Deyessa, Negussie(PhD)Gizaw, Tefferi2018-07-122023-11-052018-07-122023-11-052016-06http://etd.aau.edu.et/handle/123456789/8224Background: -Maternal death from preventable causes related to pregnancy and child birth is unacceptably high. Institutional delivery plays an important role to avert maternal death from such causes. Only16% of women delivered at health facility by 2014 in Ethiopia. Therefore, themainaim of this study is toassess the magnitude and determinantsof utilization of institutional delivery among mothers who utilized antenatal carein SodoWoredaGurage Zone, Southern Ethiopia. Methods: A community based cross-sectional study was conducted in selected kebele of SodoworedaGurage zone. By using systematic sampling technique, a total of 559 eligible mothers were included in the study. The data were collected using interviewer administered structured questionnaire. Data were entered into EPI data 7.0 computer programs and analyzed using SPSS version 21. Crude and adjusted odds ratios were calculated through simple and binominal multiple logistic regressions model. Result: Out of the 559 respondents, only 366 (65.5%) gave birth to their last child at health facility.Maternal educational statusAOR =5.52;95% CI; 1.45, 20.94,time travel on foot from the nearbyhealth centerAOR = 3.57; 95% CI; 1.57, 8.19],number of ANC visits at last pregnancyAOR = 4.54; 95% CI; 2.00, 10.31, autonomy to decide their place of delivery lonely or jointly with their husband AOR = CI; 4.10, 14.08, and accessibility of transportation serviceAOR =2.65;95% CI; 1.67, 4.20were found to be significantly associated with the institutional delivery service utilization. Conclusion:The institutional delivery rate in this study was higher than the national and regional report by 2014 but less compare to ANC usersto this study area. The major factors that were significantly associated with this low utilization of institutional delivery were maternal level of education , time taken to reach the nearby by health facility, maternal autonomy on deciding place of delivery, accessibility of transportation and the frequency of ANC Information, education, communication, and empowering mothers is essential, and could help them in decision making regarding their own health, being committed to use the services and able to persuade their partner and family members if they encountered opposition.And expansion of facility delivery & transport service to address the need of mothersenMaternal DeathThesis