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Abstract
Objective This study aimed to assess the trends and factors that had contributed to the change in home delivery in Ethiopia over the last decade.
Design, setting and analysis A nationally representative repeated cross-sectional survey was conducted using 2005, 2011 and 2016 Ethiopian Demographic and Health Surveys. Multivariate decomposition logistic regression analysis was employed to identify significant factors that have been contributed to the change in home delivery. Level of statistical significance was declared at a two-sided p value <0.05.
Outcome measure Trends of home delivery.
Participants A total of 33 482 women were included.
Results Home delivery has been decreased by 21% over the last decade in Ethiopia. In the last decade, 39% of the decrements in home delivery attributed to change in women’s compositional characteristics. Antenatal care visits, educational status of the women and husband, birth order, religion, wealth index and distance from a health facility were the main sources of compositional change factors for the change of home delivery. Behavioural changes towards health facility delivery contributed approximately two-thirds of the decline of home delivery in Ethiopia. Antenatal care visits, birth order and religion have significantly contributed to the change of home delivery resulted from behavioural changes towards healthcare facility utilisation over the last decade.
Conclusion Despite the importance of health facility delivery, a significant number of women still deliver at home in Ethiopia. Women’s compositional characteristics and behaviour changes were significantly associated with the change in home delivery. Multisectoral educational intervention is needed to change women’s attitudes towards home delivery. Antenatal care coverage and healthcare facility coverage should increase thereby to improve healthcare facility based-delivery practice. Further research needs to be done to explore the potential barriers of health facility delivery from a religious perspective.
- epidemiology
- public health
- quality in health care
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Footnotes
Contributors SAT, ZTT and STY were involved in this study from the inception to design, acquisition of data, data cleaning, data analysis and interpretation and drafting and revising of the manuscript. ALM and MMS were involved in project administration, principal supervision and revising the final manuscript. All authors read and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The authors had submitted a concept note to Demographic and Health Surveys
(DHS) programme/ICF International, and permission has been issued by the International Review Board of DHS programme data archivists to download the dataset for this study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. The data were available from the corresponding author, and we can provide on reasonable request.