Determinants of Home Delivery Among Women in Rural Pastoralist Community of Hamar District, Southern Ethiopia: A Case–Control Study

Abstract

Purpose

Studies addressing determinants of home delivery in pastoralist areas are scarce in Ethiopia. In this study, we aimed to assess determinants of home delivery in rural pastoralist communities of Hamar District, Southern Ethiopia.

Patients and Methods

In April 2018, we conducted a community-based case–control study. Of 35 rural kebeles (lowest level of administration) in the district, 8 were randomly selected. Ninety-nine randomly selected cases (mothers who gave birth at home) and 193 controls (mothers who gave birth at health facility) were included in the study. We used structured questionnaires to collect data. Through face-to-face interview, data on place of delivery, socio-demographic characteristics, obstetric history knowledge and attitude of mothers were collected. We used logistic regression model to measure association between variables.

Results

Late initiation of antenatal care (AOR = 4.6, 95% CI = 1.2, 17.1), husbands only decision-making (adjusted odds ratio [AOR] =7.2, 95% CI = 2.1, 24.5), women’s preference for traditional birth attendants (TBAs) (AOR = 3.9, 95% CI = 1.2, 12.5), and not involving in women’s development army (WDA), (AOR = 3.3, 95% CI = 1.0, 10.5) increased the risk of home delivery. Moreover, low maternal knowledge on danger signs of pregnancy (AOR = 6.5, 95% CI = 1.5, 29.0) and negative maternal attitudes towards institutional delivery (AOR = 4.4, 95% CI = 1.4, 14.1) were other factors that increased the risk of home delivery.

Conclusion

Among our study participants, a number of factors increased the risk of home delivery. Improving women’s awareness on the importance of institutional delivery, establishing systems for integration between TBAs and health facilities, empowering women and promoting them to participation in WDA were recommended.

Keywords:

• determinants
• home delivery
• pastoralist community
• Hamar District
• Southern Ethiopia

Acknowledgment

We thank Hawassa University for the financial support and we extend our gratitude to the data collectors, the supervisor and the study participants for their time and courtesy.

Abbreviations

ANC, Antenatal care; AOR, Adjusted odds ratio; CI, Confidence interval; COR, Crude odds ratio; DHS, Demographic and health survey; SD, Standard deviation; SPSS, Statistical package for social science; TBAs, Traditional Birth Attendants; WDA, Women Development Army.

Data Sharing Statement

The data sets used in this study are available from the corresponding author on reasonable request.

Ethics Statement

The study was approved by Institutional Review Board (IRB) of Hawassa University College of Medicine and Health Sciences (Reference No. IRB/068/10). We received official support letter from South Omo Zone Health Department and Hamar District Health Office. Informed verbal consent was obtained after appropriate information was provided for each study participants or their husbands (for mothers below 18 years of age). Study participants were informed that they have full right not to participate in the study. The study was conducted in accordance with the Declaration of Helsinki. The IRB office in Hawassa University College of Medicine and Health Sciences approved the consent process.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Hawassa University, Ethiopia.