ArticlePloS one2023
Spatial pattern and determinants of institutional delivery in Ethiopia: Spatial and multilevel analysis using 2019 Ethiopian demographic and health survey.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 9 citations in OpenAlex.
- Predicting facility delivery and its determinants among reproductive-age women in Ethiopia using machine learning algorithm: evidence from performance monitoring for action Ethiopia 2019 dataset.BMC pregnancy and childbirth · 2026Article
- Regional trends, spatial patterns and factors associated with health facility delivery among women of reproductive age in Sierra Leone.Reproductive health · 2025Article
- Institutional delivery and its determinants among reproductive-age women in Mozambique: A geographic weighted regression.PLOS global public health · 2025Article
- Strengthening primary health care in Ethiopia: A scoping review of successes, challenges, and pathways towards universal health coverage using the WHO monitoring framework.PLOS global public health · 2025Article
- Bivariate multilevel modeling of antenatal care contacts and place of delivery among reproductive-aged women in Ethiopia.PloS one · 2025Article
- Article
- Spatiotemporal distribution and bivariate binary analysis of antenatal and delivery care utilizations in Ethiopia: EDHS 2000-2016.BMC public health · 2023Article
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3 authors at 1 institution.
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Abstract
backgroundIn Ethiopia, despite the progress that has been made to improve maternal and child health, the proportion of births occurring at health institutions is still very low (26%), Which significantly contribute to a large number of maternal death 412 deaths/100,000 live births. Therefore, this study intended to determine spatial pattern and factors affecting institutional delivery among women who had live birth in Ethiopia within five years preceding survey.
methodData from 2019 Ethiopian demographic and health survey were used. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed to a nationally representative sample of 5753 women nested with in 305 communities/clusters.
resultA significant heterogeneity was observed between clusters for institutional delivery which explains about 57% of the total variation. Individual-level variables: primary education (OR = 1.8: 95% CI: 1.44-2.26), secondary education (OR = 3.65: 95% CI: 2.19-6.1), diploma and higher (OR = 2.74: 95% CI: 1.02-7.34), women who had both Radio and Television were 4.6 times (OR = 4.6; 95% CI: 2.52, 8.45), four and above Antenatal visit (AOR = 2.72, 95% CI:2.2, 3.34), rich wealth index (OR = 2.22; 95% CI: 1.62-2.99), birth interval for 18 to 33 months (OR = 1.8; 95% CI: 1.19, 2.92), and women who space birth for 33 and above months (OR = 2.02; 95% CI: 1.3, 3.12) were associated with institutional delivery. Community level variables, community high proportion of antenatal visit (OR = 4.68; 95% CI: 4.13-5.30), and Region were associated with institutional delivery.
conclusionA clustered pattern of areas with low institutional delivery was observed in Ethiopia. Both individual and community level factors found significantly associated with institutional delivery theses showed the need for community women education through health extension programs and community health workers. And the effort to promote institutional delivery should pay special attention to antenatal care, less educated women and interventions considering awareness, access, and availability of the services are vital for regions. A preprint has previously been published.
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