Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 8;20(1):1077.
doi: 10.1186/s12889-020-09125-2.

Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study

Affiliations

Determinants of institutional delivery service utilization in Ethiopia: a population based cross sectional study

Yebelay Berelie et al. BMC Public Health. .

Abstract

Background: The incidence of maternal mortality remains unacceptably high in developing countries. Ethiopia has developed many strategies to reduce maternal and child mortality by encouraging institutional delivery services. However, only one-fourth of women gave birth at health facility, in the country. This, this study aimed to identify individual level factors and to assess the regional variation of institutional delivery utilization in Ethiopia.

Methods: Data were obtained from the 2016 Ethiopian demographic and health survey. In this study, a total of 7174 reproductive age women who had birth within five years were included. We fitted multilevel logistic regression model to identify significantly associated factors associated with institutional delivery. A mixture chi-square test was used to test random effects. Statistical significance was declared at p < 0.05, and we assessed the strength of association using odds ratios with 95% confidence intervals.

Result: The level of institutional delivery was 38.9%. Women's who had focused antenatal care (FANC) visit (AOR = 3.12, 95% CI: 2.73-3.56), multiple gestations (AOR = 2.06, 95% CI: 1.32-3.21, and being urban residence (AOR = 7.18, 95% CI: 5.10-10.12) were more likely to give birth at health facility compared to its counterpart. Compared to women's without formal education, giving birth at health facility was more likely for women's who had primary education level (AOR = 1.77, 95% CI: 1.49-2.10), secondary education level (AOR = 3.79, 95% CI: 2.72-5.30), and higher education level (AOR = 5.86, 95% CI: 3.25-10.58). Furthermore, women who reside in rich (AOR = 2.39, 95% CI: 1.86-3.06) and middle (AOR = 1.66, 95% CI: 1.36-2.03) household wealth index were more likely to deliver at health facility compared to women's who reside poor household wealth index. Moreover, this study revealed that 34% of the total variation in the odds of women delivered at health institution accounted by regional level.

Conclusion: The level of institutional delivery in Ethiopia remains low. Context specific and tailored programs that includes educating women and improving access to ANC services has a potential to improve institutional delivery in Ethiopia.

Keywords: EDHS; Ethiopia; Institutional delivery; Maternal mortality; Multilevel.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The percentage of institutional and home delivery by region

References

    1. Yebyo H, Alemayehu M, Kahsay A. Why do women deliver at home? Multilevel modeling of Ethiopian National Demographic and health survey data. PLoS One. 2015;10(4):e0124718. doi: 10.1371/journal.pone.0124718. - DOI - PMC - PubMed
    1. Mezmur M, Navaneetham K, Letamo G, Bariagaber H. Individual, household and contextual factors associated with skilled delivery care in Ethiopia: evidence from Ethiopian demographic and health surveys. PLoS One. 2017;12(9):e0184688. doi: 10.1371/journal.pone.0184688. - DOI - PMC - PubMed
    1. Tarekegn SM, Lieberman LS, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian demographic and health survey. BMC pregnancy and childbirth. 2014;14(1):161. doi: 10.1186/1471-2393-14-161. - DOI - PMC - PubMed
    1. Birmeta K, Dibaba Y, Woldeyohannes D. Determinants of maternal health care utilization in Holeta town, Central Ethiopia. BMC Health Serv Res. 2013;13(1):256. doi: 10.1186/1472-6963-13-256. - DOI - PMC - PubMed
    1. ICF C. Ethiopia Demographic and Health Survey 2016, Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF DF-1.6.