Maternal mortality in Ethiopia:- Trends and associated factors of institutional delivery in Ethiopia from 2000 to 2018

Abstract Background: Every day, 830 women die from preventable causes related to pregnancy and childbirth, 99% of which occurs in developing countries and is higher among women living in rural areas and poorer communities. Seventy-five percent of all maternal deaths occur during labour and delivery and in the immediate post-partum period. In previous years studies are conducted to identify the determinants of institutional delivery in Ethiopia, but very few systematic reviews were done in recent years. The purpose of this review is to understand better and synthesize the best available evidence about determinants of health facility based childbirth. Method: For this review, both manual and electronic internet-based database search were used to find articles done on institutional delivery and it's determinants in Ethiopia. Databases used are Scopus, Google Scholar, Web of science, and PubMed. Out of 147 studies, 42 met inclusion criteria, 30, 5, 1, 1 studies were cross-sectional, case-control, follow up, and qualitative studies respectively and the rest were demographic and health survey. Key terms used in these databases search were combinations of institutional delivery, health facility delivery, determinants, associated factor, predictors and Ethiopia. Result and conclusion: In the past decades, utilization of health facilities for childbirth was increased significantly, but still lagging behind from world average utilization. Antenatal care, women's and their partners' education status and level, Place of residence and distance to nearby HF, mother's age at the time of pregnancy, occupation other than farming, and parity are strongly predicting women's place of childbirth. Women's knowledge of pregnancy and delivery related complication, exposure to mass media, healthcare providers' competency and culturally sensitivity were also identified to influence women's decision on a place of delivery. Therefore government and other stakeholders ought to work hard to improve mothers' Antenatal care service uptake and then institutional delivery utilization with the ultimate aim of eliminating preventable maternal mortality. A program should be designed aiming besides formal education, educating women and their families focusing on complications related to pregnancy and delivery, danger signs of pregnancy and importance of Antenatal care follow up and institutional delivery emphasizing on women residing in rural and farmers.MSc/MAáltalános orvostudományiangolnappalig