Facility delivery and postnatal care services use among mothers who attended four or more antenatal care visits in Ethiopia: further analysis of the 2016 demographic and health survey

Abstract

BackgroundAntenatal care provides the best opportunity to promote maternal and child health services use. But many Ethiopian mothers deliver at home and fail to attend postnatal care. Therefore, this study was done to identify factors associated with health facility delivery among mothers who attended four or more antenatal care visits. The study was also intended to identify factors associated with postnatal care service use among mothers who delivered at home after four or more antenatal care visits.MethodsThis study used the 2016 Ethiopian Demographic and Health Survey data. Two thousand four hundred fifteen women who attended four or more antenatal care visits were included to identify factors associated with health facility delivery after four or more antenatal care visits. Among them, 1055 mothers delivered at home. These women were included to identify factors associated with postnatal care service use. Stata 15.1 was used to analyze the data. Multivariable logistic regression model was fitted to identify associations between the outcome and predictor variables.ResultsAmong women who had four or more antenatal care visits, 56% delivered at health facility. Mothers with secondary or higher level of education (AOR = 2.9; 95% CI = 1.6–5.3), urban residents (AOR = 3.4; 95% CI = 1.9–6.1), women with highest wealth quintile (AOR = 2.7; 95% CI = 1.5–4.8), and working women (AOR = 1.6; 95% CI = 1.2–2.3) had higher odds of delivering at health facilities. High birth order (AOR = 0.5; 95% CI = 0.3–0.7) was negatively associated with a lower likelihood of health facility delivery. Among women who delivered at home, only 8% received postnatal care within 42 days after delivery. Only the content of care received during antenatal care visits (AOR = 1.40; 95% CI = 1.1–1.8) was significantly associated with postnatal care attendance.ConclusionWomen with lower socio-economic status had lower odds of giving birth at health facility even after attending antenatal care. The more antenatal care components a mother received, the higher her probability of delivering at health facility. Similarly, postnatal care attendance was higher among women who had received more antenatal care components.

Does knowledge of pregnancy complications influence health facility delivery? Analysis of 2014 Bangladesh Demographic and Health Survey

“…This corroborates recent studies in Bangladesh [20][21][22] and other countries [34,35,58]. The possible explanations to this finding are that women in the rural areas have varied barriers in accessing health facilities including geographical and challenges in getting information on the need to deliver in health facilities [53]. This is also related to the lower socioeconomic conditions of rural women as well as the paucity of health facilities and personnel in rural Bangladesh [6].…”

“…as Nepal [50], Cambodia [51], Ethiopia [37,52,53], Eretria [49] and India [54] have consistently revealed that high maternal education influences the use of health facility delivery. The link between formal education and the uptake of health facility delivery can be explained through several pathways.…”

“…Second, formal education erases erroneous beliefs rooted in various traditions that interpret certain healthy behaviors as taboos and by so doing can make educated women acquire positive attitudes towards health facility delivery [22]. Third, as posited by Fekadu, Ambaw and Kidanie [53] and Gebregziabher et al [49] "higher level of education is associated with better information processing skill, improved cognitive skills and value feelings of self-worth and confidence which all improve health service use." Also, Tsegay et al [34] are of the view that formal education is associated with women empowerment and as a result enable women to make better decisions relating to their healthcare and to easily notice complications they might face during pregnancy and delivery.…”

“…Education increases women's knowledge of where and how the best health care can be accessed and enhances their capability of making autonomous decisions [55]. Fekadu et al [53] also explained that educated women are aware of their health and possess greater knowledge about available health services and the risk of not delivering at a health facility. With this, they are more probable to know and choose the best from the range of services available to them.…”

High dropout rate from maternity continuum of care after antenatal care booking and its associated factors among reproductive age women in Ethiopia, Evidence from Demographic and Health Survey 2016

“…The maternity continuum of care was very vital to reduce maternal and child mortality to achieve the sustainable development goal [5,6]. Antenatal care services were started across the globe to reduce maternal and neonatal mortality by increasing skilled birth attendance and institutional delivery rate [7][8][9][10]. The World Health Organization (WHO) and other stakeholders are fighting to reduce maternal and child mortality with different intervention programs and strategies [11].…”