Observational studyWomen's health (London, England)
Effective coverage of antenatal care service utilisation in Ethiopia using service provision assessment and demography and health survey data.
Observational study in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGlobally, maternal deaths due to pregnancy and childbirth-related causes are still high. In response to the high maternal deaths, countries committed to achieving universal health coverage (UHC) by 2030. Effective coverage (EC) is a key metric for tracking the progress in the service coverage component of UHC.
objectivesThis study aimed to assess the magnitude of EC of four or more antenatal care (ANC4+) in Ethiopia.
designEthiopian Mini-Demography and Health Survey (EMDHS) 2019 and Ethiopian Service Provision Assessment (ESPA) 2021-2022 cross-sectional surveys were used for analysis.
methodsEC of ANC4+ was estimated using the EMDHS 2019 with a weighted sample of 3617 women with their most recent live birth and ESPA 2021-2022 data with a sample of 659 health facilities. Accordingly, crude coverage (CC) was calculated from the EMDHS 2019, while a quality score was calculated from the ESPA 2021-2022 data. ArcGIS Pro software was used to display EC of ANC4+ across the administrative regions of Ethiopia.
resultsIn this study, the overall CC and EC of ANC4+ were 41.5% (95% CI: 38.9, 44.0) and 21.6% (95% CI: 20.0, 23.2), respectively with the lowest in Somali region and the highest in Addis Ababa. The overall facility-weighted quality of ANC was 52.1% (95% CI: 51.3, 52.8) with the lowest in Gambela and the highest in Benishangul-Gumuz region.
conclusionThis study revealed that the EC of ANC4+ was low due to low achievement in the CC of ANC4+ and quality of care with high regional disparities. Without urgent action, Ethiopia is unlikely to meet Sustainable Development Goal-3 (SDG-3) targets for maternal health. Therefore, administrative region-specific intervention strategies should be designed to improve community engagement, infrastructure, access, and quality of ANC in Ethiopia.
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