Factors affecting health facility delivery in rural Nawalparasi district of Nepal.

Abstract

Objective: In Nepal, both percentage of women giving birth at health facility and proportion of birth assisted by skilled birth attendant is very low. The purpose of this research was to investigate the factors related to health facility delivery in two levels of care in Nepal: primary health care and tertiary health care facilities. Methods: A cross-sectional household survey was conducted in seven villages of a district lying in plain area of Nepal: Nawalparasi. A structured interview questionnaire was developed and administered face-to-face. Descriptive analysis along with chi-square test and multinomial logistic regression was used to identify the predictors of institutional delivery. Results: Women were significantly more likely to deliver at health care facilities compared to home if the distance was less than one hour, belonged to advantaged caste, had radio, television and motorbike/scooter, decision maker for place of delivery was husband, reported their frequency of antenatal (ANC) visits at 4 or more and belonged to age group 15-19. Conclusion: Women have less control over making decisions related to their choice for place of birth rather it is mostly made by husbands. The findings highlight importance of having four or more ANC visits to the health institutions and that it should be located within one-hour walking distance. Inequity in utilisation of delivery services at health institutions exists as showed by low utilisation of such services by disadvantaged caste.