Home birth prevalence and associated factors in southwest Ethiopia

In Ethiopia, antenatal care takes a focused approach, where women are encouraged to give birth in a health facility, as there are no services that provide skilled birth attendants for home births. However, nearly half of mothers booked for antenatal care give birth at home, which is associated with a higher risk of maternal mortality and poor outcomes. This study aimed to assess the prevalence of home birth and associated factors among women in southwest Ethiopia. A community-based cross-sectional study was conducted using simple random sampling. Data were collected from 1 February 2018 to 30 April 2018 from 1831 women who had given birth in the last year in selected zones of southwest Ethiopia, using a structured interviewer-administered questionnaire. The data were cleaned and exported to STATA 14 for analysis, both by bivariate and multivariate logistic regression. P≤ 0.05 at 95% confidence interval of odds ratio was taken as significant in the multivariable model. Approximately half (54.5%) of the participants gave birth at home. Rural residence (adjusted odds ratio=0.46, P=0.032), listening to the radio (adjusted odds ratio=0.53, P=0.047), attending 3–5 antenatal care visits (adjusted odds ratio=0.40, P=0.031), being widowed or divorced (adjusted odds ratio=2.89, P=0.045), prolonged labour (adjusted odds ratio=0.76, P=0.021) and waiting time for antenatal care services (adjusted odds ratio=1.85, P=0.042) were significantly associated with home birth. More than half of the participants gave birth to their last child at home, and this decision was affected by residence, prolonged labour, antenatal care frequency, media, marital status, and waiting time for antenatal care services. Interventions to increase institutional birth should prioritise those who do not attend antenatal care, are not exposed to media or who are widowed or divorced. Similarly, reducing antenatal care waiting time and encouraging mothers to attend antenatal care are vital to improving rates of institutional birth in Ethiopia.