INTENTION TO USE INSTITUTIONAL DELIVERY SERVICE AND ITS PREDICTORS AMONG PREGNANT WOMEN IN YILMANA DENSA DISTRICT NORTHWESTETHIOPIA: USING THEORY OF PLANNED BEHAVIOR

Abstract

Abstract Background: Improving institutional delivery service is one of the most crucial strategies to reduce maternal and neonatal mortalities. Globally the proportion of health facility delivery is unacceptably low. In developing countries, only 50% of pregnant women deliver in health facilities. The recent Ethiopian Mini Demographic and Health Survey, 2019 showed that only 48% of pregnant women deliver in health facilities. Knowing the intentions of pregnant women to use institutional delivery service is the best predictor of behavior. However, evidence on intention to use institutional delivery is not known in Yilmana Densa District. Objective: This study aimed to assess magnitude of intention to use institutional delivery service and its predictors among pregnant women in Yilmana Densa district from February 15/2020 to March15/2020. Methods: Community-based cross-sectional study was conducted among pregnant women in Yilmana Densa District from February to March. The total sample size of the study was 645 participants. Multi-stage followed by cluster sampling technique was used to select the study participants. Data were collected by pretested intervieweradministered

questionnaire through a face-to-face interview technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with SPSS version 20. Multivariable binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors. Results: The magnitude of Intention to use institutional delivery service among pregnant women was 74.3%. Four and above antenatal care visit (AOR=3.37, 95%CI:1.29, 8.79),past experience of institutional delivery( AOR=3.69, 95%CI:1.90,7.12),Four and more parity ( AOR=0.23, 95%CI:0.11, 0.48 ),Good knowledge on institutional delivery ( AOR=2.48, 95%CI: 1.46, 4.22),rural residence (AOR=0.51, 95%CI:0.27, 0.95),favorable attitude( AOR=3.57, 95%CI:1.94 ,6.55) and high perceived behavioral control (AOR= 3.07,95%CI: 1.75 ,5.34:) were factors significantly associated with intention to use institutional delivery service. Conclusion and recommendation: Majority of the participants had intended to use institutional delivery service. Good Knowledge on institutional delivery, one or more antenatal care visit, past experience of institutional delivery, rural residence, one or more parity, favorable attitude, and high perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation, antenatal care and behavioral change communication programs are required in Yilmana Densa District to raise intention of pregnant women towards institutional delivery. Keywords: Intention, theory of planned behavior, Yilmana Densa district