Public Health Department, College of Medicine & Health Sciences, Wachemo University, Hosanna, ET.
Department of Family Health, Hosanna College of Health Science, Hosanna, ET.
Ann Glob Health. 2023 Oct 20;89(1):73. doi: 10.5334/aogh.4101. eCollection 2023.
Health equity has emerged as a global issue in the post-2015 Sustainable Development Goals, and Ethiopia is no exception. Despite positive improvements, inequities in maternal health service utilization among demographic groups continue to be one of Ethiopia's significant challenges in decreasing maternal mortality. This study focuses on antenatal care service discrimination among a local poor group known as the "golden hands" community in Ethiopia's Kembata Tembaro zone. The subgroup community consists of outcast artesian groups known as "golden hands," formerly known as "Fuga," who face discrimination in all aspects of life owing to their living conditions and ethnic background.
A community-based comparative cross-sectional study was conducted in Ethiopia's Kembata Tembaro, zone in the Southern Nations, Nationalities, and Peoples' Region (SNNPR), from January to February 2022. The study focused on two groups, "golden hands" and "non-golden hands," consisting of women aged 15-49 years. Using stratified and multistage cluster sampling, 1,210 participants were selected, with 440 from golden hand communities and 770 from non-golden hand communities. Data was collected through translated questionnaires, and data quality was rigorously monitored. The concentration curve and index, as well as logistic-based decomposition analysis, were used to examine inequality. The statistical significance threshold was set at < 0.05 with a 95% confidence interval.
This study comprised 1,210 eligible participants, 440 of whom were golden hand community members. Discrimination accounted for 60.23% of the decreased antenatal care (ANC) service use by the golden hand community. Age, urban residence, and wealth index were the most important independent factors with statistically significant contributions to changes owing to differences in effects (discriminated difference).
Since ANC service discrimination is prevalent, the government and nongovernmental organizations should take steps to ensure that marginalized groups in society, such as golden hand women, the poor, the uneducated, and rural people, have equal access to service utilization opportunities.
健康公平已成为 2015 年后可持续发展目标中的一个全球性问题，埃塞俄比亚也不例外。尽管取得了积极进展，但在孕产妇卫生服务利用方面，不同人口群体之间仍存在不平等现象，这仍是埃塞俄比亚降低孕产妇死亡率的重大挑战之一。本研究聚焦于埃塞俄比亚孔马塔塔巴罗地区一个当地贫困群体——“金手”社区的产前护理服务歧视问题。该亚群社区由被社会排斥的自流井群体组成，被称为“金手”，以前被称为“Fuga”，由于生活条件和族裔背景，他们在生活的各个方面都面临歧视。
本研究是在 2022 年 1 月至 2 月期间在埃塞俄比亚孔马塔塔巴罗地区的南部各族州进行的一项基于社区的比较性横断面研究。该研究聚焦于两个群体，即“金手”和“非金手”，由年龄在 15-49 岁的女性组成。使用分层和多阶段聚类抽样，共选取了 1210 名参与者，其中 440 名来自金手社区，770 名来自非金手社区。通过翻译后的问卷收集数据，并严格监测数据质量。使用集中曲线和指数以及基于逻辑的分解分析来检查不平等情况。统计显著性阈值设为 < 0.05，置信区间为 95%。
本研究共纳入 1210 名符合条件的参与者，其中 440 名来自金手社区。歧视导致金手社区产前护理（ANC）服务使用率下降了 60.23%。年龄、城市居住和财富指数是最重要的独立因素，它们对由于影响差异（歧视差异）而导致的变化具有统计学意义。
由于 ANC 服务存在歧视现象，政府和非政府组织应采取措施，确保社会中的边缘化群体，如金手妇女、穷人、未受教育者和农村人口，能够平等获得服务利用机会。
