Maternal Delays for Institutional Delivery and Associated Factors Among Postnatal Mothers at Public Health Facilities of Gamo Zone, Southern Ethiopia

Figures & data

Table 1 The Socio-Economic Characteristics of Study Participants in Selected Rural Districts in Gamo Zone, Southern Ethiopia, 2019 (N=391)

Variables	Categories	Frequency
Mother’s Age	15–20	57(14.6%)
	21–34	316(80.8%)
	≥35	18(4.6%)
Ethnicity	Gamo	371(94.9%)
	Others^a	20(5.1%)
Religion	Orthodox	229(58.6%)
	Protestant	162(41.4%)
Mother’s occupation	Unemployed^b	266(68%)
	Employed	125(32%)
Husband occupation	Unemployed	248(63.4%)
	Employed	143(36.6%)
Mother’s education	Cannot read and write	226(57.8%)
	Can read and write	67(17.1%)
	Primary (1–8 grade)	54(13.8%
	Secondary and above	44(11.3%)
Husband education	Cannot read and write	201(51.4%)
	Can read and write	66(16.9%)
	Primary (1–8 grade)	61(15.6%
	Secondary and above	63(16.1%)
Household monthly income (ETB)	≤ 1000ETB	338(86.44%)
	1001–1999ETB	13(3.33%)
	≥2000ETB	40(10.23%)

Notes: ^aOthers (Amhara, Gofa, and Wolayta), ^bUnemployed (housewife).

Table 2 The Obstetric Related Characteristics of Study Participants in Selected Rural Districts in Gamo Zone, Southern Ethiopia, 2019

Variables	Categories	Frequency
Previous pregnancy related problem(N=391)	Yes	60(15.3%)
	No	331(84.7%)
ANC follow up(N=391)	Yes	333(85.2%)
	No	58(14.8%)
Frequency of ANC visit(n=333)	<4 visit	165(48.6%)
	≥4 visit	168(51.4%)
Birth preparedness and its complication readiness plan (N=391)	Well prepared	239(61.1%)
	Not well prepared	152(38.9%)
Mother’s knowledge on danger signs of labor and childbirth	Poor	182(46.5%)
	Good	209(53.5%)
Who Consulted about institutional delivery service utilization? (N=391)	Family	243(62.1%)
	HW^a	148(37.9%)
Final decision maker for institutional delivery service utilization (N=391)	Husband	146(37.4%)
	Jointly	108(27.6%)
	Women	137(35%)
Number of children (N=391)	≤ 2(alive)	194(49.6%)
	≥3(alive)	197(50.4%)
Mode of delivery (N=391)	SVD^b	385(98.5%)
	Other^c	6(1.5%)

Notes: ^aHW (health worker), ^bSVD (spontaneous vaginal delivery), and ^cOther (instrumental delivery).

Table 3 Health Facility-Related Characteristics of Study Participants in Selected Rural Districts in Gamo Zone, Southern Ethiopia, 2019 (N=391)

Variables	Categories	Frequency
Road unavailability	Yes	203(51.9%)
	No	188(48.1%)
Distance to reaching to nearby health facility	≥5km	148(37.9%)
	<5km	243(62.1%)
Transportation service unavailability	Yes	200(51.2%)
	No	191(48.8%)
Means of transportation used	Walking on foot	133(34%)
	Ambulance	59(15.1%)
	Stretcher	199(50.9%)
Absence of Skilled health provider	Yes	107(27.4%)
	No	284(72.6%)
Absence of obstetric drugs	Yes	126(32.2%)
	No	265(67.8%)
Lengthy admission process	Yes	75(19.2%)
	No	316(80.8%)
Multiple referrals	Yes	62(15.9%)
	No	329(84.1%)

Figure 1 Magnitude of maternal delays among post-natal mothers in selected rural Woredas in Gamo Zone, Southern Ethiopia, 2019.

Table 4 Factors Associated with First Maternal Delay in Utilization of Institutional Delivery Service Among Post-Natal Mothers in Selected Rural Districts of Gamo Zone, Southern Ethiopia, June 2019

Variables	Categories	First Maternal Delay		COR[95% CI]	AOR[95% CI]
		Delayed	Not Delayed
Mother’s Age	15–20	39(68.42%)	18(31.58%)	1.00	1.00
	21–34	134(42.41)	182(57.59%)	0.34[0.19,0.620]	2.50[0.53,12.02]
	≥35	10(55.56%)	8(44.44%)	0.58[0.19,1.707]	0.70[0.30,1.69]
Mother’s occupation	Unemployed	154(57.89%)	112(42.11%)	4.55[2.81,7.37]	2.20[1.15,4.16]*
	Employed	29(23.20%)	96(76.80%)	1.00	1.00
Husband occupation	Unemployed	143(57.66%)	105(42.34%)	3.51[2.25,5.47]	1.30[0.57,2.74]
	Employed	40(27.97%)	103(72.03%)	1.00	1.00
Mother’s education	Illiterate	128(56.64%)	98(43.36%)	2.61[1.72,3.97]	0.90[0.34,2.63]
	Literate	55(33.33%)	110(66.67)	1.00	1.00
Husband education	Illiterate	118(58.71%)	83(41.29%)	2.73[1.81,4.12]	0.90[0.34,2.54]
	Literate	65(34.21%)	125(65.79%)	1.00	1.00
House-hold monthly income (ETB)	≤ 1000	171(50.59%)	167(49.41%)	4.83[2.08,11.22]	0.60[0.17,1.79]
	1001–1999	5(38.46%)	8(61.54%)	2.945[0.74,11.75]	0.90[0.15,4.95]
	≥2000	7(17.50%)	33(82.50%)	1.00	1.00
Previous pregnancy-related problem	Yes	19(31.67%)	41(68.33%)	1.00	1.00
	No	164(49.55%)	167(50.45%)	2.12[1.18,3.80]	3.00[1.31,7.02]*
ANC follow up	Yes	134(40.24%)	199(59.76)	1.00	1.00
	No	49(84.48%)	9(15.52%)	8. 09[3.84,17.01)	1.26[0.46,3.43]
Birth preparedness	Well prepared	55(23.01%)	184(76.99%)	1.00	1.00
	Not well prepared	128(84.21%)	24(15.79%)	17.84[10.50,30.31]	2.70[1.29,5.71]*
Knowledge on danger signs of labor & childbirth	Poor	147(80.77%)	35(19.23%)	20.18[12.07,33.77]	7.20[3.52,14.52]*
	Good	36(17.22%)	173(82.78%)	1.00	1.00
Consultation about institutional delivery service	Family	158(65.02%)	85(34.98%)	9.15[5.52,15.14]	1.40[0.65,2.81]
	HW	25(16.89)	123(83.11)	1.00	1.00
Decision maker for institutional delivery service	Husband	117(80.14)	29(19.86)	18.07[9.98,32.75]	6.00[2.87,12.42]*
	Jointly	41(37.96)	67(62.04)	2.741[1.53,4.91]	1.20[0.56,2.37]
	Women	25(18.25)	112(81.75)	1.00	1.00
Number of children	≤2(alive)	77(39.69)	117(60.31)	1.00	1.00
	≥3(alive)	106(53.81)	91(46.19)	1.77[1.19,2.64]	1.60[0.85,3.11]

Notes: *p < 0.05. 1.00 reference category.

Abbreviations: AOR, adjusted odds ratio; COR, crudes odds ratio; CI, confidence interval.

Table 5 Factors Associated with Second Maternal Delay in Utilization of Institutional Delivery Service Among Post-Natal Mothers in Selected Rural Districts of Gamo Zone, Southern Ethiopia, June 2019

Variables	Categories	Second Maternal Delay		COR[95% CI]	AOR[95% CI]
		Delayed	Not Delayed
Mother’s occupation	Unemployed	138(51.88)	128(48.12)	2.89[1.82,4.58]	1.0[0.41,2.43]
	Employed	34(27.20)	91(72.80)	1.00	1.00
Husband occupation	Unemployed	134(54.03)	114(45.97)	3.25[2.08,5.08]	2.20[1.16,4.11]*
	Employed	38(26.57)	105(73.43)	1.00	1.00
Mother’s education	Illiterate	117(51.77)	109(48.23)	2.15[1.42,3.25]	2.80[0.96,8.05]
	Literate	55(33.33)	110(66.67)	1.00	1.00
Husband education	Illiterate	100(49.75)	101(50.25)	1.62[1.09,2.43]	0.70[0.36,1.50]
	Literate	72(37.89)	118(62.11)	1.00	1.00
Road unavailability	Yes	148(72.91)	55(27.09)	18.39[10.84,31.19]	2.30[0.95,5.79]
	No	24(12.77)	164(87.23)	1.00	1.00
Transportation unavailability	Yes	149(74.50)	51(25.50)	21.34[12.44,36.59]	6.90[3.62,13.06]*
	No	23(12.04)	168(87.96)	1.00	1.00
Distance to reaching HF	≥5km	125(84.46)	23(15.54)	22.66[13.12,39.16]	7.00[3.58,13.71]*
	<5km	47(19.34)	196(80.66)	1.00	1.00
Means of transportation used	Others^a	164(49.39)	168(50.61)	6.22[2.87,13.52]	3.30[1.13,9.54]*
	Ambulance	8(13.56)	51(86.44)	1.00	1.00
1st maternal delay	No	57(27.40)	151(72.59)	1.00	1.00
	Yes	115(62.84)	68(37.16)	4.5[2.92,6.87]	1.90[1.01,3.44]*

Notes: *p < 0.05. 1.00 reference category. ^aOthers (walking on foot and stretcher (wooden)).

Abbreviations: AOR, adjusted odds ratio; COR, crudes odds ratio; CI, confidence interval.

Table 6 Factors Associated with the Third Delay in the Utilization of Institutional Delivery Service Among Post-Natal Mothers in Selected Rural Districts of the Gamo Zone, Southern Ethiopia. June 2019

Variables	Categories	Third Maternal Delay		COR[95% CI]	AOR[95% CI]
		Delayed	Not Delayed
Absence of Skilled health provider	Yes	90(84.11)	17(15.89)	38.93[20.73,73.09]	10.40[4.24,25.69]*
	No	34(11.97)	250(88.03)	1.00	1.00
Absence of obstetric drugs	Yes	100(79.37)	26(20.63)	38.62[21.16,70.5]	8.40[3.76,18.76]*
	No	24(9.06)	241(90.94)	1.00	1.00
Lengthy admission process	Yes	58(77.33)	17(22.67)	12.92[7.06,23.09]	1.80[0.73,4.36]
	No	66(20.89)	250(79.11)	1.00	1.00
Multiple referrals	Yes	29(46.77)	33(53.23)	2.17[1.25,3.76]	1.10[0.46,2.56]
	No	95(28.88)	234(71.12)	1.00	1.00
1st maternal delay	No	46(22.11)	162(77.89)	1.00	1.00
	Yes	78(42.62)	105(57.38)	2.63[1.69,4.06]	2.10[1.04,4.26]*
2nd maternal delay	No	45(20.55)	174(79.45)	1.00	1.00
	Yes	79(45.93)	93(54.07)	3.29[2.11,5.12]	2.70[1.34,5.55]*

Notes: *p < 0.05. 1.00 reference category.

Abbreviations: AOR, adjusted odds ratio; COR, crudes odds ratio; CI, confidence interval.