dc.description.abstract |
Background: Antenatal care is a maternal health care service given by skilled health professionals
to a pregnant women. Having pregnant, women may give birth at home or health institutions.
Home delivery increases the likelihood of mortality of the mother and the newborn. Globally; each
year nearly 303,000 maternal deaths occurred from complication of pregnancy and childbirth.
Ethiopia alone accounted for 13,000 deaths, which disproportionately affects women living in the
different geographical location of the country. Thus, the aim of this study was to assess the
spatiotemporal patterns and associated factors of antenatal and delivery care utilizations in
Ethiopia.
Method: This study used the 2000, 2005, 2011 and 2016 EDHS data as a source. A total weighted
sample of 30762 women (7966 in 2000, 7297 in 2005, 7908 in 2011 and 7591 in 2016) was used.
Spatial analysis was done to explore the distribution of ANC and DC using ArcGIS version 10.8
software. The separate and bivariate logistic regression analysis with and without the spatial effect
were modeled using the SAS version 9.4. Model comparison was done using AIC, and BIC. Models
that accounted for the spatial effect were relatively best fitted and hence used to identify factors
associated with ANC and DC utilization in Ethiopia.
Results: The spatial distribution of ANC and DC were non-random in Ethiopia. The East and
west Gojjam, awi, North and South wollo, Fafan, East Hararge, Sidama, Gamo Gofa and Gedio
were cold spot zones of ANC and DC consistently in each survey year. The overall odds ratio of
ANC and DC were 2.029. 10.4%, 12.2%, 19.4%, and 31.8% had ANC in 2000, 2005, 2011
and2016 respectively. Similarly 5.5%, 6.8%, 12.1% and 33.2% of women had DC respectively.
Women and husband in low education, partner occupation, religion, regions, reside in rural, lower
birth order, low birth interval, unable to access mass media, low wealth status were simultaneously
significant factors of ANC and DC.
Conclusions: Despite of the government report as women have improved access on maternal
health care, a considerable number of women are still giving birth at home without attending the
recommended antenatal care visit. Therefore, it needs great interventions in the cold spot areas
focusing on women and partner education, rural dwellings, poor household residences, women
having smaller birth interval and lower birth order and improve media access.
Keywords: Antenatal care, delivery care, EDHS, Spatial analysis, Ethiopia, Bivariate logistic. |
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