Why Do Women Deliver at Home? Multilevel Modeling of Ethiopian National Demographic and Health Survey Data

摘要: Background Despite of the existing intensive efforts to improve maternal health in Ethiopia, proportion birth delivered at home remains high and is still top priority among national threats. Objective The study aimed examine effects individual women community-level factors women’s decision on place delivery Ethiopia. Methods Data were obtained from nationally representative 2011 Ethiopian Demographic Health Survey (EDHS) which used a two-stage cluster sampling design with rural-urban regions as strata. The EDHS collected data big sample size but our focused 7,908 whose most recent was within five years preceding 576 communities living in. analyzed using two-level mixed-effects logistic regression determine fixed-effects individual- random-intercept between-cluster characteristics. Results In current study, 6980 out 7908 deliveries (88.3%) took home. Lower educational levels (OR=2.74, 95%CI:1.84,4.70; p<0.0001), making no or only limited number ANC visits (OR=3.72,95%CI:2.85, 4.83; non-exposure media (OR=1.51, 95%CI 1.13, 2.01; p=0.004), higher parity (OR=2.68, 95%CI:1.96,3.68; perceived distance problem reach facilities (OR=1.29, 95%CI:1.03,1.62; p=0.022) positively associated delivery. About 75% total variance odds giving accounted for between-community differences characteristics (ICC=0.75, p<0.0001). With regard characteristics, rural (OR=4.67, 95%CI:3.06,7.11; pastoralist (OR=4.53, 95%CI:2.81,7.28; poverty (OR=1.49 95%CI:1.08,2.22; p=0.048), lower utilization (OR=2.01, 95%CI:1.42,2.85; p<0.0001) facility p=0.004) had positive influence give home. Conclusions Not women, also deliver