The Trend Of Deeterminants Of Home Delivery In Ethiopia From 1995 To 2016

Back ground: The world health organization (WHO) has reported that the proportion ofrndeliveries attended by skilled health providers rose from 58% in 1990 to 68% in 2008rnworldwide, but remained at only about 50% in Africa. This study therefore tried to identifyrntrends of home delivery and changes in each associated factor over time in Ethiopia.rnObjective: To analyze the trend of determinants of home delivery since 1995 to 2016 so as to rnidentify areas of intervention to decrease home delivery in Ethiopia.rnrnDesign: Retrospective analytical study design selected to assess the trend of determinants ofrnhome delivery rate since 1995 to 2016 so as to identify areas of intervention to decrease homerndelivery in Ethiopia using 2000, 2005, 2011 and 2016 demographic and health surveys. Analysisrndone based on 43,029 women who had given birth in the five-year preceding each survey.rnrnResult: Of all respondent 36163 (84%) of them gave birth at home and the remaining 6866(16%)rndelivered at health institutions. The highest home delivery prevalence is seen in Affar (94.2%),rnOromiya (92%) and SNNPR (91%). The Home delivery rate decline is greater in women agerngreater than 34 years (1.4%/year) than women in other age group. The highest rate of 93.3% wasrnreported among women whose age at first marriage was teenager. Interestingly, home deliveryrnrate trend in women high level of education shows small increment by 0.3% each year. Thernanalysis also found that plateau change of home delivery rate in married women. This studyrnshows home delivery rate decline among women from the ‗rich‘ and ‗middle‘ householdrn(2%/year) but for those women from the ‗poor‘ household (1.1%/year). About 17.6 times declineof home delivery rate in women who watch TV almost every day than who watch TV less thanrnonce a week. The trend line for women with no ANC visit almost had no change. Though therntrend in rural area was not having change until 2010, but it show major curve (by about 7%)rnchange since then. The steepest decline is seen in Tigray region by more than 3% per year. InrnAffar, Oromia and Somali regions the analysis show plateau home delivery rate.rnrnDiscussion: With the current drop rate of home delivery revealed in this research i.e., 1.3% perrnyear, it will take 32 year to achieve MDGs of universal access to reproductive health. Thoughrnhistory of abortion, contraceptive use and pregnancy plan are interrelated health issue, thernfinding show home delivery rate is less affected by whether the pregnancy is planned or not thanrnthe other two factorsrnrnConclusion: This study underscores that strategies to decrease home delivery prevalence in the rncountry requires a multifaceted approach that encompasses several preventive interventions suchrnas reduce the likelihood that a woman will become pregnant, improving women education,rnincome and access to media, using ANC as utility to decrease home deliver, encouraging lowrnenforcement in preventing teen age marriage and pregnancy and involving religious leaders;rnspecially traditional religious leaders; in implementations of policy and strategy. This studyrncouldn‘t unknot the real reason of the mothers not to utilize to institutional delivery services. Indepthrnqualitativernstudyrnwillrnfurtherrnhelprntorngainrnbetterrninsightrnintornthese.

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