Results: - Out of 360 sample size, 357 participants were engaged in the study with a 99% response rate and the most regular respondents' age groups were 20-24 age groups which account for 147(41.2%). The mean age of the respondent was 24.44 years (Standard Deviation, SD = 4.95). The age of the respondents ranges from 15 to 40 years. Three hundred fifty (98 %) of the women were married. The dominant parts of the respondents were Protestant by religion 289 (81 %) and Oromo by ethnic gathering 324(90.8%) (Table 1). Right around 337 (85.7 %) of the women had attended formal education. The mean month to month pay of respondents was 2452.58 Ethiopian birrs (Table2). The mean age of respondents' first pregnancy was 17.62 years with standard deviations of + 1.7 years and the mean period of the respondent of last pregnancy 23.11 years with a standard deviation of + 4.78 years (Table 3).
The investigation demonstrated most of the respondents, 281(78.7%) visit antenatal care and out of those mothers 119(42%) visit the health facility at three months, 56(19.8%) at one month, 52(18.4%) at two months, 32(11.3%) at four-month, 20(7.1%) at five months and the rest were attended antenatal care after five months of gestational age. With respect to the number of antenatal care visit out of antenatal care followers 104 (38.2%) visit four times,56(19.8%) visit three times,52(18.4%) visit six times, 44 (15.5%) visit five times, 9(3.2%) visit two times and the rest where visited more than six times. During antenatal care visit, 279(98.6%) receive any information and advice about the place to give birth and related complication during labor and delivery. Out of 279(98.8) respondents receive information about complication during labor and delivery, 98(35.3%) severe vaginal bleeding, 49(17.6%) prolonged labour, 43(15.5%) severe headache, 37(13.3%) cessation of fetal movement, 26(9.4%) markedly weight gain of mothers and 25(9%) retained placenta. The reasons given by the mother didn't go to antenatal care visits are there were no medical issue workload, terrified of the expense, Poor treatment of well-being specialist and feel disgrace (Figure3).
Utilization of institutional delivery service
The greater part (72%) of the mothers gave birth at the health facility and the rest of them gave birth at home (Figure 4 and 5). The reason given by mothers those gave birth at homes were:- it is their usual experience, had short labor, had a bad experience from past health facility delivery, felt more comfortable when giving birth at home and their family gives close attention.
Factors associated with Utilization's of institutional delivery service among Independent predictor variables
The binary logistic regression analysis was performed to identify variables candidate for multivariable logistic regression analysis with the utilization of institutional delivery services. Consequently, maternal age, educational status of mothers, educational status of husbands, spousal communication, decision-maker on place of delivery, mothers occupations, husbands occupations, current antenatal care, family size, parity, competence of skill attendants, shortage of skilled attendants in health facility, prefer of sex of care provider during labor/delivery are variables candidate for multiple logistic regression, since their p- values were less than 0.25 (Tables 4).
In this study multivariable logistic regression analysis was performed to identify factors which had a strong association with utilization of institutional delivery service (Table 5).
According to this finding age at first pregnancy, educational status of mothers, educational status of husbands, spousal communication, husbands occupations, current antenatal care, and parity were had a strong statistical association with utilization of institutional delivery service.
A multivariable logistic regression analysis shows as age at first pregnancy greater than 18 years were 2.077 (1.768-5.620) times more likely to give birth at a health facility than those who became pregnant before 18 years of age. Mothers’ education was very important factors determine the place of delivery, thus mothers attended secondary school and above were 4.613(1.096-11.912) times and primary school attended mothers were 3.183(2.406-3.443) times more likely to give birth at a health facility than illiterate mothers.
Husband education had also a statically significant association with utilization of institutional delivery service. A wife whose husbands’ attended secondary school and above were 4.911(10.792-30.441) times and primary school attended 2.129(8.359-12.616) time more likely to give birth at a health facility compared with illiterate husbands. According to this finding spousal communication on the place of delivery also had a positive association with institutional delivery services. Spousal communication on the place of delivery was 4.270(1.823-10.004) times more likely to utilize institutional delivery service compared with no communication in the place of delivery. Mothers who had currently attended antenatal care were 46.740(16.778-30.210) more likely to utilize institutional delivery services than others.
The study finds out occupations of a husband had a statistically significant association with utilization of institutional delivery services. Mothers whose husbands’ the government employs 2.942 (2.734-5.137) times more likely to give birth at a health facility compared with private employ. Another strong factor for the utilization of health care for delivery is parity. Mothers who gave birth three times and less(<=3) and four to six(4-6) were 6.969(1.305-37.212) and 4.449(2.787-25.138) times more likely to give birth at health facility respectively as compared with mothers who gave birth seven times and more.