Utilization of Institutional Delivery among Women of Child Bearing Age in Lume Woreda East Shewa Zone
Creators: name: Berarti, Kemal
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2014

description: Background: Reducing maternal morbidity and mortality is a global agenda. With maternal mortality ratio of 676 per 100,000 live births, maternal mortality and morbidity levels in Ethiopia are among the highest in the world. It has long been recognized that delivery in medical institution under the care and supervision of trained health-care providers promotes child survival and reduces the risk of maternal mortality. Yet, still majority of mothers in Ethiopia deliver at home and the case in Oromia is even worse where institutional delivery is documented to be less than national figure (5%vs 6% in 2005)and( 8%vs 10% in 2011). It implies that home deliveries could result in maternal death due to hemorrhage and lack of appropriate management. Objective: This study seeks to identify factors that influence institutional delivery among women of 15-49 years of age in Lume district, East Shewa Zone, Oromia region. Method: Mixed methods cross sectional community based study was carried out among women of child bearing age in Lume woreda from February to May 2014. Multistage sampling technique was used to select the study subjects for the survey while purposive sampling was used to identify participants for qualitative study. Structured questionnaire was employed to determine socio-demographic and obstetric factors that affect utilization of institutional delivery. In-depth interview was employed to explore cultural beliefs and practices that determine utilization of institutional delivery. Results: Out of 465 mothers who participated in the survey, 37% of them reported to have delivered at health facility. Those women participants and their husbands with secondary and above levels of education were found to consider institutional delivery than those with no education AOR=6.40, 95%CI=3.37-12.16 and AOR=4.76, 95%CI=2.33-9.72. Mothers who reported severe hemorrhage as pregnancy and delivery complication were found to have delivered more in health facility than who did not report AOR=2.96, 95%, CI=1.47-5. Unfriendly approach of health workers, husbands' influence on choice of delivery point and mothers' preference of home delivery influence utilization of institutional delivery Conclusion: This study shows that institutional delivery was still low compared to national target although it is higher than the national report for institutional delivery. Education, reported severe hemorrhage were found to determine decisions to institutional delivery. Participants' perception towards health workers, husband influence on place of delivery and mothers' preference of home delivery were among the main barriers for institutional delivery. This implies that mothers who give birth at home assisted by non professional are liable to death due to complications and infections. Therefore; increasing formal education by government and empowering of women on choice of place delivery as well as promoting awareness about value of institutional delivery as compared to home delivery would improve institutional delivery