Home Delivery and Associated Factors among Child Bearing Age Women Who Gave Birth in the Preceding Two Years in Zala District, Southern Ethiopia

Abstract

Introduction: A key intervention to achieve the goal of a reduction of maternal mortality is significant reduction of deliveries that occur at home. In Ethipia, the MMR has declined from 676/100,000 live births in 2011 to 420/100,000 live births in 2013 with a skilled attendant of 23% where 77% deliveries occurred at home without proper medical attention and care during childbirth. Little is known about cultural factors that contributed to home delivery. Therefore, this study aims to explore the cultural factors in adition to other factors that previous studies did not address in detail. Objective: To assess prevalence of home delivery and associated factors among child bearing age women who gave birth in the preceding two years in Zala District, Southern Ethiopia. Methods: A community based cross sectional study that triangulates quantitative with qualitative approaches was conducted from March 15 to April 10, 2015 on 447 women. Multistage sampling through simple random technique were employed to select study participants. Ten non-employed diploma and two degree level health professionals were recruited for data collection and supervision repectively after initial traing. Data were collected by pretested and structured questionnaire and entered and analyzed using EPI info 3.5.1 and SPSS version 20. Frequencies, binary and multiple logistic regression analysis were done. Associations were determined by using OR at 95% CI and p ≤0.05. Results: The prevalence of home delivery is found to be 67.6%. The factors that significantly affected home delivery in this study were place of residence (AOR: 5, 95% CI: 2.2, 12),women age at interview (AOR: 2.78, 95% CI: 1.2, 6.5), women’s education (AOR: 5.8, 95% CI: 2.86, 11.8), antenatal care (AOR: 3, 95% CI: 1.3, 8.5), time to reach the nearest health facility (AOR = 4.5, 95% CI = 2.2, 9), family size ( AOR= 3.9, 95% CI=2,16.77) and attitude of the mother on maternal services (AOR=3.7 95% CI= 2.2,6). Conclusions: Home delivery is highest in the study area. The most important factors that determine home delivery appear to be women’s education status, number of ANC visit, time to reach the nearest health facility and age and attitude of the women. Actions targeting the maternal education, encouraging number of ANC visits, making health facilities in accessible distance and conducting behavioral change communication were the crucial areas to tackle giving birth at home.