Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.

<h4>Introduction</h4>Maternal mortality remains high, especially in sub-Saharan Africa. Institutional delivery is one of the key intervention to reduce it. Despite service utilization reflects an interplay of demand- and supply-side factors, previous studies mainly focused on either side...

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Main Authors: Fanuel Belayneh Bekele, Kasiye Shiferaw, Adiam Nega, Anagaw Derseh, Assefa Seme, Solomon Shiferaw
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0000535
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author Fanuel Belayneh Bekele
Kasiye Shiferaw
Adiam Nega
Anagaw Derseh
Assefa Seme
Solomon Shiferaw
author_facet Fanuel Belayneh Bekele
Kasiye Shiferaw
Adiam Nega
Anagaw Derseh
Assefa Seme
Solomon Shiferaw
author_sort Fanuel Belayneh Bekele
collection DOAJ
description <h4>Introduction</h4>Maternal mortality remains high, especially in sub-Saharan Africa. Institutional delivery is one of the key intervention to reduce it. Despite service utilization reflects an interplay of demand- and supply-side factors, previous studies mainly focused on either sides due to methodological challenges and data availability. But, a more comprehensive understanding can be obtained by assessing both sides. The aim of this study is to assess individual, household, community, and health facility factors associated with deliveryplace in Ethiopia.<h4>Methods</h4>We have used the 2019 Performance Monitoring for Action survey data set, which is a nationally representative sample of women linked with national sample of health facilities in Ethiopia. A total of 2547 women who recently delivered were linked with 170 health centers and 41 hospitals. Facility readiness index was calculated based on previous study conducted by Stierman EK on similar data set. We applied survey weights for descriptive statistics. Multilevel mixed-effects logistic regression was used to identify factors influencing delivery place.<h4>Results</h4>Coverage of institutional delivery was 54.49%. Women aged 20-34 [AOR; 0.55 (0.32-0.85)] compared with those younger than 20 years; those with no formal education [AOR: 0.19 (10.05-0.76)] or attended only primary school [AOR: 0.20 (0.05-0.75)] compared with those attended above secondary; and women whose partners didn't encourage antinatal visit [AOR; 0.57 (0.33-0.98)] all have decreased odd of institutional delivery. Attending at least one antenatal visit [AOR: 3.09 (1.87-5.10)] and increased availability of medicines in the closest facility [AOR: 17.33 (1.32-26.4)] increase odds of institutional deliver.<h4>Conclusion</h4>In Ethiopia, nearly half of the total deliveries take place outside health facilities. In addition to improving women's education, utilization of antenatal care, and encouragement by partners, it is important to consider the availability of medicine and commodities in the nearby health facilities while designing and implementing programs to reduce home delivery.
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spelling doaj.art-4fe7082f38af400ba2c9885252bb15412023-09-03T14:21:31ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0129e000053510.1371/journal.pgph.0000535Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.Fanuel Belayneh BekeleKasiye ShiferawAdiam NegaAnagaw DersehAssefa SemeSolomon Shiferaw<h4>Introduction</h4>Maternal mortality remains high, especially in sub-Saharan Africa. Institutional delivery is one of the key intervention to reduce it. Despite service utilization reflects an interplay of demand- and supply-side factors, previous studies mainly focused on either sides due to methodological challenges and data availability. But, a more comprehensive understanding can be obtained by assessing both sides. The aim of this study is to assess individual, household, community, and health facility factors associated with deliveryplace in Ethiopia.<h4>Methods</h4>We have used the 2019 Performance Monitoring for Action survey data set, which is a nationally representative sample of women linked with national sample of health facilities in Ethiopia. A total of 2547 women who recently delivered were linked with 170 health centers and 41 hospitals. Facility readiness index was calculated based on previous study conducted by Stierman EK on similar data set. We applied survey weights for descriptive statistics. Multilevel mixed-effects logistic regression was used to identify factors influencing delivery place.<h4>Results</h4>Coverage of institutional delivery was 54.49%. Women aged 20-34 [AOR; 0.55 (0.32-0.85)] compared with those younger than 20 years; those with no formal education [AOR: 0.19 (10.05-0.76)] or attended only primary school [AOR: 0.20 (0.05-0.75)] compared with those attended above secondary; and women whose partners didn't encourage antinatal visit [AOR; 0.57 (0.33-0.98)] all have decreased odd of institutional delivery. Attending at least one antenatal visit [AOR: 3.09 (1.87-5.10)] and increased availability of medicines in the closest facility [AOR: 17.33 (1.32-26.4)] increase odds of institutional deliver.<h4>Conclusion</h4>In Ethiopia, nearly half of the total deliveries take place outside health facilities. In addition to improving women's education, utilization of antenatal care, and encouragement by partners, it is important to consider the availability of medicine and commodities in the nearby health facilities while designing and implementing programs to reduce home delivery.https://doi.org/10.1371/journal.pgph.0000535
spellingShingle Fanuel Belayneh Bekele
Kasiye Shiferaw
Adiam Nega
Anagaw Derseh
Assefa Seme
Solomon Shiferaw
Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.
PLOS Global Public Health
title Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.
title_full Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.
title_fullStr Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.
title_full_unstemmed Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.
title_short Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.
title_sort factors influencing place of delivery in ethiopia linking individual household and health facility level data
url https://doi.org/10.1371/journal.pgph.0000535
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