Abstract
BackgroundIn the context of high maternal morbidity and mortality in Sub-Saharan Africa, less than 80% of pregnant women receive antenatal care services. According to a 2016 national report, only 62% of pregnant women in Ethiopia made at least one antenatal care visit. The aim of this review was to systematically and quantitatively summarize the factors affecting utilization of antenatal care in Ethiopia.MethodsWe searched PubMed, Medline, EMBASE, CINAHL, Google Scholar and Maternity and Infant Care database for studies that had been conducted in Ethiopia between 2002 and 2016. We summarized the studies on the use of antenatal care services quantitatively and qualitatively. A random-effects model was conducted to obtain the pooled estimates.ResultsA total of fifteen observational studies were included in this review. The pooled prevalence of utilization of antenatal care services in Ethiopia was 63.77% (95CI 53.84–75.54). The pooled odds ratio showed that a significant positive association was found between utilization of antenatal care and urban residence (OR = 1.92, 95%CI = 1.35–2.72), women’s education (OR = 1.90, 95%CI = 1.52–2.37), husband’s education (OR = 1.49, 95%CI = 1.32–1.69) and planned pregnancy (OR = 2.08, 95%CI = 1.45–2.98). Based on narrative synthesis exposure to mass media, family income and accessibility of the service were strongly associated with utilization of antenatal care.ConclusionThe findings of this review found several modifiable factors such as empowering women through education and increasing their decision-making power, promoting family planning to prevent unplanned pregnancy, increasing awareness of women through mass media and making services more accessible would likely to increase utilization of antenatal care. Further research is needed on accessibility and availability of the service at the individual and community level to assess the predictors of antenatal care service utilization.
Highlights
Pregnancy is an important time to promote good health and prepare women and their families psychologically and emotionally for parenthood
The pooled odds ratio showed that a significant positive association was found between utilization of antenatal care and urban residence (OR = 1.92, 95%confidence interval (CI) = 1.35–2.72), women’s education (OR = 1.90, 95%CI = 1.52–2.37), husband’s education (OR = 1.49, 95%CI = 1.32– 1.69) and planned pregnancy (OR = 2.08, 95%CI = 1.45–2.98)
Further research is needed on accessibility and availability of the service at the individual and community level to assess the predictors of antenatal care service utilization
Summary
Pregnancy is an important time to promote good health and prepare women and their families psychologically and emotionally for parenthood. The World Health Organization (WHO) recommended four antenatal visits for uncomplicated pregnancies. The first of these took place within 12 weeks of gestational age [5]. Most maternal and newborn deaths and pregnancy-related complications can be prevented, detected and managed if pregnant women receive quality maternal healthcare services from a skilled health worker [8,9,10,11]. In developing countries, where maternal mortality is fourteen times higher than in high income countries, only 52% of pregnant women received the recommended number of antenatal care visits in 2014 [12]. In the context of high maternal morbidity and mortality in Sub-Saharan Africa, less than 80% of pregnant women receive antenatal care services.
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