Abstract:
Background: Institutional delivery is one of the core components to reduce maternal and new
borne morbidity and mortality. However, in Ethiopia institutional delivery coverage is still very
low and it is around 15%. There is limited study at national and local with case control study
design. Therefore, the aim of this study was to identify determinants of institutional delivery
service utilization in Omo Nada district, Southwest Ethiopia.
Methods: A community based Case Control study supplemented by qualitative was employed
from March 1to 20, 2016. Simple random sampling was used to identify study subjects after
identification of cases, those mothers who deliver at health facility and controls those mothers
who deliver at home by undertaking census. By considering 1:2 ratio of case to controls one
hundred forty two cases and two hundred eighty four mothers were planned to be included in the
study. The quantitative data was collected using pre-tested and structured questionnaire and eight
FGDs were done using interview guide. Data was entered into Epi-data software version 3.1 and
exported to SPPS Version 20 for analysis. Descriptive statistics like frequency table and graphs
were used for data presentation. Factors with p-value <0.25 in bivaraiate analysis were entered to
multi variable logistic regression and statistical significance was considered at p-value <0.05. OR
and 95% CI were used to show the strength and significance of the association.
Results: Out of 142 cases and 284 controls planned to participate 140 cases and 273 controls
were participated with response rate of 98.6% and 96.1% respectively. Based on this study
educational status of the mother [AOR=2.15, 95% CI, 1.16, 4.00], educational status of the
husband [AOR=1.91, 95% CI 1.21, 3.01], having ANC follow up [AOR=3.55, 95%CI 1.54,
6.23], Knowledge of mothers about institutional delivery [AOR=1.6,95%CI 1.23, 2.21] and use
of maternal waiting home [AOR=19.9,CI 7.38,30.41]were significant and determinants of
institutional delivery service utilization.
Conclusions: The finding of this study shows educational status of the mother, husband
education, having ANC follow up, knowledge of the mother about institutional delivery and use
of maternal waiting home were determinants of institutional delivery. Based on this increasing
education status of women and husbands, enhancing the use of maternal waiting home and
creating awareness about ANC and providing health information about institutional delivery
during ANC use were recommended.
