Antenatal care and skilled delivery service utilisation in Somali pastoral communities of Eastern Ethiopia

Umer, Abdurezak Adem; Zinsstag, Jakob; Schelling, Esther; Tschopp, Rea; Hattendof, J.; Osman, Kadra A.; Yuya, Mohammed; Ame, Al-Awad; Zemp, Elisabeth

doi:10.1111/tmi.13346

Cited by 18 publications

(14 citation statements)

References 34 publications

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“…Antenatal care utilisation in our study was lower than most local and national studies done in the country except for pastoral regions [ 57 – 59 ]. Similarly, delivery service utilisation in this study is higher than other studies done in the country but lower than the national study of health facility delivery [ 58 – 60 ].…”

Section: Discussioncontrasting

confidence: 73%

Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study

Abera

Dangisso

Lindtjørn

2021

BMC Health Serv Res

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Background Outpatient department visits per individual for each year are one of the core indicators of healthcare delivery to assess accessibility or quality of services. In addition, this study aimed to assess health service utilisation and disease patterns in southern Ethiopia, by including the health authorities’ suggestions to improve the services. No study has assessed this in Ethiopia previously. Methods An institution-based cross-sectional design study was done in 65 primary health care units in Dale and Wonsho districts, in Sidama region, for all patients visiting health facilities from 1 July 2017 to 30 June 2018. We estimated the utilisation rate as visits per person per year, the odds ratio for health use and proportions of diseases’ diagnoses. The results of our study were presented to local health authorities, and their suggestions for improvements were incorporated into the analysis. Result A total of 81,129 patients visited the health facilities. The annual outpatient health service utilisation was 0.18 (95% CI: 0.18–0.19) new visits per person per year. The health service utilisation rate per year for the rural population was lower than the urban utilisation by 91% (OR = 0.09; 95% CI: 0.08–0.09). Children in the age group of 5–14 years had lower odds of health service utilisation by 78% (OR = 0.22; 95% CI: 0.21–0.23), compared to children under 5 years of age. Females were four times (OR = 4.17; 95% CI: 4.09–4.25) more likely to utilise health services than males. Febrile illness constituted 17.9% (14,847 of 83,148) of the diagnoses in all age groups. Almost half of the febrile cases, 46.5% (3827 of 8233), were among children under 5 years of age. There were very few cases of non-communicable diseases diagnosed in the health facilities. The health authorities suggested improving diagnostic capacities at health centres, enhancing health professionals’ skill and attitudes, and improving affordability and physical accessibility of the services. Conclusion The health service utilisation rate was low in Sidama. The use of health services was lower among rural residents, men, children and elderly, and health post users. Improving the quality, affordability and accessibility of the health services, by involving responsible stakeholders could increase service usage.

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Section: Discussioncontrasting

confidence: 73%

Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study

Abera

Dangisso

Lindtjørn

2021

BMC Health Serv Res

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“…The study also revealed antenatal care attendance as a signi cant determinant of accessing skilled delivery services. Our nding corroborates with similar studies from Ethiopia [34][35][36] and Nepal [37][38][39] which showed an increased tendency towards institutional accessed delivery following antenatal visits. We observed partner's support as a signi cant determinant with positive in uence on seeking facility-based delivery and this corroborates with previous reports [40][41][42].…”

Section: Discussionsupporting

confidence: 92%

Utilization of Facility-based Delivery Services in the Wa Municipality, Ghana

Nuolabong

Akuffo

Kabiri

et al. 2022

Preprint

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Background: Access to skilled delivery services are crucial in reducing maternal mortality, however, the prevalence of women with assisted deliveries in our health facilities remains low with reasonable disparities between rural and urban Ghana. This study examined the utilization of skilled delivery by pregnant women and its associated factors in the Wa Municipality of Ghana.Methods: The study employed a community-based cross-sectional study. A simple random sampling was used to recruit two rural and two urban sub-districts and subsequently four communities selected from each of the respective sub-districts. Thirty-three eligible women of reproductive age (15- 49 years) who had delivered within the last one-year prior to the commencement of the study were selected from each community. A structured questionnaire was used to collate information on respondents socio-demographic, geographic and cultural factors that affect the utilization of skilled delivery services. Data was analyzed using Stata Statistical Software (version 12), frequencies and percentages were used to summarize data and associations between variables investigated with multiple regression analyses at a significance of p<0.05.Results: Out of the 527 women interviewed, 481 (91.6%) had a skilled delivery. Mothers were aged between 15 and 45 years with mean (± SD) age of 26.4 ± 9.4 years. After statistical adjustment, rural residence (AOR=2.7, 95% CI 0.8 – 8.9, p=0.036 compared with urban residence), never attended antenatal care (AOR=101, 95% CI 10.2 – 1017, p<0.001), health facility delivery (AOR=0.1, 95% CI 0.1 – 0.6, p<0.001), time taken to nearest health facility (≥31 minutes AOR=11.7, 95% CI 3.6 – 38.6, p<0.001), and no Husband’s consent (AOR=4.6, 95% CI 1.8 – 11.6, p<0.001) were significantly associated with uptake of skilled delivery services.Conclusion: The findings of this study demonstrate adequate utilization of skilled delivery services among women in the Municipality. Efforts towards improvement of skilled delivery coverage should focus on health education, especially among rural women together with the expansion of healthcare services.

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“…Most ANC coverage estimates from low-resource settings, including Ethiopia, rely on self-reports. 8, 29, 30 One of the strengths of our study is the contribution of longitudinal facility recorded data to conservatively count the total number of ANC visits attended by study participants to predict ANC access. As a limitation, the counts used to generate the principal outcome may underestimate the total number of visits attended due to possible visits outside the study catchment area, or incomplete retrospective data abstraction.…”

Section: Discussionmentioning

confidence: 99%

Development of prediction models for antenatal care attendance in Amhara region, Ethiopia

Wilder

Pons‐Duran

Goddard

et al. 2022

Preprint

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Background. In low-resource settings, coverage of at least four antenatal care (ANC) visits remains low. As a first step towards enhancing ANC attendance, this study aims to develop a series of predictive models to identify women who are at high risk of failing to attend ANC in a rural setting in Ethiopia. Methods. This is a cohort study conducted in the Birhan field site, North Shewa Zone. Using data of a surveillance system and a pregnancy cohort, we developed and internally validated a series of logistic regressions with regularization (LASSO), and ensembles of decision trees. Discrimination was estimated using the area under the receiving operator characteristic curve (AUC). Three prediction time points were considered: conception, and gestational weeks 13 and 24. Results. The study sample size was 2195. Mean age of participants was 26.8 years (Standard Deviation (SD) 6.1) and mean gestational age at enrolment was 25.5 weeks (SD 8.8). A total of 582 women (26.5%) failed to attend ANC during cohort follow-up. We observed AUC in the range of 0.61-0.70, with higher values for models predicting at weeks 13 and 24. All AUC values were similar with slightly higher performance for the ensembles of decision trees. Conclusions. The developed models may be useful to identify women at high risk of missing their ANC visits to target interventions to improve attendance rates. This study calls for new efforts to generate data that enables accurate prediction of ANC access, and it opens the possibility to develop and validate easy-to-use tools to predict health-related behaviours in settings with scarce resources.

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Antenatal care and skilled delivery service utilisation in Somali pastoral communities of Eastern Ethiopia

Cited by 18 publications

References 34 publications

Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study

Low and unequal use of outpatient health services in public primary health care facilities in southern Ethiopia: a facility-based cross-sectional study

Utilization of Facility-based Delivery Services in the Wa Municipality, Ghana

Development of prediction models for antenatal care attendance in Amhara region, Ethiopia

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