Poverty reduces maternity waiting home utilization in Sidama Zone, southern Ethiopia

Abstract Background : Maternity waiting home utilization is proved to decrease maternal mortality and morbidity. Maternity waiting home service utilization is a strategy to improve facility-based skilled delivery service in Ethiopia. Though the establishment of maternity waiting homes started in Ethiopia more than three decades back, the utilization of the service seems to low. The objective of this study is to estimate the magnitude of maternity waiting home utilization and identify its associated factors in Sidama Zone, southern Ethiopia. Methods: A community-based cross-sectional study was conducted on a total of 748 mothers who gave birth in the last one year in selected woredas (districts) of Sidama Zone. Data were collected from April 1- 25, 2019 using pre-tested and structured questionnaires. Data were coded and entered into EpiData version 3.5.1 and exported to Stata Version 13 software for analysis. Multivariable logistic regression analysis was performed to identify factors associated with maternity waiting home utilization adjusting for confounders. Results : In this study utilization of maternity waiting home in Sidama Zone was 67.25 % ( 95% CI: 63.79%-70.53%).Maternity waiting home utilization was significantly associated with maternal age of 31-40 (AOR=0.4; 95%CI: 0.28-0.64) related to 20-30 age category, daily laborer occupation of mothers (AOR=0.2; 95%CI: 0.06-0.76), protestant religion (AOR=1.7; 95% CI: 1.00-2.82), monthly income under poverty level(825-1320 EBR) (AOR=0.6; 95%CI: 0.36-0.92)related with extremely under poverty level(<825EBR), lack of knowledge about maternity waiting home (AOR=0.009; 95%CI: 0.002-0.03) and having a spouse who can read and write (AOR=2.0; 95%CI: 1.11-3.66) . Conclusion: Women who had knowledge about maternity waiting home, women who had a husband who can read and write and women who were protestant religion followers have higher probabilities of maternity waiting home utilization, whereas older women (31-40 years old), women who are daily laborers and women whose family income is below poverty have lower probabilities of maternity waiting home utilization. Health education about maternity waiting home utilization, spouse education and women's economic empowerment are crucial to enhance maternity waiting home utilization. Keywords: Maternity waiting home, Utilization, Associated factors, Ethiopia