Abstract:
Background: Reducing maternal mortality is a global priority which is particularly relevant to
developing countries like Ethiopia. The key to reducing maternal mortality ratio and improving
maternal health is increasing attendance by skilled health personnel throughout pregnancy and
delivery. This study aimed to determine the magnitude of institutional delivery service utilization
and associated factors in Zala district.
Methods: A community-based cross-sectional study was conducted from March 18-30, 2015 in
Zala District, South Ethiopia. Multistage sampling technique was used to select the study
participants and total of 373 mothers who have delivered within one year prior to the study
period were interviewed. Data was collected through face to face interviews using structured
questionnaire. Analysis was carried out by using SPSS version 16. Bivariate and multivariate
logistic regression analyses were carried out to examine the existence of association between the
outcome variable and selected determinant factors. Variables having P-value less than 0.25 on
binary logistic regression were the candidate for multiple logistic regressions. Statistical
significance was considered at p < 0.05 and the strength of statistical association was assessed by
odds ratios (OR) with 95% confidence intervals.
Results: The study indicated that only 19.8% of the respondents delivered in health institution.
Among women who delivered at health institution, 13.9% deliveries were in health centers, 3.2%
were in hospital and 2.7% at health posts. Factors that statistically significant association with
institutional delivery service utilization in this study were; women who live in urban were
approximately 4 times more likely to deliver in health institutions than rural dwellers (AOR =
3.64, 95% CI = [1.14,11.51]), women’s education (AOR = 8.01, 95% CI = [2.07, 31.08]),
ANC4+ visits during last pregnancy were 5 times more likely to deliver in health facilities (AOR
= 5.29, 95% CI = [2.63, 12.96]) and mothers who were delivering their first babies were 13
times more likely to deliver in health facilities than those who had five and more deliveries
(AOR = 12.98, 95%CI= [3.50, 28.13]).
Conclusion and recommendations: Institutional delivery service utilization was found to be
low in the study area. Secondary and above level of mother`s education and ANC4+ visits were
amongst the main factors that had an influence on health institution delivery. Increasing the
awareness of mothers about the benefits of institutional delivery services is recommended
