title: Determinants of use of health facility for childbirth in rural Hadiya zone, Southern Ethiopia.
abstract: Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth.
  
  
  
  A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery.
  
  
  
  Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth.
  
  
  
  Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.
authors.affiliation: College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia. aberanet@gmail.com.
authors.forename: Netsanet Abera
authors.initials: NA
authors.lastname: Asseffa
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medicine, Pan-African University, University of Ibadan, Ibadan, Nigeria.
authors.forename: Fawole
authors.initials: F
authors.lastname: Bukola
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medicine, Pan-African University, University of Ibadan, Ibadan, Nigeria.
authors.forename: Arowojolu
authors.initials: A
authors.lastname: Ayodele
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005002:Ethiopia; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D008423:Maternal Age; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Facility-based childbirth; Hadiya zone; Institutional delivery; Place of childbirth