Abstract:
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OBJECTIVES: To identify the determinants of institutional
delivery among young married women in Nepal. DESIGN: Nepal
Demographic and Health Survey (NDHS) data sets 2011 were
analysed. Bivariate and multivariate logistic regression
analyses were performed using a subset of 1662 ever-married
young women (aged 15-24 years). OUTCOME MEASURE: Place of
delivery. RESULTS: The rate of institutional delivery among
young married women was 46%, which is higher than the national
average (35%) among all women of reproductive age. Young women
who had more than four antenatal care (ANC) visits were three
times more likely to deliver in a health institution compared
with women who had no antenatal care visit (OR: 3.05; 95% CI:
2.40 to 3.87). The probability of delivering in an institution
was 69% higher among young urban women than among young women
who lived in rural areas. Young women who had secondary or above
secondary level education were 1.63 times more likely to choose
institutional delivery than young women who had no formal
education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a
health institution for delivery was also observed among poor
young women. Results showed that wealthy young women were 2.12
times more likely to deliver their child in an institution
compared with poor young women (OR: 2.107; 95% CI: 1.53 to
2.898). Other factors such as the age of the young woman,
religion, ethnicity, and ecological zone were also associated
with institutional delivery. CONCLUSIONS: Maternal health
programs should be designed to encourage young women to receive
adequate ANC (at least four visits). Moreover, health programs
should target poor, less educated, rural, young women who live
in mountain regions, are of Janajati ethnicity and have at least
one child as such women are less likely to choose institutional
delivery in Nepal. |