Factors determining choice of place of delivery: analytical cross-sectional study of mothers in Akordet town, Eritrea

Background: In Eritrea, facility delivery rates show great discrepancy within urban centers. This study was conducted in Akordet, a multi-cultural lowland town of Gash-Barka Region, aiming at assessing the factors influencing facility delivery. Methods: A community based analytical cross-sectional study was conducted among a total of 282 mothers who gave birth within the 2 years preceding the data collection time. Data collection was carried out by going house-to-house and interviewing the mothers using a structured closed ended questionnaire. Bivariate and multivariate logistic regressions were used to determine the magnitude of the relationship between place of delivery and the explanatory variables (Religion, Ethnicity, Mother's educational level, Husband's Educational level, Place of delivery preceding last pregnancy, Birth order of last child, Any complications during previous delivery, First ANC Visit during last pregnancy, Number of ANC visits during last pregnancy and Any complication during last pregnancy.). For this study, p-value <= 0.05 was considered as statistically significant. Results: The rate of facility delivery in this setting was found to be 82.3%. Almost all (96.1%) the mothers had at least one ANC visit during their last pregnancy, with the majority (59.7%) visiting ANC clinics during second trimester for the first time. Mothers whose educational level is junior and above (AOR 8.8, CI: 1.18-65.64), whose husband's educational level is junior and above (AOR 3.92, CI: 1.03-14.54), who gave birth in health facility before the last pregnancy (AOR 8.16, CI: 3.41-19.48), and those who had complications during last pregnancy (AOR 2.24, CI: 1.04-4.82) were more likely to deliver in a health facility. Mothers whose last child's birth order was 4th -6th were less likely (AOR 0.24, CI: 0.090.62) to deliver at health facility. Conclusions: Early initiation of ANC and regularity in attendance should be emphasized. Health educations given to pregnant mothers should try to persuade the mothers that each pregnancy and ensuing delivery is unique. Empowering the community in general and women in particular by increasing the level of participation in education might payoff in high level of facility delivery.