Determinants of delivery practices among Afar pastoralists of Ethiopia

INTRODUCTION: In a previous qualitative study in Afar, it was reported that most mothers deliver at home, assisted by Traditional Birth Attendants (TBAs). However, determinant factors of delivery practices in this region remain scarcely explored. The objective of this study was to elucidate these factors among the Afar community. METHODS: This cross sectional study was conducted in April 2011 in zone 3 of Afar regional state, Ethiopia. Quantitative data were collected from 478 women who had given birth during the preceding one year. RESULTS: Out of 478 interviewed mothers in urban/rural areas, 398 (83.3%) gave birth to the youngest child while at home; 370 (92.5%) were assisted by TBAs. Only 3.2% of them were assisted by Health Extension Workers/nurses in health posts or at home during delivery. We found an association between health facility delivery and ante-natal care (ANC) attendance (p<0.001), educational status (p<0.001) and occupation of the husband/wife (mother) and gravidity (p=0.003); but there was no association with the number of wives the husband had (p=0.566). In the adjusted model, ANC attendance and education status of mother were significantly associated with health facility delivery (p=0.036; p<0.001). CONCLUSION: Most deliveries in the study community took place at home. Educated mothers and ANC attending mothers have high tendency for health facility delivery. Programmes need to strengthen the capacities of mothers to attend ANC services, as well as build the capacity of Health Extension Workers (HEWs) and nurses working in health posts, in order to win the confidence of the community.