Factors associated with the place of delivery among women in Uganda

Abstract

The place of delivery is a key determinant of maternal and neonatal health outcomes, particularly in low and middle-income countries like Uganda. This study aimed to examine factors associated with the place of delivery among women of reproductive age (15-49) in Uganda. Data was extracted from the 2016 Uganda Demographic and Health Survey. This was a population-based cross-sectional study conducted with 10,263 women of reproductive age (15-49). The analysis employed both chi-square tests and multivariate logistic regression to determine the predictors of health facility delivery. The key independent variables included in the modal are current marital status, place of residence, employment status, wealth index, level of education, religion, age, women's empowerment., current pregnancy wanted, birth order, and antenatal care use. Of the 10,263 women, 7,620 (74.25%) delivered in a health facility. Multivariate logistic regression showed that women in the fourth (OR=1.28, 95% CI=1.103-1.493, p=0.001) and highest wealth index (OR=2.6, 95% CI=2.089-3.324, p=0.000) were more likely to deliver in a health facility than those in the lowest wealth index. Women with secondary (OR=1.96, 95% CI=1.612-2.380, p=0.000) and higher education (OR=5.11, 95% CI=3.186-8.180, p=0.000) were more likely to deliver in a health facility than those with no education. Muslims (OR=3.61, 95% CI=1.271-10.260, p=0.016) were more likely to deliver in a health facility than those with no religion. Women who owned land were 1.11 times more likely to deliver in a health facility compared to those who did not own land (OR=1.11, 95% CI=1.007-1.227, p=0.037). Formerly married (OR=0.72, 95% CI=0.533-0.959, p=0.025), were less likely to deliver in a health facility than single women. Women in rural areas were 43% less likely to deliver in a health care facility than those in urban areas (OR=0.57, 95% CI=0.478-0.673, p=0.000). Women with more than four antenatal care visits are 1.9 times more likely to deliver in a health facility (OR=1.93, CI: 1.755-2.212, p=0.000) compared to who had <3 antenatal care visits. The study found out that marital status, place of residence, wealth, education, religion, age, antenatal care visits during pregnancy, birth order, and land ownership significantly influenced facility-based deliveries. Women who were single, live in urban areas, were wealthier, more educated, religious, and owned land were more likely to deliver in health facilities. These factors highlight the need for targeted maternal health interventions, particularly for married, rural, poor, and less-educated women.