title: Antenatal care and women's decision making power as determinants of institutional delivery in rural area of Western Ethiopia.
abstract: BACKGROUND
  Delivery by skilled birth attendance serves as an indicator of progress towards reducing maternal mortality. In Ethiopia, the proportions of births attended by skilled personnel were very low 15 % and Oromia region 14.7 %. The current study identified factors associated with utilization of institutional delivery among married women in rural area of Western Ethiopia.
  
  
  METHODS
  A community based cross-sectional study was employed from January 2 to January 31, 2015 among mothers who gave birth in the last 2 years in rural area of East Wollega Zone. A multi-stage sampling procedure was used to select 798 study participants. A pre-tested structured questionnaire was used to collect data and female high school graduates data collectors were involved in the data collection process. Bivariate and multivariable logistic regression model was fit and statistical significance was determined through a 95 % confidence level.
  
  
  RESULTS
  The study revealed that 39.7 % of the mothers delivered in health facilities. Age 15-24 years (AOR 4.20, 95 % CI 2.07-8.55), 25-34 years (AOR 2.21, 95 % CI 1.32-3.69), women's educational level (AOR 2.00, 95 % CI 1.19-3.34), women's decision making power (AOR 2.11, 95 % CI 1.54-2.89), utilization of antenatal care (ANC) during the index pregnancy (AOR 1.56, 95 % CI 1.08-2.23) and parity one (AOR 2.20, 95 % CI 1.10-4.38) showed significant positive association with utilization of institutional delivery.
  
  
  CONCLUSIONS
  In this study proportion of institutional delivery were low (39.7 %). Age, women's literacy status, women's decision making power, ANC practice and numbers of live birth were found important predictors of institutional delivery. The findings of current study highlight the importance of boosting women involvement in formal education and decision making power. Moreover since ANC is big pillar for the remaining maternal health services effort should be there to increase ANC service utilization.
authors.affiliation: College of Medical and Health Sciences, Wollega University, P.O.Box 395, Nekemte, Ethiopia. ttesfalove@gmail.com.
authors.forename: Tesfalidet
authors.initials: T
authors.lastname: Tekelab
authors.affiliation: College of Medical and Health Sciences, Wollega University, P.O.Box 395, Nekemte, Ethiopia. birhanuyad@gmail.com.
authors.forename: Birhanu
authors.initials: B
authors.lastname: Yadecha
authors.affiliation: College of Medical and Health Sciences, Wollega University, P.O.Box 395, Nekemte, Ethiopia. alemusufa@ymail.com.
authors.forename: Alemu Sufa
authors.initials: AS
authors.lastname: Melka
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D036861:Delivery, Obstetric / Q000379:methods*; D004522:Educational Status; D005002:Ethiopia; D005260:Female; D006801:Humans; D050498:Live Birth; D016015:Logistic Models; D008427:Maternal Health Services; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012424:Rural Population / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult