Predictors of facility-based delivery utilization in central Ethiopia: A case-control study

Area of Science:

• Maternal Health
• Public Health
• Health Services Research

Background:

• Maternal health service access is a priority in low-income countries, yet facility delivery utilization remains low in Ethiopia, despite free services.
• Understanding factors influencing service uptake is crucial for improving maternal outcomes.

Purpose of the Study:

• This study aimed to identify predictors of facility delivery service utilization in central Ethiopia.

Main Methods:

• A community-based case-control study was conducted in central Ethiopia.
• Data were collected via structured questionnaires from women who delivered in facilities (cases) and at home (controls).
• Multivariable logistic regression analysis identified independent predictors of facility delivery.

Main Results:

• Facility delivery was strongly associated with birth preparedness and complication readiness (BPCR), partner involvement, and shorter decision-making and travel times.
• Knowledge of obstetric complications, attending at least four antenatal care (ANC) visits, birth order, and use of free ambulance services were also significant predictors.
• Specific odds ratios highlight the strength of these associations (e.g., AOR = 12.3 for BPCR).

Conclusions:

• Barriers to maternal service utilization persist in Ethiopia despite the availability of free services.
• Strengthening efforts to improve access to delivery services and enhance BPCR are essential for increasing institutional delivery rates.