Prevalence and Factors Associated with Institutional-based Delivery in The Gambia: Further Analysis of Population-based Cross-Sectional Data

Institutional-based delivery could be the major strategy to avoid most maternal deaths occurring from preventable obstetric complications. The study examines the prevalence and factors associated with institutional -based delivery in The Gambia. The secondary data, from The Gambia Multiple Indicator Cluster Survey (MICS) - 2018 for 3,791 women aged 15-49 years who had given birth, were extracted for the analysis. Chi-square analysis and multivariable logistic regression model were used to determine factors associated with institutional-based delivery with statistical significance set at p < 0.05. About three-quarters (78.1%) of Gambian women had institutional-based delivery. The study identified that women from richer (AOR= 2.38; 95%CI: 1.49, 3.79) and richest households (4.14; 95%CI: 2.06, 8.33) were more likely to have institutional-based delivery when compared with women from poorest households. Furthermore, women with secondary or higher education (AOR= 1.66; 95%CI: 1.28, 2.16) were more likely to have institutional-based delivery, when compared with women without formal education. Conversely, rural dwellers (AOR= 0.63; 95%CI: 0.47, 0.84), women with high parity and advanced age had significant reduction in the odds of institutional-based delivery in The Gambia. There is a need for concerted efforts to improve skilled birth attendance among women of low socioeconomic status, those living in hard-to-reach communities and the multiparous women in The Gambia. (Afr J Reprod Health 2020; 24[2]: 176-186). L'accouchement en établissement pourrait être la principale stratégie pour éviter la plupart des décès maternels dus à des complications obstétricales évitables. L'étude visait à examiner la prévalence et les facteurs associés à l'accouchement en établissement en Gambie. Les données secondaires, issues de l'enquête en grappes à indicateurs multiples (MICS) de la Gambie -2018 pour 3791 femmes âgées de 15 à 49 ans qui avaient accouché, ont été extraites pour l'analyse. Une analyse du chi carré et un modèle de régression logistique multivariable ont été utilisés pour déterminer les facteurs associés à la prestation en établissement avec une signification statistique fixée à p