Utilization and Factors Associated with Health Facility Delivery among Women of Reproductive Age in Rural Ethiopia: Mixed effect logistic regression analysis

Background Worldwide over 800 women lose their life each day from complication in pregnancy and child birth. Inequity by urban–rural residence is one of the most pronounced challenges in maternal health service coverage with women living in rural areas at a greater disadvantage than other women. This study aims to assess the magnitude and factors affecting the utilization of health facility delivery for the most recent live birth among women of reproductive age in rural Ethiopia. Methods This is a cross-sectional study based on a data from Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 2900 women of reproductive age group in rural Ethiopia. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors. Result Only 44% of reproductive-age women in rural Ethiopia gave their most recent live birth in health institutions. In the multivariable multilevel binary logistic regression analysis educational status, wealth index, marital status, household family size, attending 4+ANC, had ANC in the first trimester of pregnancy and ANC by skilled provider were found to be statistically significant factors associated with health facility delivery. Conclusion In a rural part of Ethiopia, the prevalence of institutional delivery is low. Special emphasis should be given for mothers with no formal education, with poor household wealth index, married women, and mothers with more than five household family sizes. Furthermore implementing public health programs that target to enable women to have early first trimester Ante Natal Care, ANC by skilled provider and more frequent Ante Natal Care follow-up may increase the number of health facility deliveries.