Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
College of Medical and Health sciences, Wollega University, Nekemte, Oromia region, Ethiopia.
PLoS One. 2019 Apr 11;14(4):e0214848. doi: 10.1371/journal.pone.0214848. eCollection 2019.
In 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.
We 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.
A 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.
The 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.
在撒哈拉以南非洲地区，孕产妇发病率和死亡率居高不下，只有不到 80%的孕妇接受产前护理服务。根据 2016 年的一份国家报告，埃塞俄比亚只有 62%的孕妇至少接受过一次产前护理。本次综述的目的是系统地、定量地总结影响埃塞俄比亚产前护理利用的因素。
我们在 PubMed、Medline、EMBASE、CINAHL、Google Scholar 和 Maternity and Infant Care 数据库中搜索了 2002 年至 2016 年间在埃塞俄比亚进行的研究。我们对利用产前护理服务的研究进行了定量和定性总结。采用随机效应模型获得汇总估计值。
共有 15 项观察性研究纳入本次综述。埃塞俄比亚产前护理服务利用率的汇总率为 63.77%（95%CI 53.84-75.54）。汇总的优势比表明，产前护理利用与城市居住（OR = 1.92，95%CI = 1.35-2.72）、妇女教育（OR = 1.90，95%CI = 1.52-2.37）、丈夫教育（OR = 1.49，95%CI = 1.32-1.69）和计划生育（OR = 2.08，95%CI = 1.45-2.98）呈显著正相关。基于叙述性综合分析，接触大众媒体、家庭收入和服务的可及性与产前护理的利用密切相关。
本次综述的研究结果发现了一些可改变的因素，如通过教育赋予妇女权力并增强其决策权、促进计划生育以预防非计划妊娠、通过大众媒体提高妇女的意识以及使服务更易获得，可能会增加产前护理的利用。需要进一步研究个人和社区层面服务的可及性和可用性，以评估产前护理服务利用的预测因素。
