Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Public Health. 2023 Jul;220:18-26. doi: 10.1016/j.puhe.2023.04.010. Epub 2023 May 23.
Optimal antenatal care (ANC) services are the main strategy to reduce maternal and newborn mortality. Understanding the geographic variation of ANC service utilisation is essential for regional- and local-level interventions. However, data on spatial variation of optimal ANC service utilisation are limited. Hence, this study aimed to investigate the spatial variations and determinants of optimal ANC service utilisation in Ethiopia.
This was a spatial and survey regression analysis.
The secondary analysis of the Ethiopian Demographic and Health Survey 2019 was performed to investigate the spatial variation and determinants of optimal ANC service utilisation among women who were pregnant in the 5 years preceding the survey. Spatial dependency, clustering and prediction were conducted using Global Moran's I statistics, Getis-Ord Gi∗ and Kriging interpolation, respectively, using ArcGIS version 10.8. A survey binary logistic regression model was fitted to identify determinants of optimal ANC service utilisation.
Of 3979 pregnant women, 1656 (41.62%) had optimal ANC visits in Ethiopia. Optimal ANC utilisation was shown more prevalent in Northern, Eastern, Central and Northwestern regions of Ethiopia. The results also identified low levels of optimum ANC utilisation in Northeastern, Southeastern, Southern and Western regions of Ethiopia. Wealth index, timing of initial ANC visit and region were significantly associated with optimal ANC service utilisation in Ethiopia.
Optimal ANC service utilisation showed significant spatial dependency in Ethiopia, with spatial clustering in the Northern and Northwestern regions of the country. In addition, the results from this study suggest that financial support should be considered for women living in households in the poorest wealth index and ANC initiation should begin within the first trimester. It is recommended that targeted policies and strategies are introduced to regions with low levels of optimal ANC service utilisation.
最佳产前护理（ANC）服务是降低孕产妇和新生儿死亡率的主要策略。了解 ANC 服务利用的地理差异对于区域和地方干预至关重要。然而，关于最佳 ANC 服务利用的空间变化的数据有限。因此，本研究旨在调查埃塞俄比亚 ANC 服务利用的最佳空间变化及其决定因素。
这是一项空间和调查回归分析。
对 2019 年埃塞俄比亚人口与健康调查的二次分析，旨在调查在调查前 5 年内怀孕的妇女中最佳 ANC 服务利用的空间变化及其决定因素。使用 ArcGIS 版本 10.8 分别使用全局 Moran's I 统计量、Getis-Ord Gi∗和克里金插值进行空间依赖性、聚类和预测。使用调查二元逻辑回归模型来确定最佳 ANC 服务利用的决定因素。
在 3979 名孕妇中，有 1656 名（41.62%）在埃塞俄比亚接受了最佳 ANC 检查。最佳 ANC 利用率在埃塞俄比亚北部、东部、中部和西北部地区更为普遍。结果还发现，埃塞俄比亚东北部、东南部、南部和西部地区的最佳 ANC 利用率较低。财富指数、初始 ANC 检查的时间和地区与埃塞俄比亚最佳 ANC 服务利用显著相关。
最佳 ANC 服务利用在埃塞俄比亚表现出显著的空间依赖性，该国北部和西北部地区存在空间聚类。此外，本研究结果表明，应考虑为生活在最贫困财富指数家庭中的妇女提供财政支持，并应在妊娠早期开始 ANC 检查。建议向最佳 ANC 服务利用率较低的地区引入有针对性的政策和战略。
