The effect of antenatal care on use of institutional delivery service and postnatal care in Ethiopia: a systematic review and meta-analysis

Abstract

BackgroundAlthough there are many initiatives to improve maternal health services use, utilization of health facility delivery and postnatal care services is low in Ethiopia. Current evidence at global level showed that antenatal care increases delivery and postnatal care services use. But previous studies in Ethiopia indicate contrasting results. Therefore, this meta-analysis was done to identify the effect of antenatal care on institutional delivery and postnatal care services use in Ethiopia.MethodsStudies were searched from databases using keywords like place of birth, institutional delivery, and delivery by a skilled attendant, health facility delivery, delivery care, antenatal care, prenatal care and postnatal care and Ethiopia as search terms. The Joanna Briggs Critical Appraisal Tools and the Preferred Reporting Items for Systematic Review and Meta-Analyses were used for quality assessment and data extraction. Data analysis was done using STATA 14. Heterogeneity and publication bias were assessed using I2 test statistic and Egger’s test of significance. Forest plots were used to present the odds ratio (OR) with 95% confidence interval (CI).ResultA total of 40 articles with a total sample size of 26,350 were included for this review and meta-analysis. Mothers who had attended one or more antenatal care visits were more likely (OR = 4.07: 95% CI 2.75, 6.02) to deliver at health institutions compared to mothers who did not attend antenatal care. Similarly, mothers who reported antenatal care use were about four times more likely to attend postnatal care service (OR 4.11, 95% CI: 3.32, 5.09).ConclusionWomen who attended antenatal care are more likely to deliver in health institutions and attend postnatal care. Therefore, the Ethiopian government and other stakeholders should design interventions that can increase antenatal care uptake since it has a multiplicative effect on health facility delivery and postnatal care services use. Further qualitative research is recommended to identify why the huge gap exists between antenatal care and institutional delivery and postnatal care services use in Ethiopia.

Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

“…Nonetheless, a large proportion of the women across the developing world remain deprived of the ANC services [9]. The inequality in accessing and utilizing healthcare services is further attributed to various behavioral, cultural, economic, and sociodemographic factors at individual level and remoteness of health facility, inadequate infrastructure and skilled human resource for healthcare at community level [16][17][18][19][20]. Understanding a country's specific predictors of healthcare utilisation is essential for making targeted approaches to combat pregnancy related deaths among women and newborns.…”

Prenatal care and uptake of HIV testing among pregnant women in Gambia: a cross-sectional study

“…Some studies have investigated various factors associated with maternal healthcare-seeking behavior such as behavioral, cultural, economic, and sociodemographic at different levels including individual, access to health facilities, inadequate infrastructure and skilled human resources for community healthcare [12][13][14][15][16]. Gambia does not, however, have such a study or report available, hence factors influencing low utilization of ANC services are unknown.…”

Predictors of institutional delivery service utilization among women of reproductive age in Gambia: a cross-sectional analysis

“…Previous studies have attempted to explore the determinants of using professional childbirth services from various perspectives: behavioral, cultural, economic, and sociodemographic factors at individual level and remoteness of health facility, inadequate infrastructure and skilled human resource for healthcare at community level [10][11][12][13][14]. Although a large number of studies have been conducted to explore the reasons behind the under-and non-use of SBAs in countries from Africa and other developing regions, not much is known about the use of professional childbirth services Gambia, especially the use of C-section.…”