Introduction little is known about antenatal care (ANC) utilization difference among food secure and food insecure household pregnant women and factors contributing to inequities in antenatal care use in developing country including Ethiopia. To determine the disparities in the utilization of antenatal care that exists between pregnant women in food secure and food insecure household women. Methods a community based comparative cross-sectional study was conducted in Gombora District, Hadiya zone, southern Ethiopia. Data were collected from February 25 th to March 25 th , 2015, using a pre-tested structured questionnaire. Pregnant women were selected by a simple random sampling method. The data were entered using EpiData 3.1 and exported to SPSS version 21 for analysis. Multivariate logistic regression analysis was done to compare antenatal care utilization among food secure and insecure household women at 95% confidence interval (CI). Statistical tests were done at a level of significance of p<0.05. Results two hundred sixty-seven (34.5%) of the respondents received at least one antenatal care visit on current pregnancy. Forty-nine-point one percent of food secure and 23.3% of food insecure household women utilized ANC from health professionals. Factors associated with antenatal care utilization included being from a food secure household (adjusted odds ratio [aOR]= 2.54; 95%CI: 1.79-3.59), having attained secondary or higher education (aOR=3.76; 95%CI: 2.32-6.1), good level of knowledge of antenatal care (aOR= 2.42; 95%CI 1.34-4.33) and being from a wealthy household (aOR=2.10; 95% CI: 1.34-3.28). Conclusion: this study showed a significant variation in the use of ANC in food secure and food insecure household pregnant women. Interventions to improve ANC utilization should prioritize women from poor socio-economic and low educational background.
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