Predictors of maternal and newborn health service utilization across the continuum of care in Ethiopia: A multilevel analysis

Tiruneh, Gizachew; Demissie, Meaza; Worku, Alemayehu; Berhane, Yemane

doi:10.1371/journal.pone.0264612

Cited by 14 publications

(20 citation statements)

References 35 publications

(73 reference statements)

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“…At the median and highest quantiles, women from the poorest wealth quintiles had a lower COC compared to those from the richest. In line with our finding, a study indicated that the COC is low for women from the poorest households [28]. The low COC among the poorest women implies that the policies in place are not sufficient to compensate for the disadvantages associated with poverty.…”

Section: Discussionsupporting

confidence: 88%

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Determinants of continuum of care for maternal, newborn, and child health services in Ethiopia: Analysis of the modified composite coverage index using a quantile regression approach

2023

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Maternal and child mortality remain unacceptably high in the Sustainable Development Goals era. Continuum of care has become a key strategy for improving the health of mothers and newborns. Previous research on the continuum of care in Ethiopia is often limited to maternal health services. Maternal and child health services are inseparably linked, and an integrated approach to care is essential. This study assessed the continuum of maternal, newborn, and child health care and associated factors in Ethiopia. The analysis was based on the 2016 Ethiopian Demographic and Health Survey data. We restricted our analysis to women with their most recent children—alive and living with their mother- aged 12–23 months at the time of the survey (n = 1891). The modified composite coverage index, constructed from twelve maternal and child health services, was calculated as an indicator of the continuum of care. Bivariable and multivariable quantile regression were used to analyse the relationship between the predictors and specific quantiles of the composite coverage index. The effect of each variable was examined at the 10th, 25th, 50th, 75th, and 95th quantiles. The results showed that the average composite coverage index value was 39%. The overall completion rate of the continuum of care was low (2%). Four % of the women did not receive any of the services along the continuum of care. Postnatal care for newborns had the lowest coverage (12%). This study provides evidence that factors such as the educational status of women, region, residence, socio-economic status, perceived distance to a health facility, pregnancy intention, mode of delivery, parity, and early antenatal care initiation influence the continuum of care differently across levels of the composite coverage index. The findings call for integrated and targeted strategies that aim to improve the continuum of care considering the determinants.

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Section: Discussionsupporting

confidence: 88%

“…The COC is influenced by a range of factors such. as individual and community characteristics [17,[20][21][22][23], reproductive characteristics [18,[24][25][26][27][28] and socio-economic characteristics [28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Determinants of continuum of care for maternal, newborn, and child health services in Ethiopia: Analysis of the modified composite coverage index using a quantile regression approach

2023

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“…The low rate of the fourth ANC follow-up is usually common in studies undertaken in Ethiopia. Women may not be able to attend subsequent follow-ups because of distance, low level of education, and/or poor wealth index [ 38 – 40 ]. This was also documented in studies from other low-income countries [ 41 – 44 ].…”

Section: Discussionmentioning

confidence: 99%

Antenatal care utilization and compliance with national and WHO guidelines in rural Ethiopia: a cohort study

Roro

Deressa

Lindtjørn

2022

BMC Pregnancy Childbirth

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Background Antenatal health care utilization has the potential to influence maternal and new-born health. In this study, we assessed compliance of antenatal care utilization with national and World Health Organization (WHO) guidelines. We also examined association of antenatal care utilization with adverse pregnancy outcomes as secondary outcome. Methods This was a community-based cross sectional study conducted from July 2016 to November 2017 in rural south-central Ethiopia. We described antenatal care received by pregnant women, whom we followed at three prescheduled visits during pregnancy and collected birth data at time of delivery. Extent of antenatal care content received, timing of antenatal care, place of antenatal care and place and mode of delivery were obtained and computed in accordance with national and WHO guidelines. For adverse pregnancy outcomes, computed as sum of low birth weight, preterm birth, intrauterine foetal death, and stillbirth, the exposure variable used was antenatal care utilization. Results Seven hundred and four (704) women participated in the study, and 536 (76.1%) had attended at least one antenatal care visit. Among women who attended antenatal care visit, majority, 421 (79.3%), had done so at health centres and hospitals, while 110 (20.7%) attended at health post. Average number of antenatal care visits was 2.5, which is less than that recommended in national and WHO guidelines. Only 18 (2.6%) women had attended antenatal care in their first trimester, which is low in contrast to the expected 100% specified in the guidelines. Less than half (47%) of the women delivered in a health facility. This is in contrast to the 100% expected health institution deliveries. Low birth weight was 7.9% (n = 48), and preterm birth was 4.9% (n = 31). There were 12 twin pregnancies, three stillbirths, 11 spontaneous abortions, and two intrauterine foetal deaths. We did not find significant association between adverse pregnancy outcomes and antenatal care utilization (COR = 1.07, 95% CI 0.62, 1.86). Conclusion This study showed that antenatal care service utilization in the study area was markedly low compared to that recommended in national and WHO guidelines. The obtained antenatal health care utilization was not associated with the registered adverse pregnancy outcomes.

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“…7 Other previous studies in Ethiopia used either of the indicators like; at least one ANC visit at least four ANC visits the timing of first ANC visits services received during ANC visits type of health-care provider visited, and quantity of contacts [16][17][18][19] with possible individual, and household (HH)-related determinants of use. [20][21][22][23] In this study, to provide a good summary of information all of the available mixes of indicators were exhaustively used. Additionally, it is the first study using the 2019th Ethiopian Mini Demographic, and Health Survey.…”

Section: Introductionmentioning

confidence: 99%

Are Ethiopian women getting the recommended maternal health services? The analysis of Ethiopian mini Demographic and Health Survey 2019

Birhanu

Mideksa

Yitbarek

2022

Health Science Reports

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Background and Aims: Health services during pregnancy, childbirth, and the postnatal period play a pivotal role in the survival of both the mother and the baby.We, therefore, analyzed maternal health service utilization and the related drivers among women of childbearing age in Ethiopia. Methods:We used secondary data from the 2019 Ethiopian mini Demographic and Health Survey. The survey was conducted in 11 regions, and 2 city administrations, in Ethiopia from March 21 to June 28, 2019. Maternal health service utilization was measured in terms of three dimensions including antenatal care (ANC), skilled delivery service, and postnatal care (PNC). Bi-variable and multivariable logistic regression was used. We then fitted three separate models. Data were analyzed using SPSS version 25; all analysis was adjusted for cluster and sample weight.Results: A total of 2923, 3924, and 1899 women were included for ANC, delivery, and PNC utilization, respectively. The majority of 1802 (61.7%) women had a "good" antenatal care utilization, and it was explained by the level of maternal education, marital status, and wealth index. Nearly half, of 1899 (48.1%) of the women gave birth in a health facility, and it was associated with age, educational status, wealth index, the timing of first antenatal care, and the number of antenatal care contact.Finally, one third (33.7%) of them had adequate PNC utilization and it was associated with households having a television, the timing of first antenatal care, and the number of antenatal care contacts. Conclusion:Despite the due emphasis on maternal health services by the Ethiopian government, the uptake of services is not optimal. Women empowerment and timely and adequate ANC contacts will prepare women for better uptake of services.

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Predictors of maternal and newborn health service utilization across the continuum of care in Ethiopia: A multilevel analysis

Cited by 14 publications

References 35 publications

Determinants of continuum of care for maternal, newborn, and child health services in Ethiopia: Analysis of the modified composite coverage index using a quantile regression approach

Determinants of continuum of care for maternal, newborn, and child health services in Ethiopia: Analysis of the modified composite coverage index using a quantile regression approach

Antenatal care utilization and compliance with national and WHO guidelines in rural Ethiopia: a cohort study

Are Ethiopian women getting the recommended maternal health services? The analysis of Ethiopian mini Demographic and Health Survey 2019

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