Delays for utilizing institutional delivery and Associated factors among mothers attending public Health facilities in hadiya zone, southern ethiopia

Abstract

Introduction: Labour and delivery are the shortest and most critical period during pregnancy and childbirth. The major factors that contribute to maternal death in developing countries are: delay in deciding to seek care, identifying and reaching medical facility, and receiving adequate and appropriate treatment. The study aimed to determine delays in institutional delivery and associated factors among mothers attending public health facilities, southern Ethiopia. Methods: Facility based Cross sectional study was employed on 397 labouring mothers attending Negist Elene Mohamed memorial general hospital. The sample size was determined by using single population proportion formula and the data were collected consecutively until the required sample sizes achieved. Descriptive data analysis was conducted to identify summary values and multiple logistic regressions were performed to identify independent predictors for the delays. All the analysis was done using SPSS for windows version 16.0 Results: A total of 384 laboring mothers were participated in this study. The proportion of mothers who exhibited the first delay (delayed in decision making to seek care from the public health facilities) was 154(40.1%). Maternal unemployment [AOR, 2.5; 95%CI, 1.118, 5.441]; husband educational status [AOR, 2.3; 95%CI, 1.204, 4.408]; and antenatal care visit [AOR, 0.4; 95%CI, 0.277, 0.713] were the independent predictors of the first delay. Mothers who experienced the second delay (delayed in reaching to healthcare facility) were 114(29.7%). For this, distance [AOR, 14; CI, 7.895, 26.558]; uneducated mothers [AOR, 3; 95%CI, 1.397, 6.711]; and means of transportation [AOR, 0.6; 95%CI, 0.314, 0.995] were second delay determinants. Assessing of the 3rd delay (delayed in receiving healthcare), 125(32.6%) mothers did not get emergency obstetric care upon reaching to facility. The main predictors were multiple referral levels [AOR, 0.2; 95%CI, 0.068, 0.347]; absence of care provider [AOR, 1.7; 95%CI, 1.060, 2.697]; and lengthy admission process [AOR, 2.2; 95%CI, 1.279, 3.776]. Conclusions: The very high percentage of each delay in this study suggests low utilization of emergency obstetric care among labouring mothers. This study stresses the importance of addressing three delays alongside maternal health services to achieve in further reduction of delays.