Background: Nepal has relatively high (281/100,000 live births) maternal mortality and low (35%) institutional delivery rates. Government of Nepal and supporting donor partners are working together to increase institutional delivery practices by increasing public awareness on health and improving access by providing incentives for care seeking, among others. However, many women who visit health institution for antenatal care don’t visit the institution for delivery practices. This study aims to determine if the number and quality of antenatal care affects institutional delivery practice in Nepal.

Methodology: Data from 4,148 women of 15-49 years who gave birth in the last five years preceding the survey was analyzed from the dataset of 2011 Nepal Demographic and Health Survey. Institutional delivery practice was compared with number of antenatal care visits, quality of antenatal care, counseling about pregnancy complications and place to visit and overall quality of care. Logistics regression analysis was performed using Stata 9.2 software.

Results: Women who had four or more antenatal care visits were more likely to visit health institution for delivery com-pared to those who had no or less than four visits. Similarly, those who were told about pregnancy complications and place to visit in case of complication were more likely to have institutional delivery than those who were not told of these complications. Those who received optimal quality antenatal care were more likely to have institutional delivery than those who didn’t. Overall, those who had four antenatal visits and told about complications and checked for all three aspects were six times more likely to deliver at health institution than those who didn’t.

Conclusions: The study concludes that quality of antenatal care is a strong predictor for utilization of institutions for delivery services and therefore quality of antenatal care should be emphasized to improve overall maternal and child health services.