Background
Methods
Research site and population
Study design and data collection
Selected study variables
Data storage and analysis
Results
Response rate and descriptive statistics
Variables | Institutional N (%) | Non-institutional N (%) | Total N (%) |
---|---|---|---|
Place of delivery
| 976 (48.2) | 1050 (51.8) | 2026 (100) |
Age group (years)
| |||
< 20 | 90 (9.2) | 76 (7.2) | 166 (8.2) |
20 – 24 | 301 (30.8) | 340 (32.4) | 641 (31.6) |
25 – 29 | 244 (25.0) | 246 (23.4) | 490 (24.2) |
30 – 34 | 160 (16.4) | 159 (15.1) | 319 (15.8) |
≥ 35 | 181 (18.6) | 229(21.8) | 410 (20.2) |
Marital status
| |||
Single/Divorced/Widowed | 153 (15.7) | 150 (14.3) | 303 (15.0) |
Married | 823 (84.3) | 899 (85.7) | 1722 (85.0) |
Education level
| |||
No education/dropped out from primary | 312 (32.0) | 530 (50.5) | 842 (41.6) |
Primary level | 421 (43.1) | 396 (37.7) | 817 (40.3) |
Secondary level or higher | 243 (24.9) | 124 (11.8) | 367 (18.1) |
Occupation
| |||
Subsistence farmer | 528 (55.5) | 597 (57.3) | 1125(56.4) |
Domestic worker/student | 94 (9.9) | 114 (10.9) | 208 (10.4) |
Other skilled employee | 330 (34.7) | 331 (31.8) | 661 (33.2) |
Literacy in English
| |||
Illiterate | 169 (17.4) | 309 (29.4) | 478 (23.6) |
Literate | 804 (82.6) | 741 (70.6) | 1545 (76.4) |
Maternal health knowledge
| |||
Low | 116 (11.9) | 199 (19.0) | 315 (15.6) |
Middle | 426 (43.7) | 506 (48.3) | 932 (46.1) |
High | 432 (44.4) | 343 (32.7) | 775 (38.3) |
ANC visits
| |||
Less than 4 times | 358 (36.7) | 544 (51.8) | 902 (44.5) |
4 times or more | 618 (63.3) | 506 (48.2) | 1124 (55.5) |
Birth interval
| |||
Short birth interval (<24 months) | 30 (3.1) | 51 (4.9) | 81 (4.0) |
Medium birth interval (24–47 months) | 78 (8.0) | 107 (10.2) | 185 (9.1) |
Long birth interval (>48 months) | 539 (55.2) | 690 (65.7) | 1229 (60.7) |
First birth | 329 (33.7) | 202 (19.2) | 531 (26.2) |
Household wealth index
| |||
Poorest | 154 (16.3) | 272 (26.6) | 426 (21.7) |
Poor | 299 (31.6) | 350 (34.3) | 649 (33.0) |
Middle | 226 (23.9) | 213 (20.9) | 439 (22.3) |
Rich | 110 (11.6) | 88 (8.6) | 198 (10.1) |
Richest | 157 (16.6) | 98 (9.6) | 255 (13.0) |
Media and communication equipment
| |||
Possession of one item or none | 277 (28.4) | 416 (39.7) | 693 (34.2) |
2 items | 544 (55.7) | 545 (52.0) | 1089 (53.8) |
All items | 155 (15.9) | 88 (8.4) | 243 (12.0) |
Number of household members
| |||
5 or more | 627 (64.2) | 772 (73.5) | 1399 (69.1) |
Less than 5 | 349 (35.8) | 278 (26.5) | 627 (31.0) |
Number of children under five
| |||
2 or more | 584 (59.8) | 736 (70.1) | 1320 (65.2) |
Less than 2 | 392 (40.2) | 314 (29.9) | 706 (34.9) |
Household sanitation practice
| |||
No sanitation facilities | 33 (3.4) | 95 (9.1) | 128 (6.3) |
Possession of at least one | 320 (32.8) | 464 (44.2) | 784 (38.7) |
Possession of two | 319 (32.7) | 281 (26.7) | 600 (29.6) |
Possession of all | 304 (31.2) | 210 (20.0) | 514 (25.4) |
Traveling time to nearest health facility
| |||
More than 60 min | 125 (12.8) | 185 (17.6) | 310 (15.3) |
41 – 60 min | 257 (26.3) | 304 (29.0) | 561 (27.7) |
21 – 40 min | 349 (35.8) | 401 (38.2) | 750 (37.0) |
20 min or less | 245 (25.1) | 160 (15.2) | 405 (20.0) |
Usual transportation
| |||
On foot | 822 (84.4) | 949 (90.5) | 1771 (87.5) |
Any other means of transportation | 152 (15.6) | 100 (9.5) | 252 (12.5) |
Performance of CHWs
| |||
Poorest | 357 (36.6) | 373 (35.6) | 730 (36.1) |
Poor | 82 (8.4) | 103 (9.8) | 185 (9.2) |
Middle | 200 (20.5) | 193 (18.4) | 393 (19.4) |
High | 182 (18.7) | 230 (22.0) | 412 (20.4) |
Highest | 154 (15.8) | 148 (14.1) | 302 (14.9) |
Social capital
| |||
Lowest | 171 (17.5) | 194 (18.5) | 365 (18.0) |
Low | 193 (19.8) | 185 (17.6) | 378 (18.7) |
Middle | 229 (23.5) | 263 (25.1) | 492 (24.3) |
High | 217 (22.2) | 211 (20.1) | 428 (21.1) |
Highest | 166 (17.0) | 197 (18.8) | 363 (18.0) |
Factors associated with institutional delivery
Variables | Bivariable analysis | Multivariate analysis | ||
---|---|---|---|---|
Unadjusted odds ratio (OR) | 95% CI | Adjusted OR | 95% CI | |
Age group (years)
| ||||
< 20 | Ref. | |||
20 – 24 | *0.628 | 0.430-0.917 | ||
25 – 29 | 0.740 | 0.502-1.091 | ||
30 – 34 | 0.735 | 0.486-1.111 | ||
≥ 35 | **0.564 | 0.380-0.837 | ||
Marital status
| ||||
Single/Divorced/Widowed | Ref. | Ref. | ||
Married | 0.908 | 0.695-1.187 | 1.219 | 0.892-1.665 |
Education level
| ||||
No education/dropped out from primary | Ref | Ref. | ||
Primary level | ***1.886 | 1.522-2.338 | ***1.628 | 1.287-2.058 |
Secondary level or higher | ***3.427 | 2.567-4.540 | ***2.354 | 1.710-3.241 |
Occupation
| ||||
Subsistence farmer | Ref. | |||
Domestic worker/student | 1.019 | 0.746-1.394 | ||
Other skilled employee | 1.232 | 0.995-1.525 | ||
Literacy in English
| ||||
Illiterate | Ref. | |||
Literate | ***1.984 | 1.573-2.502 | ||
Maternal health knowledge
| ||||
Low | Ref. | Ref. | ||
Middle | 1.271 | 0.956-1.691 | 1.130 | 0.829-1.540 |
High | ***1.955 | 1.458-2.622 | **1.539 | 1.113-2.129 |
ANC visits
| ||||
Less than 4 times | Ref. | Ref. | ||
4 times or more | ***1.848 | 1.523-2.243 | ***1.660 | 1.343-2.052 |
Birth interval
| ||||
Short birth interval (<24 months) | Ref. | Ref. | ||
Medium birth interval(24–47 months) | 1.234 | 0.687-2.218 | 1.475 | 0.784-2.776 |
Long birth interval (>48 months) | 1.288 | 0.778-2.131 | 1.646 | 0.953-2.844 |
First birth | **2.426 | 1.434-4.104 | ***2.862 | 1.588-5.158 |
Household wealth index
| ||||
Poorest | Ref. | Ref. | ||
Poor | *1.505 | 1.143-1.981 | *1.420 | 1.063-1.897 |
Middle | ***2.164 | 1.608-2.911 | ***2.097 | 1.529-2.876 |
Rich | ***2.392 | 1.629-3.512 | **1.948 | 1.286-2.950 |
Richest | ***3.391 | 2.382-4.825 | ***2.290 | 1.555-3.370 |
Media and communication equipment
| ||||
Possession of one item or none | Ref. | |||
2 items | ***1.494 | 1.207-1.849 | ||
All items | ***2.741 | 1.974-3.807 | ||
Number of household members
| ||||
5 or more | Ref. | Ref. | ||
Less than 5 | ***1.534 | 1.245-1.890 | **1.527 | 1.190-1.959 |
Number of children under five
| ||||
2 or more | Ref. | Ref. | ||
Less than 2 | ***1.482 | 1.210-1.815 | 1.137 | 0.887-1.457 |
Household sanitation practice
| ||||
No sanitation facilities | Ref. | Ref. | ||
Possession of at least one | **1.879 | 1.191-2.964 | 1.602 | 0.984-2.606 |
Possession of two | ***3.015 | 1.895-4.798 | ***2.480 | 1.511-4.071 |
Possession of all | ***3.904 | 2.438-6.252 | ***2.793 | 1.683-4.636 |
Traveling time to nearest health facility
| ||||
More than 60 min | Ref. | Ref. | ||
41 – 60 min | *1.394 | 1.021-1.904 | 1.357 | 0.968-1.903 |
21 – 40 min | *1.373 | 1.023-1.844 | 1.324 | 0.961-1.826 |
20 min or less | ***2.560 | 1.845-3.554 | ***2.482 | 1.735-3.549 |
Usual transportation
| ||||
On foot | Ref. | Ref. | ||
Any other means of transportation | ***1.836 | 1.368-2.466 | 1.379 | 0.992-1.918 |
Performance of CHWs
| ||||
Poorest | Ref. | |||
Poor | 0.776 | 0.543-1.109 | ||
Middle | 1.158 | 0.884-1.516 | ||
High | 0.796 | 0.610-1.039 | ||
Highest | 1.033 | 0.770-1.387 | ||
Social capital
| ||||
Lowest | Ref. | |||
Low | 1.119 | 0.816-1.535 | ||
Middle | 1.005 | 0.754-1.341 | ||
High | 1.117 | 0.825-1.510 | ||
Highest | 0.855 | 0.634-1.153 |