Determinants of Home Delivery Among Recently Delivered Women in Zala Woreda, Southern Ethiopia

Abstract

A key intervention to achieve the goal of maternal mortality reduction in deliveries that occur at home is
significant. In Ethiopia, the MMR has reduced from 676/100,000 live births in 2011 to 420/100,000 live
births in 2013 with a skilled attendant of 23%, whereas 77% deliveries occurred at home without proper
medical attention and care during childbirth. Little is known about cultural factors that contribute to home
delivery. Therefore, this study aimed to explore the cultural factors and other factors in detail that
previous studies did not address in detail and assess prevalence of home delivery and associated factors
among child bearing age women who gave birth in the preceding two years in Zala Woreda, Southern
Ethiopia. A community based cross sectional study that triangulates quantitative with qualitative
approaches was conducted from March 15 to April 10, 2015. Multistage sampling through simple random
technique was employed to select 447 study participants. Bivariate and multivariable analyses were
carried out to identify factors associated with home delivery. Qualitative data was analyzed thematically
and results were triangulated with the quantitative data. Associations were determined by using OR at
95% CI and p≤0.05. 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 to maternal services (AOR=3.7 95% CI= 2.2,
6). 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 visits, time to reach the nearest health facility
and age and attitude of the women towards home delivery. Actions targeting maternal education,
encouraging number of ANC visits, making health facilities in accessible distance and conducting
behavioral change communication were the crucial areas to tackle in giving birth at home.