School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
Department of Environmental Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
PLoS One. 2024 Mar 14;19(3):e0300257. doi: 10.1371/journal.pone.0300257. eCollection 2024.
Although there have been consistent improvements in maternal mortality, it remains high in developing countries due to unequal access to healthcare services during pregnancy and childbirth. Thus, this study aimed to further analyze the variations in the number of antenatal care utilizations and associated factors among pregnant women in urban and rural Ethiopia.
A total of 3962 pregnant women were included in the analysis of 2019 Ethiopian Demographic and Health Survey data. A negative binomial Poisson regression statistical model was used to analyze the data using STATA version 14.0. An incident rate ratio with a 95% confidence interval was used to show the significantly associated variables.
Of the 3962 (weighted 3916.67) pregnant women, about 155 (15.21%) lived in urban and 848 (29.29%) rural residences and did not use antenatal care services in 2019. Women age group 20-24 (IRR = 1.30, 95%CI:1.05-1.61), 25-29 (IRR = 1.56, 95%CI:1.27-1.92), 30-34 (IRR = 1.65, 95%CI:1.33-2.05), and 35-39 years old (IRR = 1.55, 95%CI:1.18-2.03), attending primary, secondary, and higher education (IRR = 1.18, 95%CI:1.07-1.30), (IRR = 1.26, 95%CI:1.13-1.42) and (IRR = 1.25, 95%CI:1.11-1.41) respectively, reside in middle household wealth (IRR = 1.31, 95%CI:1.13-1.52), richer (IRR = 1.45, 95%CI:1.26-1.66) and richest (IRR = 1.68, 95%CI:1.46-1.93) increases the number of antenatal care utilization among urban residences. While attending primary (IRR = 1.34, 95%CI:1.24-1.45), secondary (IRR = 1.54, 95%CI:1.34-1.76) and higher education (IRR = 1.58, 95%CI:1.28-1.95), following Protestant (IRR = 0.76, 95%CI:0.69-0.83), Muslim (IRR = 0.79, 95%CI:0.73-0.85) and Others (IRR = 0.56, 95%CI:0.43-0.71) religions, reside in poorer, middle, richer, and richest household wealth (IRR = 1.51, 95%CI:1.37-1.67), (IRR = 1.66, 95%CI:1.50-1.83), (IRR = 1.71, 95%CI:1.55-1.91) and (IRR = 1.89, 95%CI:1.72-2.09) respectively, being married and widowed/separated (IRR = 1.85, 95%CI:1.19-2.86), and (IRR = 1.95, 95%CI:1.24-3.07) respectively were significantly associated with the number of antenatal care utilization among rural residences.
The utilization of antenatal care is low among rural residents than among urban residents. To increase the frequency of antenatal care utilization, health extension workers and supporting actors should give special attention to pregnant women with low socioeconomic and educational levels through a safety-net lens.
尽管孕产妇死亡率持续改善，但由于发展中国家在妊娠和分娩期间获得医疗保健服务的机会不平等，这一数字仍然很高。因此，本研究旨在进一步分析埃塞俄比亚城乡孕妇产前保健服务利用情况的差异及其相关因素。
本研究分析了 2019 年埃塞俄比亚人口与健康调查数据，共纳入了 3962 名孕妇。采用 STATA 版本 14.0 的负二项泊松回归统计模型对数据进行分析。使用发病率比值和 95%置信区间来显示显著相关的变量。
在 3962 名（加权 3916.67）孕妇中，约有 155 名（15.21%）居住在城市，848 名（29.29%）居住在农村，2019 年未使用产前保健服务。年龄在 20-24 岁（IRR=1.30，95%CI：1.05-1.61）、25-29 岁（IRR=1.56，95%CI：1.27-1.92）、30-34 岁（IRR=1.65，95%CI：1.33-2.05）和 35-39 岁（IRR=1.55，95%CI：1.18-2.03）、接受小学、中学和高等教育（IRR=1.18，95%CI：1.07-1.30）、（IRR=1.26，95%CI：1.13-1.42）和（IRR=1.25，95%CI：1.11-1.41）、居住在中等家庭财富（IRR=1.31，95%CI：1.13-1.52）、更富裕（IRR=1.45，95%CI：1.26-1.66）和最富裕（IRR=1.68，95%CI：1.46-1.93）的妇女，使用产前保健服务的人数增加。而在农村居民中，参加小学（IRR=1.34，95%CI：1.24-1.45）、中学（IRR=1.54，95%CI：1.34-1.76）和高等教育（IRR=1.58，95%CI：1.28-1.95）、信仰新教（IRR=0.76，95%CI：0.69-0.83）、穆斯林（IRR=0.79，95%CI：0.73-0.85）和其他宗教（IRR=0.56，95%CI：0.43-0.71）、居住在较贫穷、中等、较富裕和最富裕的家庭财富（IRR=1.51，95%CI：1.37-1.67）、（IRR=1.66，95%CI：1.50-1.83）、（IRR=1.71，95%CI：1.55-1.91）和（IRR=1.89，95%CI：1.72-2.09）的妇女，已婚和丧偶/离异（IRR=1.85，95%CI：1.19-2.86）、（IRR=1.95，95%CI：1.24-3.07）与农村居民产前保健服务的利用情况显著相关。
农村居民产前保健服务的利用率低于城市居民。为了提高产前保健服务的利用率，卫生扩展工作者和支持性演员应该通过安全网的视角特别关注社会经济和教育水平较低的孕妇。
