**2.3 Discussion**

This study intended to assess the effectiveness of a community-based intervention called PWC on institutional delivery in the Northwest part of Ethiopia. Accordingly, institution delivery was higher among women who attended the PWC was 54.3% (95%CI: 49.9–59.1) compared to 39.9% (95%CI: 35.3%- 44.7%) in women who did not attend the PWC. Other previous studies supported this finding, Burkina Faso (56% VS 36%), Eritrea (46.8% VS 51.2), and Guatemala (54.7% VS 31.2%) [11–13], authors agreed that women who involved in the conference were informed about danger signs that may occur during delivery, which enable them to prefer health institution for delivery [14]. On the contrary of this finding, studies were done in Kenya (28% VS 37%), Bangladesh (10.5% VS 12.5%), and India (22.5% VS 21.8%) showed that the community-based interventions were not made difference on institutional delivery as compared to their counterpart [15, 16].

Similarly, knowledge of obstetric danger signs that may occur during pregnancy, labor, and postpartum was higher among women who attended the PWC compared to those women who did not attend the PWC. This finding was in line with the studies done in Eritrea, and Bangladesh [12, 16]. Conversely, this finding was contradicted with the studies done in Nepal and Bangladesh, which showed that obstetric danger signs knowledge of women who were involved in the intervention were similar or lower compared to women not participating in the interventions [17, 18].

About 39% of women who attended the PWC were well prepared for birth and its complication higher as compared to 28% of women who did not attend the PWC before the onset of labor, was supported with previous studies done in Burkina Faso, Eretria, Nepal, and Tanzania the higher level of well-preparedness for birth and its complication was made among women who participated in the interventions [6, 12, 19, 20]. The explanation may be women who are involved in the intervention might be informed about obstetric danger signs and birth preparedness items which elicit them to be ready to give birth at a health institution.

The odds of institutional delivery among PWC attendant women who were knowledgeable about childbirth and postpartum danger signs were higher as compared to their counterparts. Then again, among PWC non-attendant women who were knowledgeable on pregnancy danger signs were more likely to institutional delivery compared to their counterparts. It was supported by the previous studies done in Ethiopia, Pakistan, and Tanzania [14, 21, 22]. The possible clarification may be realizing obstetric threat signs may impact women's perceptions about their susceptibility to and earnestness of the complications. This may motivate women to give birth at wellbeing offices [23].

The odds of institutional delivery among both groups of women who wellprepared for birth and its complication were higher as compared not prepared. The explanation may be women who were solid and steady for birth and its complexity may be proficient about obstetric danger signs that may happen before, during, and after birth; decidedly impact to delivery at a health facility.

Voyaging time from the closest health facility was essentially connected with institutional delivery in both women who joined in and did not go to the PWC. In both groups, women who lived within 1 h of strolling from the closest health facility were more likely to institutional delivery contrasted with their counterparts. This finding was in line with other previous studies [14, 23–25]. The explanation may be an absence of methods for transportation to wellbeing offices. Secondly, fear of financial expense for transport may be contrarily affected to choose institutional delivery.

The odds of institutional delivery among PWC attendant women who had a conversation with partners/families about the place of birth were higher as compared to women who did not discuss. This may empower women to have self-rule in the decision of birthplace jointly or self alone. Women with the highest level of autonomy are most likely to seek institutional delivery [21, 26–28]. Also, this may set out a better opportunity for families to include in orchestrating transport, set aside cash, and assist mothers to choose a place of delivery.

#### **2.4 Limitation of this study**

The two group participants (PWC attendants and non-attendants) live at the same resident/kebele, there might be information contamination between attendants and non-attendants.

#### **2.5 Conclusion**

The proportion of institutional delivery was higher among women who attended the conference. Similarly, women's knowledge of obstetric danger signs and preparation for birth and its complication were higher among women who attended the conference. Knowledge on childbirth and postpartum danger signs, discussed with their partners/families about the place of delivery were associated with institutional delivery in Pregnant women's conference attendants. Distance from the nearest health facility and well preparedness for birth and its complication were associated with institutional delivery in both groups. Besides, knowledge of pregnancy danger signs was associated with institutional delivery in pregnant women's conference non-attendants.

Therefore, strengthening women to attend pregnant women's conferences may improve institutional delivery by increasing women's obstetric danger signs and birth preparedness knowledge. Furthermore, encouraging women to discuss with their families about the place of delivery should be strengthened.

For researchers, the authors recommended doing a further follow-up clusterbased study by considering a non-selected zone (buffer zone) between intervention and control groups to prevent information contamination, thereby, understanding the net effect of the intervention in the institutional delivery.

#### **Acknowledgements**

We would like to express our gratitude to Bahir Dar University, Amhara regional health bureau, South Gondar Zone Health Office, LiboKmem district Health Office, data collectors and supervisors, Health Extention workers, and study participants for their contribution.

#### **Competing interests**

The authors declare that they have no competing interests**.**

*Effect of Community-Based Intervention (Pregnant Women's Conference) on Institutional… DOI: http://dx.doi.org/10.5772/intechopen.97315*
