title: Factors associated with home delivery in Bahirdar, Ethiopia: a case control study.
abstract: BACKGROUND
  In Ethiopia although pregnant mothers increasingly attend antenatal clinics, utilization of skilled delivery service remains very low. The individual or health system factors that affect women's preferences for delivery places are not well known.
  
  
  METHODS
  A case control study was conducted in July 2010 to assess factors associated with utilization of institutional delivery service. A total of 324 mothers who recently delivered and visited either postnatal care or sought immunization services were included. Cases (n = 108) were mothers who gave birth at home and controls (n = 216) were those who delivered at health facility. Pre-tested and standardized questionnaires were used to collect relevant data by trained data collectors. Logistic regression model was used to control for confounding.
  
  
  RESULTS
  The likelihood of delivering at home was greater among mothers with inadequate knowledge of pregnancy related services (AOR = 62, 95% CI: 3, 128.4), those who started attending ANC after 24 weeks of gestation (AOR 8.7, 95% CI: 2.2, 33.3), mothers having no formal education (Adjusted OR 4.2, 95% CI 1.63, 11.27) and rural residents (AOR = 3.6, 95%CI: 1.4, 9.0).
  
  
  CONCLUSIONS
  The predominant factors associated with home delivery services were lack of knowledge about obstetrics care, delay in starting Antenatal Care (ANC) follow up, having, Illiteracy and rural residence. Audience specific behavioral change communication should be designed to improve the demand for delivery services. Health professionals should take the opportunity to encourage mothers attend delivery services during ANC follow up. Improvements should be made in social conditions including literacy and major social mobilization endeavors.
authors.affiliation: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors.forename: Fantu
authors.initials: F
authors.lastname: Abebe
authors.forename: Yemane
authors.initials: Y
authors.lastname: Berhane
authors.forename: Belaineh
authors.initials: B
authors.lastname: Girma
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004522:Educational Status; D005002:Ethiopia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data