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Background: Ethiopia is one of the countries with the highest maternal mortality ratio 676/100,000 livebirths and the lowest skilled delivery at birth (10%) in 2011. Skilled delivery care and provision of emergency obstetric care prevents many of these deaths. Despite implementation of birth preparedness and complication readiness (BPACR) packages to antenatal care users since 2007 in the study area, yet overwhelming proportion of births take place at home. The effect of birth preparedness and complication readiness on place of delivery is not well known and studied in this context.
Objective: To determine the effect of birth preparedness and complication readiness of mothers and other factors on place of delivery among women who gave birth in the last 12 months, Goba Wereda, February, 2014.
Methodology: A community based case control study preceded by initial census was conducted on a total of 358 sampled respondents (119 cases and 239 controls) who were selected using stratified-multistage sampling technique. A pre-tested and standardized questionnaire with a face-to-face interview was used to collect the data, then data was cleaned, coded and entered in to SPSS version-21, binary logistic regression models were run to identify predictors of place of delivery, Odds ratio with 95%CI was used to assess associations at a 0.05 level of significance.
Result: The response rate was 118(99.1%) and 238(99.5%) for the cases and the controls respectively. Mean(±SD) age of 27.41(±5.8) and 28.84(±5.7) years for the cases and the controls respectively. Health facility delivery accounts to 285(32.9%) and home delivery accounts to 579(67.1%) of the deliveries. And 94(79.7%) and 81(34.0%) of the cases and the controls respectively were well-prepared for birth and complication. Maternal education, religion, distance from health facility, knowledge of availability of ambulance transport and history of obstetric complication were independent predictors of place of delivery (P-value <0.01). BPACR practice had an independent effect (AOR =2.55, 95%CI: 1.12, 5.84) on place of delivery.
Conclusion and Recommendation: The study identified abetter institutional delivery utilization among mothers who were well-prepared for birth and complication. BPACR services should be further strengthened to enables women recognize danger signs and access skilled caregiver for all deliveries. |
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