Maternal Delays for Institutional Delivery and Associated Factors Among Postnatal Mothers at Public Health Facilities of Gamo Zone, Southern Ethiopia

Background: Maternal health delays like delay in deciding to seek care, reaching a health facility, and receiving appropriate care were identified as the main contributing factors for maternal mortality and morbidity in many developing countries including Ethiopia. However, little is known about the magnitude and factors predisposing for maternal health delays in Ethiopia especially in a rural part of the country. Therefore, the aim of this study is to assess the magnitude of maternal delays for institutional delivery and associated factors among mothers attending post-natal service at public health facilities of the Gamo zone, Southern Ethiopia. Methods: A cross-sectional study was conducted in rural districts of Gamo zone. Eleven public health centers in the two districts were selected randomly. The Systematic random sampling method was used to select study participants from each public health centers. A total of 394 postnatal mothers were selected every secondly and interviewed in a separate room. Face to face interview methods were used to collect the data. Binary and multivariable logistic regression analyses were conducted to identify the associated factors for the three delays. Results: The magnitude of first, second and third maternal delays were 46.80%, 44.00%, and 31.70%, respectively. Unemployed women [AOR: 2.20, 95% CI (1.15, 4.16)], birth preparedness [AOR: 2.70, 95% CI (1.29, 5.71)], husband's decisions making [AOR: 6.00, 95% CI (2.87, 12.42)] were found to be significantly associated with first delay. Distance to health facility [AOR: 7.00, 95% CI (3.58, 13.71)], and means of transportation [AOR: 3.30, 95% CI (1.13, 9.54)] were found to be significantly associated with the second delay. Availability of obstetric drugs [AOR: 8.40, 95% CI (3.76, 18.76)], and availability of skilled health provider [AOR: 10.40, 95% CI (4.24, 25.69)] were found to be significantly associated with the third delay for institutional delivery. Conclusion: The magnitude of first, second and third maternal delays were high which indicates that most mothers were not receiving institutional delivery services at the recommended time. Maternal socio-economic, obstetric factors and health-care system factors affected the three delays in this study. Therefore, improving women empowerment and resource availability at health facilities is vital.