title: Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.
abstract: BACKGROUND
  Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia.
  
  
  METHODS
  The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression).
  
  
  RESULTS
  The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization.
  
  
  CONCLUSIONS
  The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.
authors.affiliation: Wollo University, College of Natural Sciences, Department of Statistics, Dessie, +251 911 08 61 39. Fekadumelaku@yahoo.com.
authors.forename: Melaku
authors.initials: M
authors.lastname: Fekadu
authors.affiliation: Hawassa University, Institute of Environment, Gender and Development, negyon@yahoo.com : P.O.Box 679, Hawassa, SNNPR, Ethiopia; Phone 251-046-2206975.
authors.forename: Nigatu
authors.initials: N
authors.lastname: Regassa
mesh_terms: D000293:Adolescent; D000328:Adult; D001499:Bayes Theorem; D036861:Delivery, Obstetric / Q000592:standards / Q000706:statistics & numerical data*; D005002:Ethiopia; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008428:Maternal Mortality; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: antenatal care; delivery service; differentials; skill birth attendance
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