Abstract:
Background: Home delivery is the most frequent childbirth practice in Ethiopia and brings health risks for many
mothers and their babies which in turn affecting the whole families. Characterizing the spatial variations and the
associated factors of home deliveries after antenatal care visit is necessary to prioritize risks and facilitate geographically
based interventions.
Method: A community-based cross-sectional study design was carried out between February and March 2016. A total
of 528 women who had just given birth were interviewed face-to-face using a questionnaire. Geo-referenced
data were collected using a handheld global positioning system (GPS). The Bernoulli model was applied using
the SatScan ™ software to analyze the purely spatial clusters of home deliveries. ArcGIS version 10.1 was used
to visualize clusters of home delivery.
Results: The overall proportion of home deliveries was 278(52.7%), and home deliveries had spatial variations.
A primary cluster [LLR = 14.54, p < 0.001] was detected in village of Safida Giorgis. Secondary clusters were
detected in Checheho [LLR = 9.17, p < 0.05] and ZurAmba [LLR = 8.51, p < 0.05]. Predictors for home delivery included
the distance between the health extension worker’s and mother’s house [AOR = 2.2, 95% CI: 1.1, 4.3], residence [AOR =
3.8, 95% CI: 1.3, 10.9], source of information for ANC [AOR = 0.3, 95% CI: 0.13, 0.7], ANC visits [AOR = 6.1, 95% CI:1.9, 19.3],
health education [AOR = 3.4, 95% CI: 1.5, 7.4], decision on place of delivery [AOR = 0.3, 95% CI: 0.1, 0.8], and knowledge
on place of delivery [AOR = 0.04, 95% CI: 0.0, 0.1].
Conclusion: The proportion of home delivery after ANC visit was decreasing compared to other studies conducted in
the region. In addition, spatial variations of home delivery were observed in the study area. Promoting women’s
education and behavioral change communication at the grass root level, provision of the services both at home and
health facilities and improving the quality and capacity of the health providers are some of the recommendations
forwarded.
