Predictors of homebirth amidst COVID-19 pandemic among women attending health facilities in Wondo Genet, Sidama Region, Ethiopia: A case control study

Abstract

Background In developing countries, home delivery increases the risk of maternal and perinatal mortality. Despite this, home deliveries account for a considerable share of deliveries in developing nations such as Ethiopia. Evidence on factors that affect homebirth is required for the measures needed to overcome these conditions. Objective To identify predictors of homebirth among women attending health facilities in Wondo Genet, Sidama Region. Methods Unmatched case-control study was conducted from May to June 2021 among 308 mothers (102 cases and 206 controls) who recently delivered and visited either postnatal care or sought immunization service at public health facilities of Wondo Genet. A structured interviewer-administered questionnaire was used to collect data. Epi-Data version 3.1 was used for data entry, and the Statistical Package for the Social Sciences (SPSS) version 20 was used for data analysis. Bivariate and multivariate logistic regression analyses were used to identify the determinants of homebirth. The association between the outcome variable and independent variables was declared statistically significant at a P-value < 0.05 with a 95% Confidence Interval (CI) in a multivariable model. Results Rural residence [AOR: 3.41; 95%CI: 1.58-7.39], lifetime physical IPV [AOR: 2.35; 95%CI: 1.06-5.17], grand-multiparity [AOR: 5.36; 95%CI: 1.68-17.08], non-use of contraception before recent pregnancy [AOR: 5.82; 95%CI: 2.49-13.60], >30 min to reach health facility [AOR: 2.14; 95%CI: 1.02-4.51], and lack of facemask [AOR: 2.69; 95%CI: 1.25-5.77] were statistically significant predictors of homebirth. Conclusion and recommendation The access gap to maternity services should be narrowed between rural and urban women. Healthcare programs concerning women's empowerment could help reduce persistent intimate partner violence. Family planning needs to be promoted, and multiparous women should be counseled on the adverse obstetric consequences of homebirth. The devastating effect of the coronavirus disease 2019 pandemic on maternity services should be prevented.