Institutional Delivery Service Utilization And Associated Factors In Ethiopia: A Systematic Review And Meta Analysis

Abstract Background: Different primary studies in Ethiopia showed the weight of institutional delivery service utilization and factors associated with it. However, variation among those studies was seen. This study was aimed to estimate the pooled national prevalence and associated factors of Institutional delivery service utilization in Ethiopia. Methods: PubMed, Cochrane library, Web of Science, and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was applied to check heterogeneity of studies. A weighted inverse variance fixed-effects model and Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of associated factors. Result: A total of 24 studies with 19,969 participants were used for prevalence estimation. The pooled prevalence of Institutional delivery service utilization was 31% (95% CI: 0.30-0.312; I2 = 0.000%). Attitude towards institutional delivery(AOR=2.83; 95% CI 1.35 5.92 ), maternal age at first pregnancy((AOR= 3.592; 95% CI 2.269 5.686 )), residence setting(AOR= 3.844; 95% CI 1.313 11.253), educational status of mothers(AOR=2.915;95% 1.881-4.517), availability of information source(AOR= 1.797;95% CI 1.160 2.783), ANC follow-up((AOR= 2.574 95% CI 1.460 4.54 )), frequency of ANC follow up(AOR= 4.039;95% CI 1.212 13.462), knowledge of institutional delivery & danger signs during pregnancy((AOR=3.04;95% CI 1.76 5.24 )) and place of birth the most recent birth(AOR=8.44;95% CI 5.748 12.393) were identified factors of institutional delivery service utilization. Conclusions: The prevalence of institutional delivery in Ethiopia remains low. This review may help policy-makers to design institutional delivery service utilization improvements. Keywords: Institutional delivery, service utilization, Ethiopia