (AOR: 2.1; (95%CI: 10.1, 4.70), occupation other than house wife (merchant, employee, etc.) (AOR:1.9; 95%CI:1.12,4.01), age ≥ 18 years during their first marriage (AOR: 1.5; 95%CI:1.21,2.30), age ≥ 18 years during their first pregnancy (AOR: 1.8; 95%CI:1.13,3.35), primigravida (AOR: 2.5; 95%CI: 1.57,3.99), distance from health facility <1 hour (AOR: 15; 95%CI: 9.34,27.11), and women decision maker for place of delivery (AOR: 3.4; 95%CI: 1.86,6.27) were statistically significant predictors contributing for better institutional delivery utilization. Conclusion and Recommendation: Institutional delivery service utilization was found to be higher compared to other areas. Finding revealed education, occupation, age at marriage and distance from facility independently affect institutional delivery. Efforts should be made to increase maternal education access to facility to improve institutional delivery utilization. Keywords: Institutional delivery; Pregnancy; Women; Healthcare; birth averting nearly 16-33% maternal deaths, and its inverse Cesarean association [7-9]. Increasing access to facilities is a recommended strategy to ensure urgent, facility-based management of labor by a Background skilled birth attendant in a supportive environment. In Sub-Saharan Africa, this is only applicable by encouraging pregnant women to Complications of pregnancy and childbirth are taking away the lives deliver their infants in the context of properly functioning healthcare of an estimated 303,000 women annually worldwide [1]. Almost 99% facilities [10-12]. these maternal deaths occur in developing countries, while sub- Saharan Africa (SSA) shares more than half of it [1,2]. Ethiopia is one Despite concerted effort to increase access and importance of of the SSA countries that markedly contribute a high toll of avoidable institutional delivery in preventing maternal death, only 46% and 15% maternal deaths worldwide, 470 per 100,000 live births [3]. Nearly 75% of developing countries and national deliveries, respectively delivered maternal deaths in low income countries attributed to five major in health facilities for the latter the majority 84% of women give birth complications-severe bleeding; pregnancy induced hypertension, at home [13-15]. In SSA, the poorest women were over three times sepsis, obstructed labor and complications of unsafe abortion and more likely to report giving birth at home than the richest women clustered before, during or shortly after birth of which 15% (77.7% vs. 22.4% respectively), likewise Ethiopia’s situation is worse unexpected, with Ethiopia as no exception [4-6]. Understanding the than SSA [14,15]. Many SSA countries, recently have introduced critical time in which maternal death burden peaks, has better odds to initiatives designed to overcome the identified barriers as an effort to initiate key health-care interventions that could improve women’s increase facility deliveries [16]. outcomes. Evidence has shown timely access to skilled attendance at J Women's Health Care, an open access journal Volume 6 • Issue 5 • 1000394 ISSN:2167-0420 Citation: Shigute T, Tejineh S, Tadesse L (2017) Institutional Delivery Service Utilization and Associated Factors among Women of Child Bearing Age at Boset Woreda, Oromia Regional State, Central Ethiopia. J Women's Health Care 6: 394. doi:10.4172/2167-0420.1000394 Page 2 of 9 Considering the terrifying situation, the government of Ethiopia has Determining the magnitude of institutional delivery utilization committed to improve maternal and child health (MCH) and helps to know the progress of service utilization from year to year after introduced several initiatives to increase access to and enhance number of efforts made to increase utilization. The study also identifies communities demand for greater service use, through eliminating user factors associated with institutional delivery utilization that help fees, by availing emergency transport to reach a health facility for child government and non-government health stakeholders to act on those birth and community mobilization endeavors since July 2005 [17], factors. Determining the magnitude of services utilization and aligned with country's flagship community-based approaches called identifying factors associated with utilization of institutional delivery Health Extension Program (HEP). HEP served as a vehicle to improve helps the area which needs more efforts for better utilization. This equitable access to preventive, promotive, and basic curative care study was crucial in assessing the factors associated with low through implementation of 16 health packages at the community level, utilization which need to be solved and those factors contributing for since 2003. Maternal health is part of the family health package and good utilization of institutional delivery need to be favored for better includes delivery of normal births [18,19]. There is evidence from a improvement in services utilization and decreasing maternal morbidity number of countries that materialization of those initiatives improved and mortality. utilization of target services and had a positive impact on the rate of assisted deliveries and/or Cesarean sections [20-22]. Methods and Materials Ethiopia with maternal mortality ratio (MMR) of 470 adjusted per 100,000 live births, the majority (91%) of births is delivered at home Study setup and the proportion of deliveries assisted by skilled attendant is very The study was conducted in Boset Woreda, East Shoa Zone, low less than 16.8% [23]. The use of a skilled attendant has been cited Ethiopia. The district is located 123 Km South East of Addis Ababa. It as the single most critical intervention for improving maternal and is structured in to 38 kebele of which 33 rural and 5 urban; with a total child health [24]. “Skilled attendance” refers to professionally trained population of 179,529 of these 32,424 are women of reproductive age health workers with the skills necessary to manage a normal delivery group, as of the 2015 Central Statistical Agency (CSA) projected and diagnose or refer obstetric complications. Complications of population. Health institution in the district comprises of 7 health pregnancy and childbirth are the leading cause of morbidity and death centers, 33 health posts, 3 drug stores and 11 private clinics. Which among reproductive age women. Approximately 585,000 women die staffed with 15 Public Health Officers, 6 BSc. Nurses, 37 diploma every year from maternal mortality related to pregnancy and Nurses, 16 Midwife Nurses and 94 health extension workers. childbirth complications, more than 25% others suffer a debilitating Antenatal, skilled delivery and post-natal services are provided at all injury, often with lifelong consequences. More than 90% of these government health facilities in the Woreda (Figure 1). deaths and morbidity occur in developing countries, indicating that they could be averted with adequate and available recourses and health service [7-9,24]. Figure 1: The schematic presentation of the sampling procedures for assessment of utilization of institutional deliveries. Study design and period who are mentally and severely ill, not capable of being interviewed were excluded. Community based cross-sectional study design was conducted from
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