Utilization and factors associated with antenatal, delivery and postnatal Care Services in Tigray Region, Ethiopia: a community-based cross-sectional study

Alemayehu, Mussie; Gebrehiwot, Tesfay Gebregzabher; Medhanyie, Araya Abrha; Desta, Alem; Alemu, Tesfu; Abrha, Atakelti; Godefy, Hagos

doi:10.1186/s12884-020-03031-6

Cited by 19 publications

(19 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ANC visits as per the MOH recommendation consistently increases the likelihood of uptake of CoC across all hypothesis testing models. Previous studies showed that higher number of ANC visits are associated with increased uptake of MHS (37,38). When those contacts are at the recommended type of HFs, it improves the continuity of maternity care (39).…”

Section: Discussionmentioning

confidence: 95%

Continuum of Maternity Care Among Rural Women in Ethiopia: Does Place and Frequency of Antenatal Care Visit Matter?

Dadi

Medhin

Kasaye

et al. 2021

Preprint

View full text Add to dashboard Cite

Introduction: The ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre or at a higher level of health facility. In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of care. The aim of this study is to estimate effect of place of ANC-1 visit and adherence to MOH’s recommendations of MOH for ANC visits on continuum of care rural in Ethiopia. Method: We used data collected from 1431 eligible women included in the National Health Extension Program (HEP) assessment survey that covered 6364 households from 62 woredas in nine regions. The main outcome variable is continuum of care (CoC), which is the uptake of all recommended ANC visits, institutional delivery and postnatal care services. Following descriptive analysis of the collected data, Propensity Score Matching was used to estimate the effect of place of ANC-1 visit on completion of CoC, and Zero inflated Poisson regression was used to model the effect of adherence to MOH recommendation of ANC visits on intensity of maternal health continuum of care. Result: Only 13.9% of eligible women completed the continuum of care and place of first antenatal care (ANC) visit was not significantly associated with the completion of continuum of care (β = 0.04, 95%CI= -0.02, 0.09). Adherence of ANC visit to the MOH recommendation (at least 4 ANC visits at higher HFs than HPs) increased the likelihood of higher intensity of continuum of care (aIRR = 1.29, 95%CI: 1.26, 1.33). Moreover, the intensity of continuum of care was positively associated with being in agrarian areas (aIRR = 1.17, 95%CI: 1.06, 1.29), exposed to HEP (IRR = 1.22, 95%CI: 1.16, 1.28), being informed about danger signs (aIRR = 1.14, 95%CI: 1.11, 1.18) and delivery of 2nd youngest child at HF (IRR = 1.16, 95%CI: 1.13, 1.20). Increasing age of women was negatively associated with use of services (IRR = 0.90, 95%CI: 0.87, 0.94). Conclusion: Completion of maternal health continuum of care is very low in Ethiopia, however most of the women use at least one of the services. Completion of continuum of care was not affected by place of first ANC visit. Adherence to MOH recommendation of ANC visit increased the intensity of continuum of care. Intensity of continuum of care was positively associated with residing in agrarian areas, HEP exposure, danger sign told, delivery of 2nd youngest child at health facility. To boost the uptake of all maternal health services, it is crucial to work on quality of health facilities, upgrading the infrastructures of HPs and promoting adherence to MOH recommendations of ANC visit.

show abstract

Section: Discussionmentioning

confidence: 95%

Continuum of Maternity Care Among Rural Women in Ethiopia: Does Place and Frequency of Antenatal Care Visit Matter?

Dadi

Medhin

Kasaye

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…ANC visits as per the MOH recommendation consistently increases the likelihood of uptake of CoC across all hypothesis testing models. Previous studies showed that higher number of ANC visits are associated with increased uptake of MHS [ 38 , 39 ]. When those contacts are at the recommended type of HFs, it improves the continuity of maternity care [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter?

et al. 2021

View full text Add to dashboard Cite

Introduction The ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre (HC) or at a higher level of health facility (HF). In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of care. The aim of this study is to estimate effect of place of ANC-1 visit and adherence to MOH’s recommendations of MOH for ANC visits on continuum of care rural in Ethiopia. Methods We used data collected from 1431 eligible women included in the National Health Extension Program (HEP) assessment survey that covered 6324 households from 62 woredas in nine regions. The main outcome variable is continuum of care (CoC), which is the uptake of all recommended ANC visits, institutional delivery and postnatal care services. Following descriptive analysis, Propensity Score Matching was used to estimate the effect of place of ANC-1 visit on completion of CoC. Zero inflated Poisson regression was used to model the effect of adherence to MOH recommendation of ANC visits on intensity of maternal health continuum of care. Result Only 13.9% of eligible women completed the continuum of care, and place of first antenatal care (ANC) visit was not significantly associated with the completion of continuum of care (β = 0.04, 95% CI = -0.02, 0.09). Adherence of ANC visit to the MOH recommendation (at least 4 ANC visits at higher HFs than health posts (HPs)) increased the likelihood of higher intensity of continuum of care (aIRR = 1.29, 95% CI: 1.26, 1.33). Moreover, the intensity of continuum of care was positively associated with being in agrarian areas (aIRR = 1.17, 95% CI: 1.06, 1.29), exposed to HEP (IRR = 1.22, 95% CI: 1.16, 1.28), being informed about danger signs (aIRR = 1.14, 95% CI: 1.11, 1.18) and delivery of second youngest child at HF (IRR = 1.16, 95% CI: 1.13, 1.20). Increasing age of women was negatively associated with use of services (IRR = 0.90, 95% CI: 0.87, 0.94). Conclusion Completion of maternal health continuum of care is very low in Ethiopia, however most of the women use at least one of the services. Completion of continuum of care was not affected by place of first ANC visit. Adherence to MOH recommendation of ANC visit increased the intensity of continuum of care. Intensity of continuum of care was positively associated with residing in agrarian areas, HEP exposure, danger sign told, delivery of second youngest child at health facility. To boost the uptake of all maternal health services, it is crucial to work on quality of health facilities, upgrading the infrastructures of HPs and promoting adherence to MOH recommendations of ANC visit.

show abstract

“…In Ethiopia, though the government expanded access to facilities and free ambulance transport, the country has poor road access, difficult terrain, and roads that are often unreachable during the rainy season. A recent study in Ethiopia affirms that women living in remote areas with no access to transportation did not have access to maternal health services [43]. This might discourage women to visit the facility for skilled birth, particularly during the night time and rainy season.…”

Section: Plos Onementioning

confidence: 99%

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

Tiruneh¹,

Demissie

Worku

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background The continuum of care for maternal and newborn health is a systematic approach for delivery of an integrated effective package of life-saving interventions throughout pregnancy, childbirth, and postpartum as well as across levels of service delivery to women and newborns. Nonetheless, in low-income countries, coverage of these interventions across the life cycle continuum is low. This study examined the predictors of utilization of maternal and newborn health care services along the continuum of care in Ethiopia. Methods This was a cross-sectional population-based study. We measured maternal and newborn health care utilization practices among women who had live births in the last 12 months preceding the survey in Amhara, Oromia, SNNP, and Tigray regions of Ethiopia. We fitted multilevel random-effects logistic regression models to examine the predictors of the continuum of care accounting for the survey design, and individual, and contextual characteristics of the respondents. Results Our analysis revealed that only one-fifth of women utilized maternal and newborn health services across the antepartum, intrapartum, and postpartum continuum; most women discontinued at the postpartum stage. Continued use of services varied significantly across wealth, model family, prenatal stay at maternity waiting homes, antenatal care in the first trimester, complete antenatal care service, and the administrative region at all antepartum, intrapartum, and postpartum stages. Moreover, family conversation during pregnancy [AOR: 2.12; 95% CI: 1.56–2.88], delivery by cesarean [AOR: 2.70; 95% CI: 1.82–4.02] and birth notified to health extension workers [AOR: 1.95; 95% CI: 1.56–2.43] were found to be predictors of the continuum of care at the postpartum stage. Conclusion In Ethiopia, despite good access to antepartum care, compliance with continuity of care across the pathway decreased with significant inequitable distributions, the poorest segment of the population being at most disadvantage. The main modifiable program factors connected to the continued uptake of maternal health services include family conversation, pregnant women conference, complete antenatal care, antenatal care in the first trimester, and birth notification.

show abstract

Utilization and factors associated with antenatal, delivery and postnatal Care Services in Tigray Region, Ethiopia: a community-based cross-sectional study

Cited by 19 publications

References 16 publications

Continuum of Maternity Care Among Rural Women in Ethiopia: Does Place and Frequency of Antenatal Care Visit Matter?

Continuum of Maternity Care Among Rural Women in Ethiopia: Does Place and Frequency of Antenatal Care Visit Matter?

Continuum of maternity care among rural women in Ethiopia: does place and frequency of antenatal care visit matter?

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

Contact Info

Product

Resources

About