Factors associated with health facility delivery among reproductive age women in Nepal: An analysis of Nepal Multiple Indicator Cluster Survey 2019

Background: Delivery in health facility is an essentials factor in improving maternal health. Reducing maternal mortality is the one of the targets of Sustainable Development Goal 3. Health facility delivery is still major concern in Nepal. This study aims to determine the factors associated with delivery in health facility among women aged 15-49 years in Nepal. Methods: This study used data from Nepal Multiple Indicator Cluster Survey 2019, a nationally representative cross-sectional survey. This survey was a two-stage, stratified cluster sampling. A total of 1,950 married women age 15-49 years who had at least one live birth in the last two years preceding the survey were included in the analysis. Bivariate and multivariate logistic regression analysis were performed in this study. Results: Seventy-eight percent of women delivered in health facility. Women from urban area (AOR= 1.64, p<0.01), women residing in Sudurpaschim province (AOR=5.68, p<0.001), women who used internet (AOR=1.53, p<0.05), women with first parity (AOR=2.79, p<0.001), and women from richest household status (AOR= 6.10, p<0.005) and women who attained at least four ANC visits (AOR=12.77, p<0.001) were associated with higher odds of delivering in a health facility. Conclusion: Consideration should be given to female education, poverty reduction and promotion of maternal healthcare services with particular attention to uneducated women or with low education levels, who reside in rural areas, women from poor household status and disparity in maternal health services across the provinces.