title: Factors associated with institutional delivery in Dangila district, North West Ethiopia: a cross-sectional study.
abstract: BACKGROUND
  Childbirth in a health institution has been shown to be associated with lower rates of maternal and neonatal mortality. However, about 85% of mothers in Ethiopia deliver at home.
  
  
  OBJECTIVE
  To assess factors associated with institutional delivery service utilization among women who gave birth within one year prior to the study in Dangila district.
  
  
  METHODS
  A cross-sectional study was conducted from February 01-28, 2015. A total of 763 mothers were interviewed using structured questionnaire. SPSS version 20 was used for analysis. Crude and adjusted Odds ratios were computed for selected variables. A P-value less than 0.05 was considered statistical significant.
  
  
  RESULTS
  Only 18.3% of mothers gave birth at health facilities. Knowledge on danger signs [AOR=2.0, 95% CI: (1.1, 3.4)], plan to give birth at health institution [AOR=5.4, 95% CI: (3.0, 9.6)], having ANC follow up during pregnancy [AOR=12.9, 95% CI: (5.0, 33.3)] and time taken to get to a nearby health institution [AOR=5.1, 95% CI: (2.9, 9.1)] were associated with institutional delivery service utilization.
  
  
  CONCLUSIONS
  Institutional delivery was very low. Knowledge about danger signs, having ANC visits, and time were factors associated with institutional delivery service utilization. Thus, the findings recommend repeated re-enforcement of institutional delivery service utilization through professionals. And also, the findings recommend promotion of institutional delivery service utilization through mass media.
authors.affiliation: School of Public Health, College of Medicine and Health Science, Bahir Dar University.
authors.forename: Yeshalem Mulugeta
authors.initials: YM
authors.lastname: Demilew
authors.affiliation: School of Public Health, College of Health Science, Mekelle University.
authors.forename: Gebremedhin Berhe
authors.initials: GB
authors.lastname: Gebregergs
authors.affiliation: Midwifery Department, College of Medicine and Health Science, Bahir Dar University.
authors.forename: Azezu Asres
authors.initials: AA
authors.lastname: Negusie
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / 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; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008428:Maternal Mortality; D015999:Multivariate Analysis; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: delivery; skilled professional; unskilled personnel