Prevalence and Determinants of Home Delivery in Eastern Africa: Further Analysis of Countries Recent Demographic and Health Survey Data

Abstract Background: Despite the high proportion of maternal mortality ratio in East African countries primarily attributed to home delivery, overall magnitude of home delivery and its determinants remains unclear. Therefore, the current study aimed to determine magnitude of home delivery and its determinant factors in East Africa using Demographic and Health Survey (DHS) data.Methods: We pooled the DHS survey data of the 11 East African countries, and a total weighted sample of 125,786 women were included in the study. Generalized Linear Mixed Models (GLMM) was fitted to identify factors associated with home delivery. Variables with Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI), and p-value < 0.05 in the final GLMM model were reported to declare significantly associated factors with home delivery.Result: The weighted prevalence of home delivery was 23.79% [95% CI: 23.55 – 24.02] among women in East Africa countries. Home delivery was highest among Ethiopian women (72.5%) whereas, it was lowest among women from Mozambique (2.8%). In GMM, respondent’s age group, marital status, educational status, place of residence, living country, wealth index, media exposure and total children ever born were shown significantly associated with the home delivery in the East Africa countiesConclusion: Home delivery was varied between countries of East African zone. The home delivery was significantly increased among women aged 20-34 years, higher number of ever born children, rural residence, never married or formerly married participants. To the contrast home delivery was decreased with higher educational level, media exposure, and higher wealth index. Wide range interventions to decrease home delivery should focus on addressing inequities associated with maternal education, family wealth, increased access to media, as well as narrowing the gap between the rural and the urban areas, poor and rich families, and married and unmarried mothers.