Abstract
BackgroundGlobally, the magnitude of maternal mortality is the major public health problem. Nearly all (99%) of maternal deaths occur in low- and middle-income countries. Of which 66% occur in sub-Saharan Africa. Institutional delivery under the hygienic environment with the necessary skills and equipment promotes to identify and treat complications, infections, and the death of the mother and baby. In Ethiopia, the utilization of maternal health services is very low. For instance, 62% of women had antenatal care utilization during pregnancy while only 26% of women utilize institutions for delivery in 2016. Therefore, this study examined the association between antenatal care follow up and intestinal delivery among a nationally representative woman in Ethiopia.MethodsA cross-sectional study design was used to examine 7575 women from the 2016 Ethiopia Demographic and Health Survey. Both descriptive and inferential statistics were utilized. Variables in the bivariate logistic regression with p-value < 0.2 were entered into the multivariable logistic regression. Odds ratios and corresponding 95% confidence intervals (CI) were reported. In the multivariable analysis, variables with p-value < 0.05 were considered as statistically significant.ResultsThe prevalence of institutional delivery service utilization for last childbirth was 11.3%. In comparison with women with no antenatal care visits, the multivariable odds ratio (95% confidence interval) of institutional delivery among those who attend one to three and four or more antenatal care visit were 2.49 (1.66, 3.74) and 3.90 (2.60, 5.84), respectively. Other factors significantly associated with institutional delivery include urban residence 2.25 (1.44, 3.51), complete primary education 3.22 (2.09, 4.98), complete secondary or higher education 1.59 (1.16, 2.17), poorer household wealth index 2.57 (1.57, 4.20), middle household wealth index 1.63 (1.05, 2.52), and richer household wealth index 1.56(1.03, 2.58).ConclusionAntenatal care follow-up was significantly associated with institutional delivery service utilization. As the number of antenatal care visits increased the odds of facility delivery increased. Thus, improved access and utilization of antenatal care can be an effective strategy to increase institutional deliveries and optimal maternal and child health outcomes.
Highlights
The magnitude of maternal mortality is the major public health problem
Antenatal care follow-up was significantly associated with institutional delivery service utilization
As the number of antenatal care visits increased the odds of facility delivery increased
Summary
The magnitude of maternal mortality is the major public health problem. Institutional delivery under the hygienic environment with the necessary skills and equipment promotes to identify and treat complications, infections, and the death of the mother and baby. Almost all (99%) of maternal deaths occur in low-and-middle-income countries, 66% of which in Sub-Saharan Africa alone [2, 3]. The 2016 Ethiopia Demographic and Health Survey (EDHS) reported that maternal mortality ratio (MMR) is estimated to be 412 deaths per 100,000 live births which was high among rural and non-institutional delivered women [4]. Skilled birth attendants during childbirth in a hygienic environment with necessary skills and types of equipment are important to identify and treat complications, infections, and death of the mother, and child [5]
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