- Title
- Giving birth in Ethiopia: a spatial and multilevel analysis to determine availability and factors associated with healthcare facility births
- Creator
- Tegegne, T. K.; Chojenta, C.; Getachew, T.; Smith, R.; Loxton, D.
- Relation
- BJOG: An International Journal of Obstetrics and Gynaecology Vol. 127, Issue 12, p. 1537-1546
- Publisher Link
- http://dx.doi.org/10.1111/1471-0528.16275
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2020
- Description
- Objective: To assess spatial variations in the use of healthcare facilities for birth and to identify associated factors. Design: Cross-sectional analysis of population- and healthcare facility-based data. Setting: Ethiopia Demographic and Health Survey (EDHS 2016) linked to Service Provision Assessment data (SPA 2014). Population: A sample of 6954 women who gave birth in the 5 years preceding EDHS 2016 and 717 healthcare facilities providing delivery care. Methods: Secondary data analysis of linked population and health facility data was conducted. Multilevel and spatial analyses were conducted to identify key determinants of women’s use of health facilities for birth and to assess spatial clustering of facility births. Main outcome measure: Health facility birth. Results: A one-unit increase in the mean score of the readiness of health facilities to provide basic emergency obstetric care (EmOC) was associated with a two-fold increase in the odds of facility birthing (adjusted odds ratio, aOR, 2.094, 95% CI 1.187–3.694). A woman’s attendance for at least four antenatal care visits was significantly associated with facility birth (aOR 8.863, 95% CI 6.748–11.640). Distance to a healthcare facility was inversely related to a woman’s use of facility birthing (aOR 0.967, 95% CI 0.944–0.991). Women in the richest wealth quintile were also more likely to have facility births (aOR 2.892, 95% CI 2.199–3.803). Conclusions: There were geographic variations in facility births in Ethiopia, revealing critical gaps in service availability and readiness. It is important to ensure that health facilities are in a state of readiness to provide EmOC. Tweetable abstract: Failure to ensure health facility readiness is associated with failure to give birth at a healthcare facility.
- Subject
- health facility births; health facility delivery; institutional delivery; multilevel analysis; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1436366
- Identifier
- uon:40001
- Identifier
- ISSN:1470-0328
- Rights
- This is the peer reviewed version of the following article: Tegegne, T. K.; Chojenta, C.; Getachew, T.; Smith, R.; Loxton, D. “Giving birth in Ethiopia: a spatial and multilevel analysis to determine availability and factors associated with healthcare facility births”. BJOG: An International Journal of Obstetrics and Gynaecology Vol. 127, Issue 12, p. 1537-1546 (2020), which has been published in final form at http://dx.doi.org/10.1111/1471-0528.16275. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
- Language
- eng
- Full Text
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