Factors Affecting Choice of Place for Childbirth among Women’s in Ahferom Woreda, Tigray, 2013

Background: Reduction of maternal mortality is a global priority particularly in developing countries including Ethiopia where maternal mortality ratio is one of the highest in the world. The key to reducing maternal mortality ratio is increasing attendance by skilled health personnel throughout pregnancy and delivery. However, delivery service is significantly lower in Tigray region. Therefore, this study aimed to assess factors affecting choice of place of child birth among women in Ahferom woreda. Method: A community based cross-sectional study both quantitative and qualitative method was employed among 458 women of age 15-49 years that experienced child birth and pregnancy in Ahferom woreda, Central zone of Tigray regional state, Ethiopia from February to October 2013. Multi stage stratified sampling technique with Probabilities proportional to size was used to select the study subjects for quantitative and focus group discussions (FGDs) for the qualitative survey. Study subjects again were selected by systematic random sampling technique from randomly selected kebelle’s in the Woreda. Data was collected using structured interview questionnaire and entered, cleaned and analyzed using SPPS version 16.0 statically package software. Descriptive statistics and associations between variables were assessed by using multivariate regression analysis. Results: A total of 458 women participated in the quantitative survey. One third of women were age 35 and above, 118 (25.8%) were aged between 25-29 years. 247 (53.9%) of women were illiterate, 109 (23.8%) get primary education, only 55 (12%) attend secondary education and above. 58.7% of women choice home as place of birth and 41.3% choice health facilities. Women whose husbands illiterate were less likely to choice health facility as place of child birth when compared to women whose husbands were receive secondary education and aboveAOR(95%CI).23 (.173-.76). Regardless of women having health information; women who get health information about the benefit of institutional deliveries increase the probability of choosing health institution 3.6 times higher than those who did not get the information COR,95% CI 17 (6.9-44.3)& AOR,95% CI 3.6 (1.017-12.7) Conclusion and Recommendations: Age of the respondents, women education, husband education, attending ANC, having information on the benefit of health institution delivery, reliance on tradition, distance and provider approach toward laboring women were significant predictors for the choice of women place of child birth. Therefore, government and other responsible bodies should make efforts to increase community based health education, awareness creation and improve better access to information for women regarding maternal health care services. Moreover, Tigray regional health bureau in collaboration with the woreda and other stakeholders should provide means of transport (ambulance) to encourage referral between communities and health care providers.