Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility–based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility–based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility–based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.
A community-based cross-sectional study was carried out from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years in Gindhir District. The estimated total population of the District was 164,703, of which 36,449 of the population are in a childbearing age of 15–49 years. In this District, there are five urban and 32 rural kebeles, which are the lowermost administration in Ethiopia. Within the District, there are one Hospital, 8 health centers, and 32 health posts. 32 The source and study populations were all women who had given birth in the past 2 years in the Gindhir District. All mothers in selected kebeles from Gindhir District who gave birth in the past 2 years were included in the study, and mothers with any known illness or pain that may have rendered them unable to hear or listen, talk, or respond to questions were excluded from the study. The sample size was calculated using a single population proportion formula: P (proportion of facility-based delivery service utilization: 34%), 33 margin of error (5%), a design effect of 2, and a 10% non-response rate. Accordingly, the sample size was found to be 759. For this study, a stratified multi-stage sampling technique was used to include the respondents. Primarily, the district was stratified into urban and rural kebeles. The sampling frame was prepared with the list of mothers who gave birth at the nearby healthcare facilities (health post, health center, and hospital) of selected kebele in the past 2 years. From each stratum (urban and rural), 3 urban and ten rural kebeles and study participants (mothers) were selected using simple random sampling (lottery method). To access mothers who have given birth in the past 2 years, health extension workers and women’s development army leaders of each kebele were used. The data collection tool was adapted from previous studies conducted in different parts of Ethiopia that could satisfy the objectives and variables under the study.34-36. The data collection tool was primarily prepared in English and translated into the local language, “Afan Oromo,” then translated back into the English language to check its consistency. The data collectors and supervisors were trained for 1 day on data collection tools and methods. The data collection tool was pretested among 5% of the total sample (38 mothers) in 2 kebeles not included in the study. The data collectors were ten health extension workers who were not working in the healthcare facility of a selected kebele and were supervised by 3 public health professionals. A structured data collection tool was used to collect data through a face-to-face interview. The completeness of collected data was checked manually, coded, and entered using EPI Data version 3.1 and exported to IBM statistical package for social science version 23 for data processing and analysis. The outcome variable of this study was assessed using the item, “is the mother giving birth to the last child in the health facility by trained birth attendants in the past two years?” (categorized as “Yes” if the mother gives birth at the health facility and “No” if the mother gives birth at home).” On the other hand, knowledge of maternal health services was assessed using 11 items (coded as Yes = 1 and No/I don’t know = 0), and mothers who scored >50% were considered to have good knowledge and those who scored below ≤50% as having poor knowledge. The frequency tables and charts were used in descriptive analysis. All required assumptions were checked to apply multivariable logistic regression to identify factors associated with the outcome variable. In this regard, Hosmer and Lemeshow’s model fitness test was used, and multicollinearity of independent variables was checked using variance inflation factor (VIF). The variables with a P-value .20 in the bivariable analysis can be candidates for the multivariable binary logistic regression. If the P-value was <.05 with a 95% confidence level, all variables in the multivariable logistic regression analysis were considered statistically significant.
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