Underutilization of the recommended frequency of focused antenatal care services in Northwest Ethiopia: Using Andersen's healthcare service utilization model approach

Abstract

Background: World Health organizations (2001) introduced an antenatal care model called Focused Antenatal Care (FANC) and recommended to have a minimum of four visits. This model is still feasible for low resource setting countries like Ethiopia. Underutilization of the recommended frequency of FANC results to hurt maternal and child health outcomes. Methods: Institutional based cross-sectional study was conducted from August 1 to October 30, 2019, at Debre Markos Referral Hospital, and a total of 358 post-partum mothers were participated in this study. A multivariable binary logistic regression was employed to identify factors associated with underutilization of the recommended frequency of FANC visits. A p-value < 0.05 was a cut-off point to declare statistical significance. Results: The magnitude of the recommended frequency of FANC visits was 55.6%. The high odds of underutilization were observed among mothers who did not watch television [AOR = 3.5; 95% CI (1.25-5.99)], not listing radio [AOR = 4.29; 95% CI (1.67-10.97)], reside far from health facility [AOR = 11.3; 95% CI (4.15-30.90)], and lack companionship/s when visited health facility [AOR = 3.5; 95% CI (1.91-6.50)]. Whereas, mothers age between 20 and 34 years [ AOR = 0.21; 95% CI (0.07-0.67)] and had follow up at private clinic/s [AOR = 0.013; 95% CI (0.001-0.143)] were inversely associated with underutilization. Conclusion: More than half of the total study participants were underutilized the recommended frequency of FANC which was high. Community mobilization through mass media, improve geographical access to the health facility, and improve client-provider relationships could improve FANC utilization.

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

“…For predisposition factors, we suggested that age, sex, race/ethnicity, education, and family structure composition may have an impact on the utilization of health service [ 14 , 15 , 24 – 26 ]. Specifically, it was divided into 5 proxies: (i) Sex ratio (SR, %), which reflects the sex composition.…”

“…Previous scholars in various countries have used the Andersen’ s Behavioral Model (hereinafter referred to as Anderson Model) to explore the impact of various factors on the utilization of health services [ 14 , 15 , 24 – 27 ]. According to their research findings, need factors (e.g.…”

Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review

“…The ensuing factors have been pointed out as contributors to an increase in the utilization of ANC and SBD services: encouraging females/girls' education [71,113], peer influence, spousal involvement/support in MHC partner education [58,71], partner educator [113,172], education monitoring strategies, unpleasant pregnancy history, employment, media, religion, and pregnancy preparedness. In Uganda, Guinea, Malawi and Ethiopia, studies in these aforementioned countries by Atuhaire et al, Atuoye et al, Stewart et al, and Tareke et al discovered that having decision-making power to visit a health facility, financial independence and easy access to the health facilities were directly linked with ANC and SBD utilization services [56,119,164,180]. • Staffing of medical personnel: nurses, midwives and doctors in a health facility.…”

“…He et al's study in Zambia identified the importance of addressing socio-demographic inequalities such as women's education, ethnic background, the wealth status of the household, parity, husband's education, and exposure to mass media to help promote the utilization of ANC services [140]. Langa Nigeria, Eastern Africa, Nigeria, Southern Africa, Ethiopia, Benin and Uganda reported on socio-economic inequalities among women, lower levels of education, poorer backgrounds and household wealth status as the most significant contributing factors to the gap between urban and rural areas in healthcare service utilization [52,56,83,85,109,117,143,156]. Overall, these findings show the disparities that exist in maternal health services in urban-rural communities, making progress towards reducing maternal mortality a huge challenge.…”

Effect of optimal antenatal care on maternal and perinatal health in Ethiopia

“…The utilization of propensity score (PS) helps to make a balanced score within the potential cofounder between the exposed and unexposed groups based on surveillance data, hence resembling characteristics of randomized trials (53). To have a comparable balanced group of the respondent for the observed covariates, potential factors that influenced the utilization of ANC such as maternal age, maternal parity, maternal education status, religion, residence, ownership of the facility, type of health facility, and type of region were balanced accordingly (54)(55)(56)(57)(58). Considering the gaps in previous studies, and the benefit of the proposed approach, PSA was employed to determine the effect of optimal ANC care on maternal and perinatal health.…”