Determinants of early discharge after birth among mothers delivered vaginally at health facilities: further analysis of the Ethiopian demographic health survey

Desalegn Anmut Bitew; Mengistie Diress; Yibeltal Yismaw Gela; Daniel Gashaneh Belay; Anteneh Ayelign Kibret; Dagmawi Chilot; Deresse Sinamaw; Mohammed Abdu Seid; Abdulwase Mohammed Seid; Wudneh Simegn; Habitu Birhan Eshetu; Amare Agmas Andualem

doi:10.1186/s12889-023-16922-y

Determinants of early discharge after birth among mothers delivered vaginally at health facilities: further analysis of the Ethiopian demographic health survey

BMC Public Health. 2023 Oct 30;23(1):2128. doi: 10.1186/s12889-023-16922-y.

Affiliations

¹ Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia. desalegn1227@gmail.com.
² Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
³ Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
⁴ Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
⁵ College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia.
⁶ Department of Biomedical Science, Debre Markos University, P. O. Box 269, Debre Markos, Ethiopia.
⁷ Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, P. O. Box: 272, Debre Tabor, Ethiopia.
⁸ Department of Clinical Pharmacy, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
⁹ Department of Social and Administrative Pharmacy, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
¹⁰ Department of Health Education and Behavioral Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
¹¹ Department of Anesthesia, Wollo University, P. O. Box, 1145, Dessie, Ethiopia.

Abstract

Introduction: The majority of maternal and newborn deaths take place during the first few hours and days after birth and thus postnatal contacts should begin as early as possible, especially within the first 24 h, then again within two to three days after delivery. Globally, early postnatal discharge has increased over the past 50 years and currently too. Even if Ethiopia has very low PNC coverage, there is no evidence on who is discharged early. Hence, the aim of this study was to determine the magnitude and the predictors for early postnatal discharge in Ethiopia.

Methods: This study was based on the secondary data analysis using the Ethiopian Demographic and Health survey (EDHS) 2016 data set. The weighted sample of 2,225 delivered mothers were included for the final analysis. The model was best fitted as assessed by Hosmer-Lemeshow test (p value = 0.1988). The variables with P-value ≤ 0.2 in the bi- variable binary logistic regression analysis were included in to the multi-variable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed to assess the strength of association between the outcome and independent variables. The variables with a P-value of less than 0.05 in the multi-variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable.

Result: The overall magnitude of early discharge was 70.41% (CI: 68.48, 72.30). Residence (rural; AOR: 0.61, 95% CI: 0.46, 0.80), educational status (No education; AOR: 1.87, 95% CI: 1.19, 2.94), religion (Muslim; AOR: 0.69, 95% CI: 0.55, 0.87, Others; AOR: 0.24, 95% CI: 0.10, 0.57), wealth index (Poor; AOR: 0.77; 95% CI: 0.59, 0.99), marital status (Not married; AOR: 0.29; 95% CI: 0.13, 0.67), ANC visits (No ANC visits; AOR: 0.63; 95% CI: 0.46,0.86), parity (3rd parity; AOR: 1.48; 95% CI: 1.03, 2.11), and size of the child (larger size; AOR: 0.63;95% CI: 0.50,0.79, (smaller size; AOR: 0.72; 95% CI: 0.56,0.92) were independent determinants of early discharge.

Conclusion: A substantial proportions of mothers in Ethiopia had been discharged early (before 24 h). Residence, education, wealth index, religion, marital status, ANC follow up, parity and size of the child were predictors of early discharge. Adequate hospital stay should be promoted. Since the early discharge in Ethiopia is very high, home based postnatal visit should be strengthened focusing the identified predictors.

Keywords: Birth; Determinants; Early discharge; Ethiopia.

MeSH terms

Child
Ethiopia
Female
Health Facilities
Health Surveys
Humans
Infant, Newborn
Islam
Marital Status
Mothers
Patient Acceptance of Health Care*
Patient Discharge
Pregnancy
Prenatal Care*