Department of Health Systems Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Health Promotion and Health Communication, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
BMC Health Serv Res. 2024 Sep 6;24(1):1034. doi: 10.1186/s12913-024-11515-w.
Ethiopia has made strides in reducing maternal mortality, but significant discrepancies in maternal health service utilization exist across socioeconomic levels. According to studies, women from higher-income households are far more likely to use essential services such as antenatal care, delivery care, and postnatal care than poorer women. This wealth disparity is a primary contributor to persistently high maternal mortality, particularly among poor populations. The study's goal was to assess wealth disparities in maternal health service uptake and identify contributing factors.
We used the Ethiopian Mini Demographic Health Survey (EMDHS), conducted in 2019 on women aged 15-49 living in selected census areas, with a weighted sample size of 3,909. The Erreygers Concentration Index (ECI) was used to measure wealth inequalities in maternal health care, and the ECI decomposition was used to identify factors contributing to inequality in maternal health services.
Maternal health service utilization was pro-rich among women in Ethiopia. The prevalence of antenatal care service (ANC), delivery, and postnatal care (PNC) service utilization showed a pro-rich distribution among Ethiopian women, with ECI = 0.115 (95% CI: 0.091-0.137), ECI = 0.223 (95% CI: 0.191-0.276), and ECI = 0.121 (95% CI: 0.041-0.200), respectively. The ECI indices were decomposed to examine the contributing factors to disparities in maternal service utilization in Ethiopia. Mother's current age, household family size, region, birth order, and parity were contributors to maternal health service utilization.
The ANC service, delivery service and PNC service utilization showed a pro-rich distribution among Ethiopian women. Mother's current age, household family size, region, birth order, and parity are important contributors of maternal health service inequality. To improve access and usage among low-income women, policymakers can develop programs including increasing the number of free or subsidized services and providing transportation.
埃塞俄比亚在降低产妇死亡率方面取得了长足进步，但在社会经济水平上，产妇保健服务的利用存在显著差异。根据研究，高收入家庭的女性比贫困家庭的女性更有可能使用产前护理、分娩护理和产后护理等基本服务。这种财富差距是导致产妇死亡率持续居高不下的主要原因，尤其是在贫困人群中。本研究旨在评估产妇保健服务获取方面的财富差距，并确定促成因素。
我们使用了 2019 年在选定的普查区进行的埃塞俄比亚微型人口与健康调查（EMDHS），调查对象为年龄在 15-49 岁的女性，加权样本量为 3909 人。使用 Erreygers 集中指数（ECI）衡量产妇保健服务中的财富不平等，使用 ECI 分解来确定导致产妇保健服务不平等的因素。
埃塞俄比亚妇女的产妇保健服务利用呈亲富模式。产前护理服务（ANC）、分娩和产后护理（PNC）服务的利用情况显示出埃塞俄比亚妇女的亲富分布，ECI=0.115（95%CI：0.091-0.137）、ECI=0.223（95%CI：0.191-0.276）和 ECI=0.121（95%CI：0.041-0.200）。对 ECI 指数进行分解以检验导致埃塞俄比亚产妇服务利用差异的因素。母亲的当前年龄、家庭规模、地区、出生顺序和胎次是产妇保健服务利用的促成因素。
ANC 服务、分娩服务和 PNC 服务在埃塞俄比亚妇女中呈现亲富分布。母亲的当前年龄、家庭规模、地区、出生顺序和胎次是产妇保健服务不平等的重要促成因素。为了提高低收入妇女的获得和使用机会，政策制定者可以制定计划，包括增加免费或补贴服务的数量并提供交通服务。
