Determinants of Institutional Delivery in Ethiopia: A cross-sectional study

Background & aim: Government of Ethiopia is promoting institutional delivery despite the fact that there are a high number of home deliveries in the country mainly in hard-to-reach areas. Choice of institutional delivery is vital for the reduction of maternal and neonatal mortalities. The present study aimed to investigate the determinants of institutional delivery in Ethiopia. Methods: This cross-sectional survey was conducted on 11023 women (age range: 15-49 years) who delivered in the preceding five years before the 2016 Ethiopian demographic health survey in Ethiopia from January 18, 2016 to June 27, 2016. The primary outcome variable was institutional delivery. Statistical analysis was performed using SPSS software (version 20). The multivariate logistic regression was used to identify variables that had a significant association with institutional delivery (P<0.05).  Results: Institutional delivery was 4.36 times higher in women with secondary education (OR: 4.36; 95% CI: 3.12-6.09). In addition, it was threefold higher among the subjects who were the residents of urban areas (OR: 3.26; 95% CI: 2.19-4.35). Institutional delivery was higher among women who had antenatal care (ANC) visits (OR: 1.81; 95% CI: 1.58-2.07) and watched television at least once a week (0R: 1.90; 95% CI: 1.35-2.66). Based on the wealth index, the wealthiest subjects were 2.61 times more likely to deliver in health institutions (OR: 2.61; 95% CI: 1.95-3.50). Conclusion: Having higher educational levels, being wealthy, residing in urban areas, having ANC visits at least once, and watching television at least once a weak were considered as important determinants for the choice of institutional delivery.