Factors Associated with Non-Institutional Delivery among Pregnant Women in Nepal

Delivery location may influence maternal morbidity and mortality, especially in developing countries such as Nepal. The aim of this study was to determine factors associated with place of delivery among pregnant women in Nepal in order to inform health policy makers attempting to improve mother and child health. Data from the Multiple Indicator Cluster Survey, conducted in 2014, were retrospectively reviewed. In the survey, women aged 15-49 years were interviewed face-to-face using a structured questionnaire. Study subjects were women who had giving birth within the previous two years. A total of 2,086 women (48.9%) had non-institutional delivery (46.5% at home). Logistic regression models were used to identify significant factors influencing non-institutional delivery. Results showed that increasing educational level and wealth quintile index corresponded to a decreasing percentage of non-institutional delivery. More than half (55.5%) of women from rural areas had a non-institutional delivery. Multiparous women (57.2%) and those having less than 4 antenatal care visits (66.8%) had relatively higher rates of non-institutional delivery. In conclusion, there is a need to intensify education for pregnant women, especially those who have had previous childbirth experience. It is also crucial to target women from poor households, to increase their awareness, and promote institutional delivery.