Adequacy of prenatal care services and associated factors in Southern Ethiopia

Afework Tadele,Bekelu Teka

doi:10.1186/s13690-021-00614-3

Afework Tadele, Bekelu Teka

Open Access

https://doi.org/10.1186/s13690-021-00614-3

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Abstract

BackgroundPrenatal care is an important component for the continuum of care in maternal and child health services. Despite increased attention on prenatal care service coverage, the adequacy of service provision has not been well addressed in Ethiopia. Therefore, this study aimed to describe the status of the adequacy of prenatal care and its associated factors in Southern Ethiopia.Method A longitudinal study done by the Performance care Monitoring and Accountability (PMA2020) project was used. The study was conducted from August 2016 to January 2017 in Southern Ethiopia. A multistage stratified cluster design in which all enumeration areas were randomly selected using probability proportional to size and all households were screened to identify 324 pregnant women of six or more months. Questions regarding early attendance of prenatal care, enough visits, and sufficient services were asked to measure the adequacy of prenatal care. Finally, an ordered logistic regression analysis was employed to assess factors associated with the adequacy of prenatal care services.ResultsOf the total pregnant women 44.21 % attended enough visits, 84.10 % had early visits, and 42.03 % received sufficient services. The women residing in urban areas had 2.35 odds of having adequate prenatal care in reference to rural areas (adjusted odds ratio (aOR) 2.35 [95 % CI 1.05–5.31]). Women who attended primary and secondary education had 2.42(aOR 2.42 [95 % C.I. 1.04, 5.65]), and 4.18 (aOR 4.18 [95 % CI 1.32, 13.29]) odds of adequate prenatal care in reference with those who never attended education respectively. The women participating in one to five networks have 2.18 odds of adequate prenatal care in reference to their counterparts (aOR 2.78 [95 % CI 1.01, 7.71]).ConclusionsThe adequacy of prenatal care services in Southern Ethiopia is very low. The Ethiopian health care system should strengthen one to five networks to discuss on family health issues. Further research, should validate the tools and measure the adequacy of the services in different contexts of Ethiopia using a mixed method study for an in-depth understanding of the problem.

Highlights

Prenatal care is an important component for the continuum of care in maternal and child health services
The women residing in urban areas had 2.35 odds of having adequate prenatal care in reference to rural areas (adjusted odds ratio 2.35 [95 % CI 1.05–5.31])
The Ethiopian health care system should strengthen one to five networks to discuss on family health issues

Summary

Introduction

Prenatal care is an important component for the continuum of care in maternal and child health services. First contact during the first three months of pregnancy (timely), a minimum of four, most recently at least eight contacts for antenatal care (sufficient) and adequate services (with appropriate content) prenatal care service is significantly important in improving maternal and neonatal health outcomes [4, 15]. This indicates that prenatal care could positively influence birth outcomes by producing changes in mother’s behaviors, improving mother’s nutritional intake, reducing morbidity risks and terminating pregnancy that could lead to poor birth outcomes through the application of its four goals: early detection of pregnant women at risk, action to prevent any future difficulties, diagnosis and treatment of preexisting medical conditions, and prompt referral in case of complications developed [16, 17]. According to the focused antenatal care model that recommends a minimum of four prenatal care visits and content of the packages that comprise physical examinations (blood pressure measurement, fetal heartbeat assessment), laboratory investigations (urine and blood samples), preventive procedures (tetanus injection and iron supplementation) and counseling on signs of pregnancy complications and measures to be taken by the mother [18]

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