Abstract
BackgroundThe benefits of maternal health care to maternal and neonatal health outcomes have been well documented. Antenatal care attendance, institutional delivery and skilled attendance at delivery all help to improve maternal and neonatal health. However, use of maternal health services is still very low in developing countries with high maternal mortality including Ethiopia. This study examines the association of unintended Pregnancy with the use of maternal health services in Southwestern Ethiopia.MethodsData for this study come from a survey conducted among 1370 women with a recent birth in a Health and Demographic Surveillance Site (HDSS) in southwestern Ethiopia. An interviewer administered questionnaire was used to gather data on maternal health care, pregnancy intention and other explanatory variables. Data were analyzed using STATA 11, and both bivariate and multivariate analyses were done. Multivariate logistic regression was used to assess the association of pregnancy intention with the use of antenatal and delivery care services. Unadjusted and adjusted odds ratio and their 95% confidence intervals are reported.ResultsMore than one third (35%) of women reported that their most recent pregnancy was unintended. With regards to maternal health care, only 42% of women made at least one antenatal care visit during pregnancy, while 17% had four or more visits. Institutional delivery was only 12%. Unintended pregnancy was significantly (OR: 0.75, 95% CI, 0.58-0.97) associated with use of antenatal care services and receiving adequate antenatal care (OR: 0.67, 95% CI, 0.46-0.96), even after adjusting for other socio-demographic factors. However, for delivery care, the association with pregnancy intention was attenuated after adjustment. Other factors associated with antenatal care and delivery care include women’s education, urban residence, wealth and distance from health facility.ConclusionsWomen with unintended pregnancies were less likely to access or receive adequate antenatal care. Interventions are needed to reduce unintended pregnancy such as improving access to family planning information and services. Moreover, improving access to maternal health services and understanding women’s pregnancy intention at the time of first antenatal care visit is important to encourage women with unintended pregnancies to complete antenatal care.
Highlights
The benefits of maternal health care to maternal and neonatal health outcomes have been well documented
We examine the associations of pregnancy intention with the use of maternal health services in Southwestern Ethiopia
This is a cross-sectional study conducted in Gilgel Gibe Health and Demographic Surveillance System (HDSS) in Jimma zone, Southwestern Ethiopia, which is located at 260 kilometers to the southwest of Addis Ababa
Summary
The benefits of maternal health care to maternal and neonatal health outcomes have been well documented. Use of maternal health services is still very low in developing countries with high maternal mortality including Ethiopia. There is evidence that access to skilled assistance and well equipped health institutions during delivery can reduce maternal mortality and morbidity and improve pregnancy outcomes [8,9,10,11]. Delivery assisted by skilled provider is an important intervention in reducing maternal mortality, and one of the MDG indicators to track national effort towards safe motherhood. Use of these interventions in most of the countries with high maternal and child mortality is still unacceptably low
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