Tariku Mandaras, Tusa Biruk Shalmeno, Weldesenbet Adisu Birhanu, Bahiru Nebiyu, Enyew Daniel Berhanie
Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.
Front Glob Womens Health. 2022 Jul 14;3:893322. doi: 10.3389/fgwh.2022.893322. eCollection 2022.
In Ethiopia, the magnitude of antenatal care (ANC) practice and institutional delivery is low as compared with developed countries. The majority of the pregnant women have not completed their ANC follow-up and only 43% of women have reached the four and above ANC. This study was conducted to determine the magnitude of ANC dropout and associated factors among pregnant women in Ethiopia.
Secondary data analysis was conducted using the 2019 Ethiopia Mini Demographic and Health Survey 2019 (2019 EMDHS). The sample was selected using a stratified, two-stage cluster sampling design and the data were analyzed using the binary logistic regression model to identify factors associated with ANC dropout. Adjusted odds ratio (AOR) with 95% CI was reported to declare significance and strength of association. A total weighted sample of 2,143 women who had antenatal care follow-up during pregnancy was included. In the multivariate logistic regression analysis, variables having a -value < 0.05 were considered to have a significant association with ANC dropout.
The magnitude of ANC dropout was 39.12% (95% CI: 37.07 and 41.20%) among women who had ANC follow-up in Ethiopia. Aged 30-49 years [AOR = 0.71; 95% CI: (0.54, 0.94)], attended primary [AOR = 0.79; 95% CI: (0.62, 0.99)], secondary [AOR = 0.63; 95% CI: (0.44, 0.87)], and higher education [AOR = 0.39; 95% CI: (0.25, 0.62)], were in first trimesters [AOR = 0.49; 95% CI: (0.40, 0.60)] at the time of first ANC visit, and had access to laboratory service [AOR = 0.25; 95% CI: (0.13, 0.51)] were found to be a negative significant associated factors of ANC dropouts, whereas being rural resident [AOR = 1.53; 95% CI: (1.11, 2.10)] has a positive significant association with ANC dropouts.
More than one-third of the pregnant women in Ethiopia had dropped out from their ANC follow-up in the study period. Being old-aged, educated, urban resident, having a first ANC visit in the first trimester, and having access to laboratory service were negatively associated with ANC dropouts. Therefore, we recommended encouraging women to have ANC visit at an early stage of pregnancy and conducting basic laboratory investigations during their visit. When undertaking that, due attention should be given to young, uneducated, and rural dweller women.
与发达国家相比,埃塞俄比亚的产前保健(ANC)实施情况和机构分娩率较低。大多数孕妇未完成产前保健随访,只有43%的妇女接受了四次及以上的产前保健。本研究旨在确定埃塞俄比亚孕妇中产前保健中断的程度及其相关因素。
使用2019年埃塞俄比亚微型人口与健康调查(2019 EMDHS)进行二次数据分析。样本采用分层两阶段整群抽样设计选取,并使用二元逻辑回归模型分析数据,以确定与产前保健中断相关的因素。报告调整后的优势比(AOR)及95%置信区间(CI),以说明关联的显著性和强度。纳入了2143名在孕期接受过产前保健随访的妇女的总加权样本。在多变量逻辑回归分析中,p值<0.05的变量被认为与产前保健中断有显著关联。
在埃塞俄比亚接受产前保健随访的妇女中,产前保健中断率为39.12%(95%CI:37.07和41.20%)。年龄在30 - 49岁[AOR = 0.71;95%CI:(0.54,0.94)]、接受过小学教育[AOR = 0.79;95%CI:(0.62,0.99)]、中学教育[AOR = 0.63;95%CI:(0.44,0.87)]和高等教育[AOR = 0.39;95%CI:(0.25,0.62)]、首次产前保健就诊时处于孕早期[AOR = 0.49;95%CI:(0.40,0.60)]以及能够获得实验室服务[AOR = 0.25;95%CI:(0.13,0.51)]被发现是产前保健中断的负向显著相关因素,而农村居民[AOR = 1.53;95%CI:(1.11,2.10)]与产前保健中断呈正向显著关联。
在研究期间,埃塞俄比亚超过三分之一的孕妇中断了产前保健随访。年龄较大、受过教育、城市居民、首次产前保健就诊在孕早期以及能够获得实验室服务与产前保健中断呈负相关。因此,我们建议鼓励妇女在怀孕早期进行产前保健就诊,并在就诊期间开展基本实验室检查。在此过程中,应特别关注年轻、未受过教育和农村居民妇女。