Non-Institutional Childbirths and the Associated Socio-Demographic Factors in Gambella Regional State, Ethiopia

Determinants of non-institutional childbirth: Evidence from the Peruvian demographic and health survey

Objective

We aimed to evaluate the determinants of non-institutional delivery among women of childbearing age in Peru.

Methods

We conducted a secondary analysis of data from the Peru 2019 Demographic and Family Health Survey (ENDES). This multi-stage survey sampling is representative at the urban-rural, regional, and national levels. The outcome variable was place of delivery, collected by self-reporting. Binary logistic regression models were used to assess the factors associated with non-institutionalized delivery. Thus, we estimated crude and adjusted odd ratios (aOR). For the multivariable model, the manual forward selection method and the Wald test were used to obtain a final parsimonious model.

Results

The final sample included 14,061 women of reproductive age between the ages of 15 and 49. The prevalence of non-institutional delivery was 7.8 %. Multivariate regression analysis found that having a secondary education (aOR:0.48; 95 % confidence interval [CI]:0.39-0.58) or higher (aOR:0.57; 95 %CI:0.42-0.78); belonging to the second (aOR:0.26; 95 %CI:0.20-0.33), third (aOR:0.28; 95 %CI:0.21-0.38), fourth (aOR:0.21; 95 %CI:0.13-0.33), or fifth wealth quintile (aOR:0.15; 95 %CI:0.09-0.27); and suffering intimate partner violence (aOR:0.76; 95 %CI:0.64-0.91) were associated with lower odds of non-institutional delivery, while not having some type of health insurance (aOR:3.12; 95 %CI:2.47-3.95), living in a rural area (aOR:1.93; 95 %CI:1.54-2.42), and having had three or more deliveries (aOR:1.36; 95 %CI:1.07-1.72), were associated with higher odds of non-institutional delivery.

Conclusions

We found that not having health insurance, residing in a rural area, and having had three or more deliveries were factors associated with non-institutional delivery in women of childbearing age. We propose that should focus public health strategies towards providing education to women about maternal health, and likewise, facilitating access to specialized health centers for rural populations.

Practice of non-institutional delivery and its associated factors among women who gave birth in Southern Ethiopia, 2022

BACKGROUND

Non-institutional delivery is one of the major reasons that results in high mortality rates for a mother and her neonate. The World Health Organization estimates that only 43% of mothers have access to skilled delivery services. A recent Ethiopian Mini Demographic Survey indicated that more than half of Ethiopian women have given birth non-institutionally. This shows that maternal health remains a major public health challenge in Ethiopia, irrespective of the government's measures for institutional delivery. So, the aim of this study was to assess the practice of non-institutional delivery and its associated factors among women who gave birth in the study area.

METHODS

A community-based cross-sectional study was carried out on 260 study participants from June 1 to July 1, 2022, in Boloso Bombe Woreda. Data collection was done using a structured questionnaire, and systematic sampling techniques were used to select the study subjects. The data was entered into the EPI data version 3.1 and analyzed using SPSS version 25. The adjusted odds ratio, along with 95% confidence intervals, was used, and the level of statistical significance was declared at a P-value of 0.05.

RESULT

Out of 260 women interviewed, 252 (97%) pregnant women participated in the interview. The prevalence of non-institutional delivery among study participants was 68.7% (95% CI: 63.1-72.9). Mothers who were a daily laborer [AOR = 6.6;95%CI(3.6(1.2-11.2), last pregnancy planned [AOR = 0.4; 95%CI (0.4(0.2-0.8)), an absence of antenatal care contacting history [AOR = 3.3; 95%CI (1.3-8.6)], respondents' knowledge on the labor complication [AOR = 3; (95%CI); 3.5(2.2-6.1)], and place of first delivery [AOR = 8.7 95%CI(3.2-23)] were factors that significantly associated with practice of non-institutional delivery.

CONCLUSION

This study indicated that the majority of study participants practiced non-institutional delivery in this study area. Thus, we strongly recommend that all responsible bodies take immediate action, such as community health education on pregnancy-related complications, encouraging ANC visits, and raising awareness of the advantages of preventing non-institutional delivery in order to reduce non-institutional pregnancy practices and improve the factors identified.

Practice of Non-Institutional Delivery and Its Associated Factors Among Women Who Gave Birth in Southern Ethiopia, 2022

Background

Since 2000, the Ethiopian ministries of health and other stakeholders have taken some measures to enhance institutional delivery. However, the Ethiopian Demographic Health Survey 2019 report indicated that more than 50% of Ethiopian reproductive-age women gave birth outside health facilities. Therefore, the purpose of this study was to assess the practice of noninstitutional delivery among women who gave birth at Boloso Bombe Woreda (district) in southern Ethiopia.

Methods

A community-based cross-sectional study was carried out on 252 study participants from June to July 2022 in Boloso Bombe Woreda. Data collection was done using a structured questionnaire and systematic sampling techniques were used to select the study subjects. Data were entered into the EPI data, version 3.1, and analyzed using SPSS, version 25. Adjusted odds ratios (AORs), along with 95% confidence intervals (CIs), were used and the level of statistical significance was declared at a p-value of 0.05.

Results

In this study, 252 participants completed the survey, with a 97% response rate. The prevalence of noninstitutional delivery among study participants was 68.7% (95% CI: 63.1-72.9). In this study, mother's occupation, such as working as a daily laborer (AOR = 3.6; 95% CI [1.2-11.2]); absence of antenatal care history (AOR = 3.3; 95% CI [1.3-8.6]); poor knowledge of labor complications (AOR = 3.5; 95% CI [2.2-6.1]); and place of first delivery (AOR = 8.7; 95% CI [3.2-23]) were factors that were positively and significantly associated with the practice of noninstitutional delivery. However, last pregnancy planned was negatively associated with the practice of noninstitutional delivery (AOR = 0.4; 95% CI [0.2-0.8]).

Conclusions

This study indicated that the majority of study participants practiced noninstitutional delivery in this study area. Therefore, we strongly recommend that all responsible bodies should take immediate action to reduce the practice of noninstitutional delivery and improve those identified factors.

To what extent is antenatal care in public health facilities associated with delivery in public health facilities? Findings from a cross-section of women who had facility deliveries in Nigeria

BACKGROUND

Facility delivery remains an important public health issue in Nigeria. Studies have confirmed that antenatal care may improve the uptake of facility delivery. However, information is rarely available in Nigeria on the extent to which antenatal care in public health facilities is associated with delivery in public health facilities. The objective of the study was thus to examine the extent of the association between antenatal care in public health facilities and delivery in public health facilities in Nigeria. The study was guided by the Andersen behavioral model of health services use.

METHODS

The cross-sectional design was adopted. Data were extracted from the most recent Nigeria Demographic and Health Survey (NDHS). A sample of 9,015 women was analyzed. The outcome variable was the facility for delivery. The main explanatory variable was the antenatal care facility. The predisposing factors were maternal age, age at first birth, parity, exposure to mass media, and, religion. The enabling factors were household wealth, work status, partners' education, women's autonomy, health insurance, and, perception of distance to the health facility. The need factors were pregnancy wantedness, the number of antenatal care visits, and the timing of the first antenatal care. Statistical analyses were performed with the aid of Stata version 14. Two binary logistic regression models were fitted.

RESULTS

Findings showed that 69.6% of the women received antenatal care in public health facilities, while 91.6% of them subsequently utilized public health facilities for deliveries. The significant predisposing factors were age at first birth, parity, maternal education, and religion, while household wealth, work status, women's autonomy, and partners' education were the significant enabling factors. The timing of the first antenatal contact, pregnancy wantedness, and the number of antenatal care visits were the important need factors.

CONCLUSION

To a significant extent, antenatal care in public health facilities is associated with deliveries in public health facilities in Nigeria. It is imperative for governments in the country to take more steps to ensure the expanded availability of public health facilities in all parts of the country since their use for antenatal care is well-associated with their use for delivery care.

Magnitude, Trends, and Determinants of Institutional Delivery Among Reproductive Age Women in Kersa Health and Demographic Surveillance System Site, Eastern Ethiopia: A Multilevel Analysis

Background

Institutional delivery service utilization is a critical and proven intervention for reducing maternal and neonatal mortality. Institutional delivery service utilization can improve maternal health and wellbeing by ensuring safe delivery and reducing problems occurring during childbirth. In Ethiopia, almost all previous researches were cross-sectional studies and most of them were based on small sample sizes and there are no sufficient reports for the trends. Therefore, this study aimed to assess the magnitude, trends, and determinants of institutional delivery using surveillance data from the Kersa Health and Demographic Surveillance System (HDSS), in Eastern Ethiopia from 2015 to 2020.

Methods

The study was conducted among reproductive-aged women selected from the Kersa HDSS site, Eastern Ethiopia for the duration of 2015 to 2020. Data were extracted from the Kersa HDSS database system. After coding and recoding, the data was exported to R software for further analysis. A chi-squared test was used for trends to examine the significance of the change. A multilevel logistic regression model was fitted to identify determinants of institutional delivery. An adjusted odds ratio with a 95% confidence interval (CI) was used to measure the strength of the associations. Statistical significance was declared at a p-value < 0.05.

Results

A total of 20,033 reproductive age women were employed for analysis. The overall magnitude of institutional delivery was 45.03% with 95% CI (44.33–45.72). The institutional delivery has shown a decreasing trend over the 6 years' and there is statistical significance for the declining. Semi-urban resident [AOR = 2.33, 95% CI: 1.37–4.48], urban resident [AOR = 7.18, 95% CI: 5.24, 8.71], read and write [AOR = 1.54, 95% CI: 1.18, 2.01], literate [AOR = 1.46, 95% CI: 1.34–1.59], and antenatal care [AOR = 1.73, 95% CI: 1.58–1.88] were significantly associated with institutional delivery.

Conclusion

The magnitude of institutional delivery was relatively low and has shown a decreasing trend. Community-based interventions should be strengthened to reverse the decreasing trend of institutional delivery. Targeted information dissemination and communication should be provided to those mothers who have no formal education and attention should be given to rural residents.

The Effects of the Maternal Health Improvement Project in the Louga Region of Senegal

Maternal mortality remains a major global health challenge in sub-Saharan Africa. Senegal is one of the countries in the region that lagged behind in reaching the Millennium Development Goal 5, the deadline of which passed in 2015. The objective of this study was to assess the effects of information, education, and communication (IEC) activities conducted in Louga, Senegal. Community groups and facilitators conducted IEC campaigns, home visits, and various awareness-raising activities. This study used secondary data as part of the baseline and mid-term evaluations. Participants included women and men who had one or more children under five years of age. It was found that the level of awareness of at least three danger signs of pregnancy recognised by men significantly increased, and husbands/partners more frequently accompanied their wives during antenatal care in 2019 than in 2018. Women's empowerment improved significantly in terms of women making their own health decisions, joining community decision-making associations or groups, and using contraception. This project indicates that policies and programs are needed to increase men's involvement and empower women to further women's reproductive health to achieve the Sustainable Development Goal 3 and reduce maternal mortality in Senegal.