Background
over the past few decades, maternal and child mortality had drawn the attention of governments and policymakers. Institutional delivery has been among the implementations to reduce maternal and child mortality. The fact that the problem was persisted made studies research for more factors. Thus, the current study was intended for further analyses of EMDHS to identify the magnitude and its spatial patterns and predictors of in institutional delivery.
Methods
A cross-sectional survey data from EMDHS 2019 was analyzed involving 5,488 reproductive-age women regarding institutional deliveries. We presented descriptive statistics using mean, standard deviations, and proportions. To check the nature of the distribution of institutional delivery, we applied the global Moran’s I statistics. Getis-Ord Gi statistics was applied to detect spatial locations, and we applied spatial interpolation to predict unknown locations of institutional delivery using the Ordinary Kriging method. Kulldorff’s SatScan was also applied to identify the specific local clustering nature of institutional delivery using the Bernoulli method. We applied multilevel binary logistic regression for the scrutiny of Individual and community-level factors. We applied P < 0.25 to include variables in the model and P < 0.05 to declare associations. AOR with 95% CI was used to describe variables
Results
The prevalence of institution/facility delivery was 2,666.45(48.58%) in the survey. The average number of children was 4.03 ± 2.47, and most women in this survey were in the age group of the 25-29years (31.84%) and 30–34 years (21.61%). Women who learned primary education (AOR = 1.52; 95% CI 1.20–1.95), secondary education (AOR = 1.77; 95% CI 1.03–3.07), and higher education (AOR = 5.41; 95% 1.91–15.25), while those who can read and write sentence (AOR = 1.94; 95% 1.28–2.94), Rich (AOR = 2.40 95% CI 1.82–3.16), and those followed 1–2 ANC (AOR = 2.08; 95% CI 1.57–2.76), 3 ANCs (AOR = 3.24; 95% CI 2.51–418), and ≥ 4 ANCs (AOR = 4.91; 95% CI 3.93–6.15) had higher odds of delivering at health institutions.
Conclusion
The institutional delivery was unsatisfactory in Ethiopia, and there were various factors associated differently across the regions. Pastoralist regions showed high home delivery than institutions which invites further interventions specific to those regions. Factors like age, highest education level achieved, preceding birth interval, literacy status, wealth status, birth order, regions, and rural residences were all affected institutional delivery so that interventions considering awareness, access, and availability of the services are vital.