Home delivery practice and its predictors in South Ethiopia.

BACKGROUND: Institutional delivery is one of the key interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries like Ethiopia are home deliveries and are not attended by skilled birth attendants. We investigated the prevalence and determinants of home delivery in three districts in Sidama administration, Southern Ethiopia. METHODS: Between 15-29 October 2018, a cross sectional survey of 507 women who gave birth within the past 12 months was conducted using multi-stage sampling. Sociodemographic and childbirth related data were collected using structured, interviewer administered tools. Univariate and backward stepwise multivariate logistic regression models were run to assess independent predictors of home delivery. RESULTS: The response rate was 97.6% (495). In the past year, 22.8% (113), 95% confidence interval (CI) (19%, 27%) gave birth at home. Rural residence, adjusted odds ratio (aOR) = 13.68 (95%CI:4.29-43.68); no maternal education, aOR = 20.73(95%CI:6.56-65.54) or completed only elementary school, aOR = 7.62(95% CI: 2.58-22.51); unknown expected date of delivery, aOR = 1.81(95% CI: 1.03-3.18); being employed women (those working for wage and self-employed), aOR = 2.79 (95%CI:1.41-5.52) and not planning place of delivery, aOR = 26.27, (95%CI: 2.59-266.89) were independently associated with place of delivery. CONCLUSION: The prevalence of institutional delivery in the study area has improved from the 2016 Ethiopian Demography Health Survey report of 26%. Uneducated, rural and employed women were more likely to deliver at home. Strategies should be designed to expand access to and utilization of institutional delivery services among the risky groups.

Prevalence of Early Removal of Long-Acting Contraceptive Methods and Its Associated Factors in Sidama Regional State, Ethiopia.

BACKGROUND: Long-acting reversible contraceptive methods, IUD and sub-dermal implant, offer women the most effective method to control fertility. Yet, reports on high early removal rates were emerged, prompting concern among service providers and highlighting the need to review removal rates and its reasons. Therefore, this study was conducted to assess the prevalence of early removal rates of LARCs and its associated factors in Sidama Regional State, Southern Ethiopia. METHODS:  Community-based cross-sectional study was conducted in Sidama Regional State, Ethiopia from June 1 to June 30, 2019. A multistage sampling technique was used to select 21 administrative units in the first stage. Then, systematic sampling was used to select 475 women who have ever used implants or IUD 3 years preceding the data collection period. Data were entered into Epi Info version 3.4.3 and exported to SPSS version 20 for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed. P-value <0.05 was used to declare a significant association. RESULTS: The mean (±SD) of the participant's age was 29.81 (±5.69) years. The prevalence of early removal rate of LARCs was 10.3%, ie, 43 (10.8%) among Implanon/jadelle users and 6 (7.8%) among IUD users. Eleven (22.4%) discontinued within the first six months and 38 (77.6%) utilized for more than six months and discontinued before the 12th month. Women who were not advised about advantage [OR= 2.81 (95% CI: 1.23-6.40)] and effectiveness of contraceptive [OR= 2.70 (95% CI: 1.30-5.60)] and those who were satisfied with the family planning service [OR= 2.24 (95% CI: 1.10-4.57)] were identified as factors. CONCLUSIONS: The prevalence of early removal rate was considerably high among the study subjects. Providing appropriate counseling about the advantage and effectiveness of family planning and improving client satisfaction need to be considered to reduce the early removal rate.