Trends in Reproductive Health indicators in Ethiopia: 2000-2014

Abstract

Introduction: The Millennium Development Goals include a focus on Reproductive Health (RH) indicators which are of substantial importance in low and middle income countries. However, little has been reported of the time-trend in these indicators in Ethiopia. This study aims to describe trends in RH indicators in Ethiopia from 2000-2014. Methods: This study is a time-trend analysis of RH indicators. We used 15-years of RH indicator data sourced mainly from Federal Ministry of Health and Demographic and Health Survey. Maternal mortality ratio, antenatal care coverage, skilled birth attendance coverage, postnatal care coverage, contraceptive prevalence rate and total fertility rate were selected and analysed using numerical and graphic summaries. We used coefficient of determination (R 2 ) for the Federal Ministry of Health facility based data to examine the variation in annual progress explained by the regression model. Confidence intervals were used in the Demographic and Health Survey data to indicate the period when significant difference was observed. Trends of indicators from both data sources were also compared. Results: During the 15-years study period, antenatal care coverage increased from 29% to 98% (R 2 = 95%). It increased more rapidly than skilled birth attendance which remained low at 41% in 2014. Postnatal care coverage increased from 5% to 64% (R 2 = 96%). Modern contraceptive prevalence rate among the married women improved from 6.3% (5.8%, 6.8%) to 40% (38.7%, 41.3%) within the 15-year period. Maternal mortality ratio decreased from 990 in 2000 to 420 in 2013. The total fertility rate decreased from 5.5 to 4.1 children per woman. With lowest performance in 2000, Ethiopia demonstrated better improvement compared to selected sub-Saharan African countries. Variations in the trends were observed when data from both sources were compared. Conclusions: RH service coverages have shown remarkable improvement while maternal mortality ratio, although reduced, remained high. There was a significant gap in the continuum of maternal health services.

Dropout from maternity continuum of care and associated factors among women in Debre Markos town, Northwest Ethiopia

“…In our country Ethiopia, trends of reproductive health indicators from 2000-2014 showed that even though there is a significant improvement of maternal health care services utilization, the gap in the continuum of maternal health care services remains remarkably high [8]. According to Ethiopia Demographic and Health Survey(EDHS) 2016 report, out ofallreproductive-aged women, 62% received antenatal care (ANC) and 28% had skilled delivery assistance, among women, gave birth in the 2 years before the survey, 17% had a postnatal check [9].This showed that there is a significant drop out through maternity continuum of care and still little progress has been made in closing the gap between the level of maternal health care services.…”

Utilization of decentralized health facilities and factors influencing women’s choice of a delivery site in Gida Ayana Woreda, western Ethiopia

“…Sub-Saharan Africa shared the highest burden, accounting for almost half (48.3%) of all maternal deaths globally. Maternal mortality in Ethiopia remains high with a ratio of 497 deaths per 100,000 live births [4,7,8]. The 2015 MMR estimate of the country was 410 per 100,000 live births compared to 373, 338, and 280 in Rwanda, Kenya, and Uganda, respectively [5].…”

“…The 2015 MMR estimate of the country was 410 per 100,000 live births compared to 373, 338, and 280 in Rwanda, Kenya, and Uganda, respectively [5]. The country reported the largest maternal mortality ratio from all causes for total world deaths [7,8] and did not achieve the goal of driving down maternal deaths to 267 per 100,000 by 2015 [9]. The high maternal death rate was primarily attributed to underutilization of antenatal clinics [10–15] and institutional delivery [16–22].…”

“…The high maternal death rate was primarily attributed to underutilization of antenatal clinics [10–15] and institutional delivery [16–22]. Several studies indicated that proper follow-up of maternal care can prevent more than 80% of deaths [7,23–26] and others suggest that increasing access to emergency care around the time of delivery is the most essential intervention for driving down maternal deaths [27–34]. According to Woldegiorgis et al [7], only 11.8% of all births were attended by skilled health personnel in Ethiopia, compared to 71.9% in Rwanda and 60.0% in Uganda between 1999 and 2012.…”

“…Several studies indicated that proper follow-up of maternal care can prevent more than 80% of deaths [7,23–26] and others suggest that increasing access to emergency care around the time of delivery is the most essential intervention for driving down maternal deaths [27–34]. According to Woldegiorgis et al [7], only 11.8% of all births were attended by skilled health personnel in Ethiopia, compared to 71.9% in Rwanda and 60.0% in Uganda between 1999 and 2012. Recent surveys noted that skilled birth attendance increased to 28%, far below the national target of 62% by 2015 and 80% by 2020 [9,35,36].…”