Background
Methods
Study design
Study area
Data source and measurements
Variable name | Definition (Measurement) |
---|---|
Home delivery after ANC | Was defined as women who give birth at home after having at least one ANC visit within five years before the survey |
Number of ANC visit | Was measured in number and mothers who had at least one ANC visit was considered as having ANC |
Number of parity | The number of births given before the survey, including the most recent births among women who give birth within five years before the survey. Above 5 was considered as grand multiparous. |
Age of respondent | Was age in year of the mothers who give birth within five years before the survey |
Household wealth index | It was computed based on principal component analysis in the major DHS and the detail is available in the main DHS program |
Covered by health insurance | Women were asked about did they have health insurance or not and reported as Yes/No in the EDHS program. |
Informed about birth preparedness plan during their ANC visit | This was a Yes/ No question of about have you been informed about birth preparedness plan during ANC visit. |
Last pregnancy wanted | The analysis was based on the last (Most recent) pregnancy. And Women were asked about the pregnancy was wanted or not. |
Gestational age at 1st ANC visit | Gestational age at 1st ANC visit was the duration of the most recent pregnancy in months until the women had 1st ANC visit. ANC after 4 months was considered as late ANC visit. |
Being exposed to media | Media exposure was calculated from the internet use, TV watching, radio listening, reading newspapers and those who score above the median were considered as having media exposure and the rest considered as having no media exposure. |
Data analysis
Results
Socio-demographic and economic characteristics of respondents
Variable | Category | Weighed No of home delivery | Weighed No of institutional delivery | Total frequency (%) |
---|---|---|---|---|
Age of respondent | ||||
15–24 | 638 | 645 | 1283 (27.49) | |
25–34 | 1077 | 1285 | 2362 (50.58) | |
35–49 | 500 | 524 | 1024 (21.93) | |
Place of residence | ||||
Urban | 271 | 1196 | 1367 (29.28) | |
Rural | 2044 | 1258 | 3302 (70.72) | |
Current marital status | ||||
Not married | 166 | 257 | 423 (9.06) | |
Married | 2050 | 2197 | 4247 (90.94) | |
Respondents education | ||||
No formal education | 1464 | 858 | 2322 (49.73) | |
Primary | 656 | 861 | 1517 (32.48) | |
Secondary | 72 | 411 | 483 (10.35) | |
Higher | 24 | 323 | 347 (7.43) | |
Respondents current occupation | ||||
Working | 640 | 966 | 1606 (34.39) | |
Not working | 1575 | 1488 | 3064 (65.61) | |
Religion of respondents | ||||
Orthodox | 659 | 1163 | 1822 (39.02) | |
Muslim | 1046 | 886 | 1932 (41.38) | |
Protestant | 474 | 373 | 847 (18.14) | |
Other | 36 | 32 | 68 (14.60) | |
Household wealth index of respondent | ||||
Poorest | 707 | 282 | 989 (21.19) | |
Poorer | 450 | 301 | 751 (16.08) | |
Middle | 509 | 274 | 783 (16.78) | |
Richer | 336 | 315 | 651 (13.95) | |
Richest | 213 | 1281 | 1494 (31.99) | |
Exposed to media | ||||
No | 1514 | 996 | 2510 (53.76) | |
Yes | 701 | 1458 | 2159 (46.24) |
Pregnancy and maternal health service related factors of women
Variable | Category | Weighted No of home delivery | Weighted No of institutional delivery | Total frequency (%) |
---|---|---|---|---|
Number of Parity | ||||
1–6 | 1848 | 2204 | 4052 (86.78) | |
Above 6 | 368 | 249 | 617 (13.22) | |
Gestational age at 1st ANC visit | ||||
≤4 month | 1066 | 766 | 1832 (39.23) | |
After 4 months | 1150 | 1688 | 2838 (60.77) | |
Number of ANC visit | ||||
1–3 visit | 1239 | 896 | 2135 (45.71) | |
≥4visit | 977 | 1558 | 2535 (54.29) | |
Place (type of health facility) of ANC visit | ||||
Private health facility | 56 | 206 | 262 (5.61) | |
Public health facility | 2084 | 2106 | 4190 (89.73) | |
Other | 75 | 142 | 217 (4.66) | |
Covered by health insurance | ||||
No | 2158 | 2313 | 4471 (95.75) | |
Yes | 57 | 142 | 198 (4.25) | |
Informed about birth preparedness plan during ANC visit | ||||
No | 1222 | 978 | 2200 (47.11) | |
Yes | 993 | 1476 | 2470 (52.89) | |
Pregnancy is wanted | ||||
Wanted then | 1769 | 1942 | 3712 (79.49) | |
Wanted later | 333 | 384 | 717 (15.53) | |
Wanted no more | 112 | 129 | 241 (5.16) |
Region | Weighted frequencies | Weighted prevalence of home delivery after ANC (95% CI) | |
---|---|---|---|
Home delivery | Institutional delivery | ||
Tigray | 181 | 440 | 29.16 (24.48, 34.33) |
Afar | 178 | 75 | 70.55 (60.60, 78.87) |
Amhara | 339 | 242 | 58.34 (52.18, 64.24) |
Oromia | 391 | 267 | 59.43 (52.41, 66.08) |
Somali | 226 | 120 | 65.28 (58.01, 71.91) |
Benishangul –Gumuz | 222 | 135 | 62.14 (54.26, 69.42) |
SNNPa | 382 | 257 | 59.79 (54.24, 65.09) |
Gambela | 128 | 149 | 46.26 (37.58, 55.18) |
Harari | 72 | 213 | 25.17 (18.58, 33.14) |
Addis Ababa | 9 | 354 | 2.41 (0.89, 6.34) |
Dire Dawa | 87 | 202 | 30.08 (21.97, 39.69) |
Spatial distribution of home delivery after antenatal care visit in Ethiopia
Most likely cluster | Enumeration area (cluster) detected | Population | Cases | LLR | RR | Coordinate/radius | P-value |
---|---|---|---|---|---|---|---|
1st most likely clusters | 308, 12, 391, 148, 216, 578, 365, 609, 408, 215, 576, 589, 420, 313, 347, 634, 468, 373, 26, 518, 405, 162, 388, 537, 445, 297, 20, 522,53, 600, 619, 360, 14, 41, 565, 272, 32, 633, 34, 271, 223, 180, 331,126, 232, 359, 316, 54, 141, 113, 438, 577, 182, 574, 434, 204, 562,502, 503, 505, 174, 306, 398, 213, 21, 142, 524, 217, 422, 227, 406,262, 450, 447, 486, 123, 86 | 657 | 418 | 53.62 | 1.52 | (7.045432 N, 38.473023 E) / 180.88 km | < 0.001 |
2nd most likely clusters | 617, 616, 354, 18, 460, 410, 345, 611, 267, 176, 10, 545, 310, 254, 496, 591, 637, 55, 368, 38, 478, 191, 547, 627, 510, 620, 571, 206, 189, 401, 572, 276, 295, 482, 102, 120, 389, 200, 229, 455, 423, 241, 201, 350, 332, 624, 484, 37, 344, 456, 66, 135, 24, 336, 249, 97 | 466 | 297 | 51.38 | 1.64 | (10.939576 N, 39.281275 E) / 196.38 km | < 0.001 |
Factors associated with home delivery after an ANC visit in Ethiopia
Variable | Category | Home delivery | Institutional delivery | COR (95%CI) | AOR (95% CI) |
---|---|---|---|---|---|
Age of respondent | |||||
15–24 | 638 | 645 | 1 | 1 | |
25–34 | 1077 | 1285 | 1.06 (0.86, 1.30) | 1.07 (0.86, 1.32) | |
35–49 | 500 | 524 | 1.36 (1.05, 1.75) | 1.18 (0.87, 1.86) | |
Number of parity of respondents | |||||
1–6 | 1848 | 2204 | 1 | 1 | |
Above 6 | 368 | 249 | 1.50 (1.17, 1.93) | 1.26 (0.92, 1.72) | |
Number of ANC visit | |||||
≥4visit | 977 | 1558 | 1 | 1 | |
1–3 visit | 1239 | 896 | 1.59 (1.32, 1.91) | 1.41 (1.17, 1.71) * | |
Respondents level of education | |||||
No education | 1464 | 858 | 1 | 1 | |
Primary | 656 | 861 | 0.46 (0.38, 0.56) | 0.45 (0.36, 0.55) ** | |
Secondary | 72 | 411 | 0.12 (0.08, 0.17) | 0.11 (0.08, 0.18) ** | |
Higher | 24 | 323 | 0.05 (0.03, 0.09) | 0.06 (0.03, 0.11) ** | |
Respondents current occupation | |||||
Not working | 1575 | 1488 | 1 | 1 | |
Working | 640 | 966 | 0.78 (0.64, 0.95) | 0.86 (0.70, 1.06) | |
Religion of respondents | |||||
Orthodox | 659 | 1163 | 1 | 1 | |
Muslim | 1046 | 886 | 2.02 (1.42, 1.88) | 1.57 (1.13, 2.19) * | |
Protestant | 474 | 373 | 1.48 (0.98, 2.23) | 1.72 (1.16, 2.53) * | |
Other | 36 | 32 | 0.96 (0.40, 2.25) | 1.03 (0.43, 2.42) | |
House hold wealth index of respondents | |||||
Poor | 1155 | 574 | 1 | 1 | |
Middle | 427 | 313 | 0.60 (0.46, 0.77) | 0.66 (0.51, 0.86) ** | |
Rich | 633 | 1567 | 0.35 (0.27, 0.45) | 0.42 (0.32, 0.54) ** | |
Being exposed to media | |||||
No | 1514 | 996 | 1.65 (1.34, 2.04) | 1.18 (0.95, 1.48) | |
Yes | 701 | 1458 | 1 | 1 | |
Type of health facility for ANC visit | |||||
Private facilities | 56 | 206 | 0.46 (0.27,0.77) | 0.60 (0.35, 1.03) | |
Public facilities | 2084 | 2106 | 1 | 1 | |
Other1** | 75 | 142 | 0.72 (0.45, 1.17) | 0.71 (0.43, 1.15) | |
Covered by health insurance | |||||
No | 2158 | 2313 | 2.13 (1.39, 3.84) | 2.16 (1.29, 3.62) * | |
Yes | 57 | 142 | 1 | 1 | |
Informed about birth preparedness plan during their ANC visit | |||||
No | 1222 | 978 | 2.34 (1.93, 2.83) | 2.21 (1.83, 2.69)* | |
Yes | 993 | 1476 | 1 | 1 | |
Last pregnancy is wanted | |||||
Wanted then | 1769 | 1942 | 1 | 1 | |
Wanted later | 333 | 384 | 1.38 (1.08, 1.77) | 1.55 (1.20, 2.01) * | |
Wanted no more | 112 | 129 | 1.22 (0.82, 1.82) | 1.05 (0.70, 1.57) | |
Gestational age at 1st ANC visit | |||||
≤4 month | 1066 | 766 | Not sig(p = 0.28) | ||
After 4 months | 1150 | 1688 | |||
Current marital status | |||||
Not married | 166 | 257 | not sig (p = 0.29) | ||
Married | 2050 | 2197 | |||
ICC for the null model | o.67 (0.62, 0.72) | ||||
ICC for the final model | 0.44 (0.39,0.50) |