Determinants of home delivery among mothers in abobo woreda, gambella region, southwest Ethiopia: case control study

Abstract

Background: Home delivery is giving birth to a baby in a place of home. One of the major reasons for high maternal mortality ratios in Sub-Saharan Africa is that most births take place at home. To enhance the number of deliveries at health facilities, there is a need to identify determinants of home delivery among mothers across all settings. Objectives: The aim of this study was to determine factors associated with home delivery, among mothers in Abobo Woreda, Southwest Ethiopia, 2019. Methods: A community based case control study was conducted on 264 mothers (88 cases and 176 controls) from March12-April 2/2019 in Abobo woreda, Southwest Ethiopia. Sample size was calculated using Epi info version 7. Cases were mothers who had gave birth at home or others home (family or relatives) in the last one year preceding the study while controls were mothers who had gave birth at health facility in the last one year preceding the study. Sample frame was prepared for cases and controls. Stratified random sampling technique was employed. A pretested and structured questionnaire was used. Data were checked, coded, entered to Epidata version 3.1 and analyzed using SPSS version 20. Univariate, bivariate and multivariable analysis were employed. Variables with P-value less than 0.05 in multivariable analysis were considered as significant variables with their corresponding 95% CI and adjusted odds ratio. Result: - Two hundred sixty four (88 cases and 176 controls) were included in this study with 100% response rate. Of total respondents, 47(53.4%) cases and 58(33.0%) controls were above age of 30 years. No formal education [AOR:5.07, 95%CI :( 2.18-11.50)], poor knowledge on obstetric complications [AOR: 3.83,95%CI :( 1.98-7.40)], negative attitude towards delivery service[AOR: 3.25, 95%CI: (1.70-6.19)], poor household wealth index [AOR:4.55:95%CI:(2.01- 10.31)] and no antenatal care visit [AOR:3.29,95%CI:(1.63-6.63)] were found to be independent predictors of home delivery. Conclusion and Recommendation: - In this study, determinant factors associated with home delivery were no formal education, poor knowledge on obstetric complications, negative attitude towards delivery services, poor household wealth category and no ANC visit. Hence Gambella regional state, woreda health office, health workers, health extension workers and researchers need to tackle home delivery by focusing on the identified factors.