title: Determinants of institutional delivery among childbearing age women in Western Ethiopia, 2013: unmatched case control study.
abstract: BACKGROUND
  Place of delivery is a crucial factor which affects the health and wellbeing of the mother and newborn. Institutional delivery helps the women to access skilled assistance, drugs, equipment, and referral transport. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia.
  
  
  METHODS
  Retrospective unmatched case control study design was used to assess determinants of institutional delivery in Western Ethiopia from September to October 2013. A total of 320 respondents from six districts of East Wollega zone, West Ethiopia were included. Data were collected using pretested and structured questionnaires. Data were entered and cleaned by Epi-info then exported and analyzed using SPSS software. Statistical significance was determined through a 95% confidence level.
  
  
  RESULTS
  Education [Adjusted Odds Ratio (AOR) (95% Confidence Interval (CI)) = 2.754(1.510-8.911)], family size [AOR (95% CI) = .454(.209-.984)], residence [AOR (95% CI) = 3.822 (1.766-8.272)] were important predictors of place of delivery. Four or more antenatal care [(ANC) (AOR (95% CI) = 2.914(1.105-7.682)], birth order [(AOR (95% CI) = .136(.054-.344), age at last delivery [(AOR (95% CI) = 9.995(2.101-47.556)], birth preparedness [AOR (95% CI) = 6.957(2.422-19.987)], duration of labour [AOR (95% CI) = 3.541(1.732-7.239)] were significantly associated with institutional delivery. Moreover service related factors such as distance from health institutions [AOR (95% CI) = .665(.173-.954)], respondents' awareness of skill of health care professionals [AOR (95% CI) = 2.454 (1.663-6.255)], mode of transportations [AOR (95% CI) = .258(.122-.549)] were significantly associated with institutional delivery.
  
  
  CONCLUSIONS
  Policy makers, health service organizations, community leaders and other concerned bodies have to consider the predictors of institutional delivery like education, birth order, antenatal care utilization and residence to improve institutional delivery in the area.
authors.affiliation: College of medical and health sciences, Wollega University, Nekemte, Oromia, Ethiopia.
authors.forename: Tesfaye Regassa
authors.initials: TR
authors.lastname: Feyissa
authors.affiliation: School of Health Sciences, Adama University, Asella, Oromia, Ethiopia.
authors.forename: Gebi Agero
authors.initials: GA
authors.lastname: Genemo
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005002:Ethiopia; D005260:Female; D006801:Humans; D036801:Parturition; D011247:Pregnancy; D012098:Reproduction; D012189:Retrospective Studies; D055815:Young Adult