Trend of home birth and its associated factors in Ethiopia during COVID-19 and social crisis (2019–2023)

TL;DR

Home births in Ethiopia decreased from 2019 to 2023, but factors like limited prenatal care and lack of partner support remain significant.

Contribution

This study provides the first analysis of home birth trends in Ethiopia during the 2019–2023 period, including the impact of the social crisis and the pandemic.

Findings

Home birth rates dropped significantly from 37.80% in 2019 to 29.90% in 2023.

Women with fewer than four ANC visits were nearly twice as likely to give birth at home.

Lack of partner encouragement and not discussing skilled delivery during ANC visits were also significant factors.

Abstract

Maternal mortality is unacceptably high in some countries of the world, including Ethiopia. Access to skilled delivery is one of the prevention methods for maternal and neonatal deaths. However, a significant number of women gave birth at home due to many reasons. In, Ethiopia, after the implementation of many interventions to reduce home birth, the change in its trend was not studied. Hence, this study was aimed to address this information gap.

To determine the trend of home birth and its associated factors in Ethiopia during COVID-19 and Social Crisis from 2019–2023.

We obtained the data from the Performance Monitoring for Action, which employed panel design with embedded cross-sectional surveys from 2019–2023. A total sample of 8,419 women who gave birth were included in this analysis. A two-stage cluster sampling was applied to select study participants. The datasets were appended, edited, and analyzed using STATA 17 and SPSS 25. Microsoft Excel was used to prepare line graphs. A binary logistic regression model was fitted to identify factors associated with home delivery. We used an adjusted odds ratio with 95% CI to measure the strength of associations.

The level of home birth showed a significant decline from 37.80% in 2019 to 29.90% in 2023. Having less than four ANC visits [AOR = 1.91, 95% CI (1.25, 2.92)], not encouraged by partners to visit clinics [AOR =  2.15, 95%CI (1.19, 3.87)], and did not discuss delivery by skilled attendant during ANC visit [AOR =  1.70, 95% CI (1.09, 2.64)] were some of the variables significantly associated with home birth.

Home birth is declining in Ethiopia. Providers and health managers should use ANC visits as a good opportunity to inform, encourage and follow mothers to attend birth at a health facility.

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