Yoseph Amanuel, Kifle Kibru, Berego Yohannes Seifu, Belayneh Mehretu, Tamiso Alemu, Mutwiri G, Guillen-Grima Francisco
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
PLoS One. 2025 May 30;20(5):e0321882. doi: 10.1371/journal.pone.0321882. eCollection 2025.
In Ethiopia, there has been considerable recent investment and prioritization in the maternal health program. However, coverage rates have been low and stagnant for a long time, indicating the existence of systemic utilization barriers. Therefore, it is fundamental to synthesize the current body of knowledge to successfully address these problems and enhance program effectiveness to increase antenatal care (ANC) uptake.
We conducted a scoping review of the literature. Using various combinations of search strategies, we searched Pubmed/Medline, WHO Library, ScienceDirect, Cochrane Library, Google Scholar, and Google for this review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) were used to conduct the review. We included studies that used any study design, data collection, and analysis methods related to antenatal care utilization.
A total of 76 studies, national surveys, and estimates were included in this review. The analysis revealed that ANC utilization coverage varied considerably by region, from 27% in Somali to 90.6% in the Oromia region, with significant disparities in socioeconomic status, access to healthcare, and vaccination knowledge. Ten priority research areas covering various aspects of the national ANC services were identified through a comprehensive review of the existing body of knowledge led by experts using the Delphi method.
The barriers to recommended ANC service utilization differ depending on the context, suggesting that evidence-based, locally customized interventions must be developed and implemented. This review also identified evidence gaps, focusing on health system-related utilization barriers at the lower level, and identified additional research priorities in Ethiopia's ANC service. The first step in developing and executing targeted program approaches could be identifying coverage of ANC services utilization among those with disadvantages.
在埃塞俄比亚，近期在孕产妇健康项目上有大量投资并将其列为优先事项。然而，覆盖率长期以来一直很低且停滞不前，这表明存在系统性的利用障碍。因此，综合当前的知识体系对于成功解决这些问题并提高项目成效以增加产前保健（ANC）的利用率至关重要。
我们对文献进行了范围综述。通过各种搜索策略组合，我们在PubMed/Medline、世卫组织图书馆、科学Direct、Cochrane图书馆、谷歌学术和谷歌上进行了此次综述的搜索。使用系统评价和Meta分析扩展的范围综述的首选报告项目（PRISMA-ScR）来进行综述。我们纳入了使用任何与产前保健利用相关的研究设计、数据收集和分析方法的研究。
本综述共纳入了76项研究、全国性调查和估计数据。分析显示，ANC利用覆盖率因地区而异，从索马里的27%到奥罗米亚地区的90.6%，在社会经济地位、获得医疗保健的机会和疫苗接种知识方面存在显著差异。通过由专家使用德尔菲法对现有知识体系进行全面综述，确定了涵盖国家ANC服务各个方面的十个优先研究领域。
推荐的ANC服务利用障碍因背景而异，这表明必须制定并实施基于证据的、因地制宜的干预措施。本综述还发现了证据空白，重点关注较低层面与卫生系统相关的利用障碍，并确定了埃塞俄比亚ANC服务的其他研究优先事项。制定和执行有针对性的项目方法的第一步可能是确定弱势群体中ANC服务利用的覆盖率。
