Obstetrics and Gynecology

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Browsing Obstetrics and Gynecology by Subject "Home delivery"

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    The Trend of Deeterminants of Home Delivery in Ethiopia from 1995 to 2016
    (Addis Abeba University, 2021-07) Alemayehu, Liben; Dr.Negash, Shiferaw(Assoc. prof. of obstetrics and gynecology and gynecologic oncologist); Dr.Arage, Seid(Asst. prof. of obstetrics and gynecology)
    Back ground: The world health organization (WHO) has reported that the proportion of deliveries attended by skilled health providers rose from 58% in 1990 to 68% in 2008 worldwide, but remained at only about 50% in Africa. This study therefore tried to identify trends of home delivery and changes in each associated factor over time in Ethiopia. Objective: To analyze the trend of determinants of home delivery since 1995 to 2016 so as to identify areas of intervention to decrease home delivery in Ethiopia. Design: Retrospective analytical study design selected to assess the trend of determinants of home delivery rate since 1995 to 2016 so as to identify areas of intervention to decrease home delivery in Ethiopia using 2000, 2005, 2011 and 2016 demographic and health surveys. Analysis done based on 43,029 women who had given birth in the five-year preceding each survey. Result: Of all respondent 36163 (84%) of them gave birth at home and the remaining 6866(16%) delivered at health institutions. The highest home delivery prevalence is seen in Affar (94.2%), Oromiya (92%) and SNNPR (91%). The Home delivery rate decline is greater in women age greater than 34 years (1.4%/year) than women in other age group. The highest rate of 93.3% was reported among women whose age at first marriage was teenager. Interestingly, home delivery rate trend in women high level of education shows small increment by 0.3% each year. The analysis also found that plateau change of home delivery rate in married women. This study shows home delivery rate decline among women from the ‗rich‘ and ‗middle‘ household (2%/year) but for those women from the ‗poor‘ household (1.1%/year). About 17.6 times declineof home delivery rate in women who watch TV almost every day than who watch TV less than once a week. The trend line for women with no ANC visit almost had no change. Though the trend in rural area was not having change until 2010, but it show major curve (by about 7%) change since then. The steepest decline is seen in Tigray region by more than 3% per year. In Affar, Oromia and Somali regions the analysis show plateau home delivery rate. Discussion: With the current drop rate of home delivery revealed in this research i.e., 1.3% per year, it will take 32 year to achieve MDGs of universal access to reproductive health. Though history of abortion, contraceptive use and pregnancy plan are interrelated health issue, the finding show home delivery rate is less affected by whether the pregnancy is planned or not than the other two factors Conclusion: This study underscores that strategies to decrease home delivery prevalence in the country requires a multifaceted approach that encompasses several preventive interventions such as reduce the likelihood that a woman will become pregnant, improving women education, income and access to media, using ANC as utility to decrease home deliver, encouraging low enforcement in preventing teen age marriage and pregnancy and involving religious leaders; specially traditional religious leaders; in implementations of policy and strategy. This study couldn‘t unknot the real reason of the mothers not to utilize to institutional delivery services. Indepth qualitative study will further help to gain better insight into these.