Effects of antenatal care service utilization on maternal near miss in Gamo Gofa zone, southern Ethiopia: retrospective cohort study

Abstract

Background Antenatal care (ANC) provides an opportunity to prevent, identify and intervene maternal health problems. Maternal near miss (MNM), as an indicator of maternal health, is increasingly gaining global attention to measure these problems. However, little has been done to measure the effect of ANC on MNM in Ethiopia. Therefore, this study is aimed at determining the effect of ANC on MNM and its associated predictors at Gamo Gofa zone, southern Ethiopia. Methods Employing a retrospective cohort study design, 3 years data of 1440 pregnant mothers (480 ANC attendant and 960 non-attendant) were collected from all hospitals in the zone. Taking ANC visit as an exposure variable; we used a pretested checklist to extract relevant information from the study participants’ medical records. Characteristics of study participants, their ANC attendance status, MNM rates and associated predictors were determined. Results Twenty-five (5.2%) ANC attendant and seventy-one (7.4%) non-attendant mothers experienced MNM, (X2 = 2,46, df = 2, p = 0.12). The incidence rates were 59.6 (95% CI: 40.6–88.2) and 86.1 (95%CI: 67.3–107.2)/1000 person-years for the ANC attendant and non-attendant mothers, respectively. Mothers who were living in rural areas had higher hazard ratio of experiencing MNM than those who were living in urban areas, with an adjusted hazard ratio (AHR) of 1.68 (95% CI, 1.01, 2.78). Conclusion ANC attendance tended to reduce MNM. However, late initiation and loss to follow-up were higher in the current study. Therefore, on time initiation and consistent utilization of ANC are required.

Number of antenatal care utilization and associated factors among pregnant women in Ethiopia: zero-inflated Poisson regression of 2019 intermediate Ethiopian Demography Health Survey

“…Now a day’s ANC address a wide range services including, identifying threats during the prenatal period, birth preparedness and complication readiness, family planning, child feeding options and nutritional counseling during pregnancy and after birth [ 22 , 28 , 29 , 31 , 33 – 35 ]. WHO guide line recommends at least four ANC for normal pregnancy and extra visit for women with complications.…”

“…In Ethiopia, different researches have been done on prevalence and/or factors associated with ANC utilization [ 35 , 38 – 49 ]. Maternal educational status, age, residence, accessing radio, wealth index, pregnancy status, number of children, accessibility of health facilities, occupation and religion are determinant factors identified by scholars [ 50 – 63 ].…”

Maternal and fetal health outcomes of cesarean sections (CS) in Ethiopia: results from retrospective cross-sectional study of Southern Ethiopia Gurage Zone Governmental Hospitals

“…In all, 13.32% of pregnant women did not receive ANC care during pregnancy, which could be attributed to the increased chance of developing complications. Risk assessment and risk management are key components of prenatal care and have been linked to improved maternal outcomes and fewer maternal complications, particularly for women with high-risk pregnancies (pregnancyrelated complications) [21,22] . This shows that there is much to be done to raise awareness of the benefits of ANC follow-up in this rural community along with increasing access to primary health care services.…”

Number of Antenatal Care Utilization and Associated Factors Among Pregnant Women in Ethiopia: Zero-Inflated Poisson Regression of 2019 Intermediate Ethiopian Demography Health Survey.

“…But it still low. (37) In Ethiopia, different researches have been done on prevalence and/or factors associated with ANC utilization (35,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). Maternal educational status, Age, residence, accessing radio, wealth index, pregnancy status, number of children, accessibility of health facilities, occupation and religion are determinant factors identi ed by scholars (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63).…”

“…Behavioral change communication on personal hygiene, utilization of available services and interventions are provided for the women and the family at large (23,25,27,(30)(31)(32). Now a day's ANC address a wide range services including, identifying threats during the prenatal period, birth preparedness and complication readiness, family planning, child feeding options and nutritional counseling during pregnancy and after birth (22,28,29,31,(33)(34)(35). WHO guide line recommends at least four ANC for normal pregnancy and extra visit may be there for women with complications.…”