Factors influencing women's choice for place of child birth in rural Ethiopia: a cross-sectional study

Background: Pregnancy and childbirth complications are foremost cause of deaths and incapacity among women of the reproductive age in developing countries. In Ethiopia, nearly a third to a fourth of births occur without the help of a trained birth assistant. Objectives: The aim of this study was to assess the prevalence of institutional delivery and the determinants for choice of place of delivery. Methodology: A cross-sectional study design was employed from June to August 2018 and systematic sampling method used to select eligible respondents. From a total number of 5,398 pregnant women of whom 85% had visted ANC facilities, thestudy recruited 402 mothers aged 25-34 years. These mothers had given birth one year prior to data collection in the Wondo Genet District of Ethiopia. Data was cleansed, coded, entered into Epi Data 3.1 and analyzed using SPSS version 20. Logistic regression was used to identify statistically significant variables for the choice of place for delivery. Results: More than half 216 (53.7%) of the respondents were rural residents and more than onethird 147 (36.6%) were not able to read nor write. From every 10 women, 4 were housewives thus 249 (61.9%). More than 75% of them had access to the media (majorly television and radio) Factors that were statistically significant for the choice place of delivery were primary and above educational status of women, (AOR=0.14, CI, 0.03-0.68), income greater than 3000 ETB (AOR=8.35 CI, 3.6-19.4), four or more ANC frequency (AOR=4.14 CI, 2.0-8.6) and previous planned pregnancy (AOR=4.14 CI, 2.0- 8.6). Conclusion: Prevalence of institutional delivery was 61.2%. This calls for the District Health Committee to work on myth and misconception surrounding institutional delivery. Appropriate information, education, and communication will be a vital strategy in helping women to take the initiative of visiting health facilities. Educational status and monthly income were statistically important factors in disseminating health information to enhance knowledge of the women

Factors associated with long-acting family planning service utilization in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Even though the modern contraceptive use was improved in Ethiopia, the utilization of long-acting family planning services is still low because of numerous factors. The aim of this systematic review was to synthesize logical evidence about factors associated with long acting family planning service utilization in Ethiopia. METHODS: The participants of the study were married women of reproductive age in Ethiopia. This search included all published and unpublished observational studies written in the English language conducted before April 30, 2018, in Ethiopia. Electronic and non-electronic sources were used. PubMed, MEDLINE (EBSCO), CINHAL (EBSCO), Embase (EBSCO), POPLINE and the search engines like Google, Google Scholar Mednar and world cat log were used. The overall selected search results were 15 studies. Each study was evaluated using the Joanna Briggs Institute Quality Assessment Tool for Observational Studies. Data synthesis and statistical analysis were conducted using ReviewManagerVersion5.3.5. RESULTS: Women's inadequate knowledge level [OR, 0.29; 95% CI: 0.10, 0.83, P = 0.02], women's age between 15 and 34 [OR, 0.82; 95% CI: 0.53, 0.93, P = 0.01], not having electronic media [OR, 0.65; 95% CI: 0.53, 0.79, P < 0.0001] and women from rural area [OR = 0.65;95% CI:0.50, 0.81, P = 0.0009] were less likely associated in the use of long-acting family planning services. The odds of utilizing long acting family planning methods were high among non-government- employed women and husband [OR, 1.77; 95% CI: 1.29, 2.43, P = 0.0004], [OR, 1.69; 95% CI: 1.33, 2.15, P < 0.0001] respectively. Having no previous exposure to any modern family planning method [OR = 2.29; 95%CI: 1.83, 2.86, P < 0.00001] and women having no discussion with husband [OR = 1.92 (95%CI: 1.50, 2.45) P < 0.00001] were more likely associated in the utilization of long-acting family planning services. CONCLUSION: Lack of information and knowledge, having discussion with husband, being women of younger age, having less than five living children, being government-employed women and husband, not having electronic media, and being residents in rural area were significant barriers for underutilization of long acting family planning methods in Ethiopia. Hence, the investigators suggest that key stakeholders should design interventions strategies to avert attitudinal, cultural and informational barriers towards long-acting family planning methods. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: 2018: CRD42018096373.The online version of this article (10.1186/s40834-019-0095-z) contains supplementary material, which is available to authorized users.