title: Magnitude and factors associated with institutional delivery service utilization among childbearing mothers in Cheha district, Gurage zone, SNNPR, Ethiopia: a community based cross sectional study.
abstract: BACKGROUND
  Ethiopia is one of the six countries that contributes' to more than 50 % of worldwide maternal deaths. While it is revealed that delivery attended by skilled provider at health facility reduced maternal deaths, more than half of all births in Ethiopia takes place at home. According to EDHS 2011 report nine women in every ten deliver at home in Ethiopia. The situation is much worse in southern region. The aim of our study is to measure the prevalence and to identify factors associated with institutional delivery service utilization among childbearing mothers in Cheha District, SNNPR, Ethiopia.
  
  
  METHODS
  A community based cross sectional survey was conducted in Cheha District from Dec 22, 2012 to Jan 11, 2013. Multistage sampling method was employed and 816 women who gave birth within the past 2 years and lived in Cheha district for minimum of one year prior to the survey were involved in the study. Data was entered and analyzed using Epi Info Version 7 and SPSS Version 16. Frequencies and binary logistic regression were done. Factors affecting institutional delivery were determined using multivariate logistic regression.
  
  
  RESULTS
  A total of 31 % of women gave birth to their last child at health facility. Place of residence, ability to afford for the whole process to get delivery service at health facility, traveling time that takes to reach to health institution which provides delivery service, husband's attitude towards institutional delivery, counseling about where to deliver during ANC visit and place of birth of the 2(nd) youngest child were found to have statistically significant association with institutional delivery.
  
  
  CONCLUSIONS
  Institutional delivery is low in the study area. Access to health service was found to be the most important predictor of institutional delivery among others. Accessing health facility within reasonable travel time; providing health education and BCC services to husbands and the community at large on importance of using health institution for delivery service; working to improve women's economic status; counseling women to give birth at health institution during their ANC visit and exploring the overall quality of ANC service are some of the areas where much work is needed to improve institutional delivery.
authors.affiliation: Johns Hopkins University - Technical Support for the Ethiopian HIV/AIDS ART Initiative project, Addis Ababa, Ethiopia. felekehg@yahoo.com.
authors.forename: Feleke
authors.initials: F
authors.lastname: Habte
authors.affiliation: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia. meazademissie@gmail.com.
authors.forename: Meaza
authors.initials: M
authors.lastname: Demissie
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D005002:Ethiopia; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D018454:Spouses / Q000523:psychology; D055815:Young Adult