Individual and Community-Level Predictors of Women’s Decision on Place of Delivery: A Multilevel Mixed-Effects Analysis on Ethiopia National Demography and Health Survey

Henock Yebyo, Mekelle University
Mussie Alemayehu, Mekelle University
Alemayehu Bayray, Mekelle University

Background: Despite of the existing intensive efforts to improve maternal health in Ethiopia, the proportion of birth delivered at home remains high. Objective: To examine effects of individual and community-level factors of women’s decision on place of delivery in Ethiopia. Methods: We analyzed data of 7,908 women from the nationally representative Ethiopian Demographic and Health Survey using multilevel modeling. Results: In Ethiopia, 6980(88.3%) of deliveries took place at home. Lower educational status (OR=2.74, 95%CI:1.84,4.70), attending a limited number of antenatal care (OR=3.72, 95%CI:2.85,4.83), non-exposure to media (OR=1.51, 95%CI 1.13,2.01), and distance (OR=1.29, 95%CI:1.03,1.62) were positive predictors to home delivery. Rural communities (OR=4.67,95%CI:3.06,7.11), pastoralist communities (OR=4.53, 95%CI:2.81,7.28), communities with higher poverty status(OR=1.49 95%CI:1.08,2.22), and lower proportion of antenatal care users (OR=2.01, 95%CI:1.42,2.85) had a positive influence on women to give birth at home. Conclusions: Not only individual characteristics of women, but also community-level factors determine women’s decision to deliver at home.