Place of delivery and associated factors among pastoralist community mothers who gave birth in the past 12 months in Liben district of Guji zone, Southern Ethiopia, 2015

Abstract

Background: In 2012, 40 million births in developing regions were not attended by skilled health personnel, and over 32 million of those births occurred in rural areas. Home delivery if was not conducted by professionals increase the risk of transmission of HIV/AIDS to relatives or traditional birth attendants who conduct deliveries without protective equipment’s. It is estimated that 85% of births in Ethiopia occur at home without skilled attendance though, 40% receive some level of antenatal care from a skilled provider (that is, from a doctor, nurse, or midwife) for their most recent birth. In 2014 Oromia regional health bureau report, in Liben District, even though large numbers of mothers attend antenatal clinic at least once is 84.7% in their period of pregnancy, only 12.3% deliver in health institutions. Objective: aim this study was to assess place of delivery and identify associated factors among mothers of pastoralist community who gave birth in the past 12 month in Liben District of Guji zone, Ethiopia, 2015 Methods: A community based cross-sectional study was conducted from March 15 to April 6, 2015, among 645 mothers who gave birth in the past 12 months in Liben pastoralist District of Guji Zone, Oromia region. Study participants were selected by multistage sampling technique. Data were collected by eight trained primary school teachers by face-to-face interview using structured questionnaire. Descriptive statistics was conducted to determine prevalence of outcome (place of delivery) and describe distribution of different factors. Bivariate and multivariable logistic regressions were conducted to identify factors independently associated with place of delivery. Odds ratio (OR) was used as a measure of association. P-value < 0.05 was used to declare statistical significance. Results: A total of 645 (99.4%) mothers participated in the study. Out of all deliveries, only 167(25.9%) took place at health institutions. Attending at least primary school [AOR = 5.82, (95%CI: (2.64, 12.83)], having sufficient knowledge on danger signs of pregnancy and labor [AOR = 12.99, (95%CI: (5.43, 31.06)], having hospital [AOR = 4.08, (95%CI: (1.95, 8.55)] and health center [AOR = 2.71, (95%CI: (1.04,7.04) in the vicinity, had no previous experience of delivery at HI [AOR = 0.06, (95%CI): (.02, .21)], middle [AOR = 0.27, (95%CI: (.10, .73)] and high wealth quintile[AOR = 0.37, (95%CI: (.14-.98)], Had no ANC visit [AOR = 0.54, (95%CI: (.06,0.75)]and 1 to 3 ANC visit [AOR = 0.27, (95%CI: (.12,.61)], Husband/relative decided place of birth [AOR = 12.73, (95%CI): (5.05, 32.05)], previous obstetric history [AOR = 0.003, (95%CI): (.001, .031)], satisfied with service provided at HI[AOR = 3.77, (95%CI: (1.63, 8.75)] were factors independently associated with place of delivery. Conclusion Even though 97%of the mothers attended at least one ANC visit, only 25.9% of them delivered at health institutions and the rest majority delivered at home with help of relatives or TBAs depicting gap between ANC and delivery care. Educational status of mothers, knowledge of mothers, economic status, level/type of health institution, perceived quality of service, use of ANC, previous obstetric history, decision maker of place of birth and previous delivery at health institutions were factors associated with place of delivery.