Abstract:
Background: Most obstetric complications occur unpredictably during the time of delivery, but
can be prevented with proper medical care in the health facilities. Despite the Ethiopian
government’s efforts to expand health service facilities and promote health institution based
delivery service in the country, an estimated 85% of births still take place at home.
Objective: The review was conducted with the aim of generating the best evidence on the
determinants of institutional delivery service utilization in Ethiopia.
Methods: Both published journals and unpublished grey literatures from 2000 to 2014 were
retrieved. The reviewed studies were accessed through electronic web based search strategy
from PUBMED, HINARI, Medley reference manager, Cochrane Library for systematic reviews
and Google Scholar. Review Manager V5.3 Software was used for meta-analysis. Mantel-Hansel
Odds ratios and their 95% confidence intervals were calculated. Heterogeneity of the study was
assessed using I2test.
Results: From 202 retrieved studies, only 34 studies fulfilled the preset criteria and included for
the Meta analysis. Living in urban areas (OR = 13.16), primary and above educational level of
the mother and husband (OR = 4.95) and (OR = 4.43) respectively, ANC visit (OR = 5.11),
visiting ANC as recommended (OR = 3.24), parity one women (OR = 3.05), encountered
problems during pregnancy (OR = 2.83) and distance less than 5km from nearby health facility
(OR = 2.6) showed significant association with institutional delivery service utilization.
Women’s autonomy was not significantly associated with institutional delivery service
utilization.
Conclusion and Recommendation: Residence setting, educational attainment, Parity, Antenatal
care visit, frequency of Antenatal care visit, Distance to health facility and problems during
pregnancy were factors positively and significantly associated with institutional delivery service
utilization. Promoting couples education beyond primary, health education regarding the danger
signs of pregnancy and benefit of institutional delivery through available communication
networks such as health development army for uneducated and rural mother and Promotion of
antenatal care visits and the completion of four standard visits by pregnant women were
recommended
