Institutional Delivery Among Young Women in Ethiopia: Further Analysis of Trends and Determinants, from the Four Consecutive Ethiopia Demographic and Health Survey

PURPOSE: Although young people have a right to sexual and reproductive health, they are facing inadequate access to information and services. The Ethiopian government has started implementing policies and strategies to eliminate inequalities in reproductive health service use. However, there are huge disparities in institutional delivery utilization between different age groups. Therefore, this study aimed to explore trends and factors associated with institutional childbirth among young women in Ethiopia. METHODS: Ethiopian demographic and health survey data (EDHS) from 2000 to 2016 surveys were used. Data on the most recent births to women aged 15–24 years that occurred in the 5 years preceding the survey period were extracted. All the four EDHS data were used to examine trends of institutional delivery, whereas determinants for institutional delivery were analyzed from a 2016 dataset by using multivariable logistic regression analysis. FINDINGS: Between 2000 and 2016, the proportion of institutional delivery among young women increased from 6% (95% CI=3.7–6.5%) to 40.1% (95% CI=30.6–44.3%). The odds of institutional delivery increased for young women who had attended secondary and above education (AOR=2.68; 95% CI=1.559–4.607), started ANC visits early (AOR=1.518; 95% CI=1.095–2.105) and received four or more ANC visits (AOR=1.87; 95% CI=1.370–2.561). However, the odds were lower among young women who had two (AOR=0.31; 95% CI=0.185–0.514), and three or more children (AOR=0.62; 95% CI=0.452–0.849). CONCLUSION: There is an increase in trend of institutional delivery among young women during the 2000 to 2016 EDHS. Having higher educational levels, early ANC booking, and attending four or more ANC visits were positively associated with institutional delivery. Increased number of children is negatively associated with institutional delivery. Strengthening strategies for improving girls’ education and addressing their socioeconomic and demographic vulnerabilities, and strengthening strategies being implemented for encouraging early and recommended ANC visits is crucial.