Magnitude of optimal access to ANC and its predictors in Ethiopia: Multilevel mixed effect analysis of nationally representative cross-sectional survey

Abstract

Background Optimal access to ANC, such as the first ANC visit at first trimester, four or more ANC visits, and skilled health care provider can significantly reduce maternal mortality in an inclusive way. Previous studies conducted in Ethiopia on optimal ANC are restricted to frequencies of ANC visit. Therefore, the aim of this study was to assess the magnitude of optimal ANC access as a comprehensive way and its predictors among pregnant women in Ethiopia. Methods Secondary data source from a recent demographic and health survey was used for analysis. This study includes a weighted sample of 4771 pregnant women. A multilevel mixed-effect binary logistic regression analyses was done to identify both the individual and community level factors. Odds ratio along with the 95% confidence interval was generated to identify the predictors of optimal access to ANC. A p-value less than 0.05 was declared as statistical significant. Results In Ethiopia, one in five (20%) pregnant women had optimal access to antenatal care. Regarding the factors at individual level, pregnant women aged 25–34 years [aOR = 1.58, 95% CI = 1.23–2.03] and 35–49 years [aOR = 2.04, 95% CI = 1.43–2.89], those who had educated primary [aOR = 1.67, 95% CI = 1.33–2.09], secondary and higher [aOR = 1.81, 95% CI = 1.15–2.85], Primipara [aOR = 2.45, 95% CI = 1.68–3.59] and multipara [aOR = 1.48, 95% CI = 1.11–1.98] had higher odds of accessing optimal ANC. With the community level factors, the odds of optimal access to ANC was higher among pregnant women who lived in urban area [aOR = 2.08, 95% CI = 1.33–3.27], whereas, lower odds of optimal ANC access among those pregnant women who reported distance to the health facility as a big problem [aOR = 0.78, 95% CI = 0.63–0.96]. Conclusion and recommendation The study concludes that in Ethiopia, optimal access to ANC was low. The study identified that both individual and community level factors were predictors for optimal ANC access. Therefore, the Ethiopian government should intensify extensive education on ANC in a comprehensive way. Moreover, especial attention from the Ethiopian ministry of health for those women who reported distance as a big problem and for rural resident women is mandatory.

Less than one in four mothers get quality intrapartum health care services in Ethiopia

“…Skilled birth attendant (doctors, health officers, nurses, and midwifes) refers to provider of delivery during labour. When a woman received care from numerous providers, the most skilled provider was recorded 22 . Those mothers who reported the aforementioned skilled birth attendant, birth at health facility, and newborn begin breast feeding within 1 h were considered as getting quality intrapartum care and coded as 1 otherwise no quality of intrapartum care and was codded as 0.…”

“…The data for all the three community level variables were not normally distributed. Therefore, each variables were categorized as “low” if the proportion was below 50%, “high” for including median and above the median value 22 , 36 .…”

“…In sub Saharan Africa and many low income countries, quality of intrapartum care remains a concern 17 – 19 . Related with quality of maternal and child health care services, a country representative studies were restricted on the assessment of quality antenatal care 20 – 22 . Although many primary studies were conducted in Ethiopia to determine the prevalence of quality of intrapartum care, so far, the studies were limited in a small geographical area and are inconclusive 23 – 28 .…”

Level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia: new WHO-recommended ANC 8+ model

“…However, in this study, variables such as type of institution, perceived quality of care, level of respectful and non-abuse care and partner involvement were additionally included in this study. Even though some studies have been conducted on the factors contributing to optimal antenatal care utilization in Ethiopia ( 16 , 17 ), after the introduction of the recommended new ANC model, there is some information and certainly undiscovered factors that were revealed within this study. Therefore, the objective of the present study was to assess the level of optimal antenatal care and the factors related to adequate contacts of antenatal care during pregnancy in Arba Minch town.…”