DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20213764

Prevalence and predictors of institutional delivery in Lumjung, Tanahun and Gorkha district of Nepal: a community-based cross-sectional study

Gayatri Khanal, Niki Shrestha, Govinda Dhungana, Suneel Priyani

Abstract


Background: The Maternal mortality rate (MMR) in Nepal had dropped from 444 per 1, 00,000 live births in 2005 to 239 per 1, 00,000 live births in 2016. However, the MMR of Nepal is still highest in the South Asian countries except Afghanistan. Although maternal mortality has declined noticeably in Nepal, there still persists a low proportion of institutional deliveries. The aim of the study was to assess the factors influencing the utilization rate of institutional delivery.

Methods: A cross-sectional study was conducted in selected village development committee of Lamjung, Tanahun and Gorkha district using semi-structured interview schedule. A random sample of 1410 married women who gave birth in the last two years were included in the study. Multiple logistic regression analysis was carried out to identify the factors associated with institutional delivery.  

Results: The prevalence of institutional delivery in three districts was 73.1%, highest in Lamjung (78.8%) and lowest in Gorkha (67.8%).  Employed women (aoR=1.7, CI=1.05-2.80), seeking antenatal check-up (aoR=5.8, CI=3.00-11.16), secondary (SLC) or above education (aoR= 3.3, CI=1.93-5.54), more than 20 years of age at marriage (aoR=1.5, CI=1.02-2.04), Kshetri by cast (aoR=1.7, CI=1.11-2.64) were statistically significant and associated with an increased rate of institutional delivery.

Conclusions: Occupation, education, antenatal check-up, age at marriage, and ethnicity/cast are major factors for determining institutional delivery. The concerned authorities have to consider the predictors of institutional delivery in formulating the policy and plan for implementing safe motherhood delivery.


Keywords


Institutional delivery, Married women, Prevalence, Cross-sectional study, Nepal

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References


Agus Y, Horiuchi S. Factors influencing the use of antenatal care in rural West Sumatra, Indonesia. BMC Pregnancy Childbirth. 2012;12:9.

Mageda K, Mmbaga EJ. Prevalence and predictors of institutional delivery among pregnant mothers in Biharamulo district, Tanzania: a cross-sectional study. Pan Afr Med J. 2015;21:51.

Titaley CR, Hunter CL, Dibley MJ, Heywood P. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia. BMC Pregnancy Childbirth. 2010;10:43.

WHO. Proportion of births attended by a skilled health workers. Geneva: WHO; 2008.

Kruk ME, Prescott MR. The role of health systems and policies in promoting safe delivery in low- and middle-income countries: a multilevel analysis. Am J Public Health. 2012;102(4):645-50.

United Nations. Millennium Development Goals, 2015. Available at: http://www.un.org/millenniumgoals. Accessed on 04 July 2021.

Weil O, Fernandez H. Is safe motherhood an orphan initiative? Lancet. 1999;354(9182):940-3.

Bhandari RT, Dangal G. Safe Delivery Care: Policy, Practice and Gaps in Nepal. J Nepal Med Assoc. 2013; 52(192):637-44.

Government of Nepal, Ministry of Health and Population. Demographic and Health Survey, 2006. Available at: https://dhsprogram.com/pubs/pdf/FR257/FR257[132012].pdf. Accessed on 04 July 2021.

WHO, UNICEF, UNFPA. Trends in Maternal Mortality: 1990 to 2015, 2015. Available at: http://apps.who.int/iris/bitstream/10665/194254/1/9789241565141_eng.pdf. Accessed on 04 July 2021.

Ensor T, Clapham S, Prasai DP. What drives health policy formulation: Insights from the Nepal maternity incentives Scheme?. Health Policy. 2009; 90(2):247-53.

Government of Nepal. National Planning Commission. Sustainable Development Goals 2016-2030, 2015. Available at: http://un.org.np/sites/default/files/Draft_Report_SDG_Nepal_2016_2030_1.pdf. Accessed on 04 July 2021.

Campbell OM, Graham WJ, Lancet Maternal Survival Series steering group. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368(9543):1284-99.

Koblinsky M, Matthews Z, Hussein J, Mavalankar D, Mridha MK, Anwar I, et al. Going to scale with professional skilled care. Lancet. 2006;368(9544):1377-86.

Ministry of Health and Population. Annual Report of Department of Department of Health Services (2012/2013). Kathmandu: Government of Nepal, Ministry of Health and Population, 2013. Available at: http://apps.who.int/iris/bitstream89241565141. Accessed on 04 July 2021.

National Population Census. Household and Population by sex. Central Bureau of Statistics, 2012. Available at: https://unstats.un.org/unsd/demographicsocial/census/documents/Nepal/Nepal-Census. Accessed on 04 July 2021.

National Population and Housing Census. Village Development Committee/ Municipality. Central Bureau of Statistics, 2014. Available at: http://apps.who.int/iris/bitstream/10665/194254/1/9789241565141_eng. Accessed on 04 July 2021.

Ministry of Health and Population of Nepal, Department of Health Services. January Annual Report 2013/2014, 2015. Available at: http://dohs.gov.np/wpcontent/uploads/2014/04/Annual_Report_2070_71.pdf. Accessed on 04 July 2021.

Shrestha SK, Banu B, Khanom K, Ali L, Thapa N, Stray B, Devkota B. Changing trends on the place of delivery: why do Nepali women give birth at home?. Reprod Health. 2012;9:25.

Karkee R, Binns CW, Lee AH. Determinants of facility delivery after implementation of safer mother programme in Nepal: a prospective cohort study. BMC Pregnancy Childbirth. 2013;13:193.

Shah R, Rehfuess EA, Maskey MK, Fischer R, Bhandari PB, Delius M. Factors affecting institutional delivery in rural Chitwan district of Nepal: a community-based cross-sectional study. BMC Pregnancy Childbirth. 2015;15:27.

Fikre AA, Demissie M. Prevalence of institutional delivery and associated factors in Dodota Woreda (district), Oromia regional state, Ethiopia. Reprod Health. 2012;9:33.

Anyait A, Mukanga D, Oundo GB, Nuwaha F. Predictors for health facility delivery in Busia district of Uganda: a cross sectional study. BMC Pregnancy Childbirth. 2012;12:132.

Mageda K, Mmbaga EJ. Prevalence and predictors of institutional delivery among pregnant mothers in Biharamulo district, Tanzania: a cross-sectional study. Pan Afr Med J. 2015;21:51.

Adhikari RK, Dahal LH. Factors affecting place of delivery in Dhading district. J Ins Med. 2008;30:40.

Feyissa TR, Genemo GA. Determinants of institutional delivery among childbearing age women in Western Ethiopia, 2013: unmatched case control study. PLoS One. 2014;9(5):97194.