UTILIZATION OF INSTITUTIONAL DELIVERY SERVICE AND ASSOCIATED FACTORS IN SEKOTA TOWN: USING ANDERSON’S HEALTHCARE UTILIZATION MODEL

Abstract

Abstract Background: Utilization of institutional delivery service is one of the main and proven interventions to reduce maternal complications and death. It ensures safe birth, reduces both actual and potential complications, and increases the survival of most mothers and newborns. Maternal health is becoming a worldwide alarm because the lives of billions of women in reproductive age can be safe guarded through use of institutional delivery service. The high number of maternal mortality in under developing countries is due to low level of maternity health care seeking behavior. Ethiopia is the main contributor to the global death of mothers in giving poor institutional delivery services. Objective: The objective of this study is to assess utilization of institutional delivery services and associated factors among women who give birth in Sekota district, Amhara region, North East Ethiopia, 2020. Methods: A quantitative then qualitative methods study was carried out in Sekota district. Interviewer administered structured and pretested questionnaire was used to collect the data. The data was coded and entered in to a computer by using EPI data 3.1 and then exported to SPSS version 20 for analysis. To confirm the association, variables found to have association in the bivariate analysis were transferred to a final multivariable model. Moreover, multivariable logistic regression analysis was used to control confounders and check the separate effects of the various factors associated with utilization of institutional delivery services. Results: In this study the magnitude of institutional delivery service utilization among mothers who utilized delivery care in Sekota woreda were 61.7% within 95 % CI (56.3 - 66.9).The study revealed that Autonomous women (AOR =0.29, 95% CI =0.09-0.96), know benefits of giving birth at health facility (AOR =6.19, 95% CI = 1.77 - 21.67), family size (AOR =2.98, 95% CI =1.013 - 8.78), type of health facility (AOR =5.297, 95% CI =1.86 15.08),know most complication are preventable had significant association with institutional

delivery.

A total of four experts were interviewed; they says factors are inadequate skilled professionals, lack of in service training, shortage of equipment's and supplies, low maternal knowledge on benefits of HF delivery and risks of HD at the existing institutions. The observation focused on infrastructure, basic facilities, equipment’s, supplies, and some essential drugs. Conclusion: Factors affecting institutional delivery service utilization are related to the user (women) and provider (health system) those are interrelated to each other. Consequently, women education, promotion of maternal education, prenatal care utilization, information education, and communication on obstetric risks and general health service expansion were recommended. Keywords: delivery place, delivery service utilization, Sekota district.