Delays In Utilization of Institutional Delivery Service and Associated Factors in Yem Special Woreda, South West Ethiopia

Abstract

Background: Pregnancy and childbirth remain serious life threatening events for many women in low income countries. The death of a woman in child birth signifies far more than the tragic loss of a single life; it can threaten the survival of the whole family, especially the new born baby and other young children. Reducing maternal morbidity and mortality is a global priority which is particularly relevant to developing countries like Ethiopia. One of the key strategies for reducing maternal morbidity and mortality is increasing institutional delivery service utilization of mothers under the care of skilled birth attendants. Objective: To assess delays in utilizing institutional delivery service and associated factors among women who gave birth at public health facilities in yem special woreda, south west Ethiopia. Method: A facility based cross sectional study design supplemented with a qualitative method was used. The study was conducted at public health facilities which provide institutionaldelivery service in yem special woreda from February to April 2015. The sample size was 393 for quantitative study and 8 FGD for qualitative one. Data were coded, edited and entered to epi-data. After cleaning, analysis was done by using SPSS version 16.0. Both binary and multivariate logistic regressions were used to determine the association between dependent and independent variables. Odd ratio along with 95% CI was estimated to measure the strength of association and level of statistical significance was declared at p-value < 0.05. Result: A total of 389 women were included into the study. Of this 297 (76.3%) of mother faced delay in utilization of institutional delivery service from health facility. The prevalence of delays to utilize institutional delivery service was 76.3%. The mean (+ SD) delay time was 5 (+ 3.07) hours to utilize institutional delivery service. Delay in utilizing institutional delivery service was 2 times higher for those mother influenced by their husband for decision to utilize delivery service (AOR: 2.0(1.09, 3.95)) than those decide by their own for utilizing institutional delivery service, and 7 times higher among mothers who were not being prepared for institutional delivery service utilization (AOR: 7.18 (2.88, 17.85)) than mothers prepared. Women who have three or more children have 3 times more likely higher (AOR: 2.9(1.568, 5.444)) than mother who have two or less children in delay to utilize delivery service. Delay to utilize delivery service was 10 times higher among mother whose household monthly income less than 500 birr (AOR: 10.58(1.74, 64.11)) than whose monthly income greater than one thousand and 2 times higher among illiterate mother (AOR: 1.9 (1.07, 3.47)) than literate mother. Conclusion:- There is delays in utilizing institutional delivery service in Yem special Woreda and associated with literacy status, occupation, parity, decision making power, birth preparedness, awareness on danger sign of pregnancy and benefit of utilizing institutional delivery service, decision making power, family monthly income and distance from health facility. Parity, not being prepared for birth, family monthly income, husband decision making and literacy status of mother were predictors of delay in utilizing institutional delivery service in the woreda. So it is important to reduce these delays by improving education status, decision making, improving birth preparedness and complication readiness practice of mother and increasing delivery service utilization and promoting early booking and regular visits to ANC service by women.