Factors influencing the utilization of institutional delivery services by Chepang women in Chitwan district of Nepal
DOI:
https://doi.org/10.62992/ijphap.v2i2.5Keywords:
Institutional delivery, Multilevel analysis, Chepang Women, Chitwan District, NepalAbstract
Background: Nepal has not yet achieved less than 70 maternal deaths per 100,000 live births of the SDG. To reduce the maternal death rates, a safe motherhood program has been implemented across Nepal to provide pregnant women with free delivery care in a healthcare facility, as well as transportation incentives promoting institutional delivery. Being a marginalized group of people residing in hilly slope areas, the Chepang population is deprived of significance usage of healthcare services.
Objective: This study aimed to assess the incidence of delivery complications, and to investigate the factors associated with the utilization of institutional delivery of the Chepang women in the Chitwan district.
Methods: A cross-sectional study was conducted in Rapti, Kalika and Ichchhakamana municipalities with a proportional random sample of 557 mothers. A face-to-face interview using a structured questionnaire was performed to collect the data. Using stepwise logistic regression analysis, the data were analyzed.
Results: The results show that the incidence of delivery complications among those who utilized an institutional delivery was lower than the non-institutional delivery respondents. The literate parents were strongly associated with the increased usage of an institutional delivery (OR=12.08, 95%CI=6.32-23.06), and (OR=5.45, 95%CI=2.82-10.51) for literate mothers and literate spouses, respectively. Other significant factors were older ages at delivery of mothers as compared to younger ages mothers (OR= 3.28, 95%CI=1.83-5.90 for ages 20-29 year.; OR=3.75, 95%CI=1.80-7.83 for ages ≥30 year.), and engagement in business and services occupation of mothers (OR=2.01, 95%CI=1.01-4.01). The associations were observed for vehicle transportation to the delivery facility (OR =1.99, 95% CI =1.28-3.11) and travel time ≤30 minutes to the delivery facility (OR=2.80, 95%CI=1.58-4.96).
Conclusions: The results revealed a lower incidence of delivery complications among those who utilized the institutional delivery. The analysis also demonstrated that age, education, income, and convenient access to an institutional delivery facility for mothers were associated with the utilization of institutional delivery of Chepang women. The findings could benefit health professionals in developing a health intervention to increase institutional delivery services for marginalized Chepang women.
References
Lomazzi M, Borisch B, Laaser UJGha. The Millennium Development Goals: experiences, achievements and what's next. 2014;7(1):23695.
Nations U. Sustainable developmental goals 2019 [April 1, 2019]. Available from: https://www.un.org/sustainabledevelopment/health/.
Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. 2016;387(10017):462-74.
Organisation WH. Maternal mortality 2018 [Feb 23, 2019 ]. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.
Shrestha¹ MS, Shrestha MR, Shrestha MTK, Shrestha E, Joshi S, Paudel MG. Knowledge and practice of antenatal care among chepang women from chitwan, nepal. 2018.
Tuladhar H, Khanal R, Kayastha S, Shrestha P, Giri AJNMCJ. Complications of home delivery: our experience at Nepal Medical College Teaching Hospital. 2009;11(3):164-9.
Ghimire M, Maharjan RKJJoAAR. Antenatal and Post-natal Check-up Practices Among Chepang and Non-Chepang Communities of Nepal. 2014;1(2):64-73.
Sharma SR, Poudyal AK, Devkota BM, Singh SJBPH. Factors associated with place of delivery in rural Nepal. 2014;14:1-7.
Agha S, Williams EJK, Pakistan: Jhpiego. Maternal and Child Health (MCH) Program Indicator Survey 2013: Sindh Province. MNCH Services Component, USAID/Pakistan MCH Program. 2013.
Shah R, Sharma B, Khanal V, Pandey UK, Vishwokarma A, Malla DKJBRN. Factors associated with neonatal deaths in Chitwan district of Nepal. 2015;8:1-8.
Devkota B, Maskey J, Pandey AR, Karki D, Godwin P, Gartoulla P, et al. Determinants of home delivery in Nepal–A disaggregated analysis of marginalised and non-marginalised women from the 2016 Nepal Demographic and Health Survey. 2020;15(1):e0228440.
Health Mo, ERA N, ICF. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal. 2017.
Neupane B, Rijal S, Gc S, Basnet TBJHSI. A multilevel analysis to determine the factors associated with institutional delivery in Nepal: further analysis of Nepal demographic and health survey 2016. 2021;14:11786329211024810.
Gebregziabher NK, Zeray AY, Abtew YT, Kinfe TD, Abrha DTJBph. Factors determining choice of place of delivery: analytical cross-sectional study of mothers in Akordet town, Eritrea. 2019;19(1):1-11.
Yaya S, Bishwajit G, Ekholuenetale MJPo. Factors associated with the utilization of institutional delivery services in Bangladesh. 2017;12(2):e0171573.
Acharya P, Adhikari TB, Neupane D, Thapa K, Bhandari PMJPO. Correlates of institutional deliveries among teenage and non-teenage mothers in Nepal. 2017;12(10):e0185667.
Dhakal P, Shrestha M, Baral D, Pathak SJIjocbn, midwifery. Factors affecting the place of delivery among mothers residing in Jhorahat VDC, Morang, Nepal. 2018;6(1):2.
Jovic-Vranes A, Bjegovic-Mikanovic V. Which women patients have better health literacy in Serbia? Patient education and counseling. 2012;89(1):209-12.
Chaurasiya SP, Pravana NK, Khanal V, Giri DJPo. Two thirds of the most disadvantaged Dalit population of Nepal still do not deliver in health facilities despite impressive success in maternal health. 2019;14(6):e0217337.
Kifle MM, Kesete HF, Gaim HT, Angosom GS, Araya MBJJoH, Population, Nutrition. Health facility or home delivery? Factors influencing the choice of delivery place among mothers living in rural communities of Eritrea. 2018;37:1-15.
Abeje G, Azage M, Setegn TJRh. Factors associated with Institutional delivery service utilization among mothers in Bahir Dar City administration, Amhara region: a community based cross sectional study. 2014;11(1):1-7.
Mitikie KA, Wassie GT, Beyene MBJPO. Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia. 2020;15(12):e0243466.
Tadele N, Lamaro TJBhsr. Utilization of institutional delivery service and associated factors in Bench Maji zone, Southwest Ethiopia: community based, cross sectional study. 2017;17(1):1-10.
Patrick C, Stephens H, Weinstein AJSBE. Where are all the self-employed women? Push and pull factors influencing female labor market decisions. 2016;46:365-90.
Adamson PC, Krupp K, Niranjankumar B, Freeman AH, Khan M, Madhivanan PJBph. Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India. 2012;12:1-6.
Demilew YM, Gebregergs GB, Negusie AAJAhs. Factors associated with institutional delivery in Dangila district, North West Ethiopia: a cross-sectional study. 2016;16(1):10-7.
Kumar S, Dansereau EA, Murray CJJAE. Does distance matter for institutional delivery in rural India? 2014;46(33):4091-103.
Rajvanshi D, Anthony J, Namasivayam V, Dehury B, Banadakoppa Manjappa R, Prakash R, et al. Association of identification of facility and transportation for childbirth with institutional delivery in high priority districts of Uttar Pradesh, India. 2021;21:1-10.
Joshi D, Baral S, Giri S, Kumar AJPha. Universal institutional delivery among mothers in a remote mountain district of Nepal: what are the challenges? 2016;6(4):267-72.
Karkee R, Binns CW, Lee AHJBp, childbirth. Determinants of facility delivery after implementation of safer mother programme in Nepal: a prospective cohort study. 2013;13:1-7.
Downloads
Published
License
Copyright (c) 2023 International Journal of Public Health Asia Pacific

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
International Journal of Public Health Asia Pacific (IJPHAP) is licensed under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 international (CC BY-NC-ND 4.0) license, unless otherwise stated. Please read our Policies page for more information on Open Access, copyright, and permissions.