Dataset Information

Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia.

ABSTRACT:

Background

In Ethiopia, the uptake of antenatal care services has been low. Moreover, there is less frequent and late attendance of antenatal care among women who attend. Using the Anderson-Newman model of health care utilization, this study identified factors that either facilitate or impede antenatal care utilization in Kersa district, Eastern Ethiopia.

Method

A community-based cross-sectional study was conducted. A total of 1294 eligible women participated in the study. Data were collected using face to face interviews with a pre-tested structured questionnaire administered with a digital survey tool. Data were collected in a house to house survey of eligible women in the community. Bivariate and multivariate logistic regression analyses were used to examine the predisposing, enabling and need factors associated with antenatal care utilization.

Result

Out of the 1294 respondents, 53.6% (95% CI: 50.8%, 56.3%) attended antenatal care at least once during their last pregnancy. Only 15.3% attended four or more antenatal care visits and just 32.6% attended prior to the 12th week of gestation. Educational status, previous use of antenatal care and best friend's use of maternal care were significant predisposing factors associated with at least one antenatal care visit. Type of kebele, wealth index and husband's attitude towards antenatal care were significant enabling factors associated with at least one antenatal care consultation. Health Extension Workers providing home visits, perceived importance of ANC and awareness of pregnancy complications were significant need factor associated with at least one antenatal care consultation. Husband's attitude towards ANC, head of the household, awareness of pregnancy complications, and history of abortion were predictors of attending four or more antenatal care visits.

Conclusion

More than half of the women attended at least one antenatal care visit. A sizable proportion of women had infrequent and delayed antenatal care. Intervention efforts to improve antenatal care utilization should involve the following: improving women's educational achievement, peer education programs to mobilize and support women, programs to change husbands' attitudes, ameliorate the quality of antenatal care, increasing the Health Extension Worker's home visits program, and increasing the awareness of pregnancy complications.

SUBMITTER: Tesfaye G

PROVIDER: S-EPMC6283597 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia.

Tesfaye Gezahegn G Chojenta Catherine C Smith Roger R Loxton Deborah D

PloS one 20181206 12

<h4>Background</h4>In Ethiopia, the uptake of antenatal care services has been low. Moreover, there is less frequent and late attendance of antenatal care among women who attend. Using the Anderson-Newman model of health care utilization, this study identified factors that either facilitate or impede antenatal care utilization in Kersa district, Eastern Ethiopia.<h4>Method</h4>A community-based cross-sectional study was conducted. A total of 1294 eligible women participated in the study. Data we ...[more]

PMID: 30521640

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Project description:OBJECTIVE:To better understand factors contributing to underutilization of laboratory services for health care delivery in sub-Saharan Africa, we conducted a study in Senegalese Antenatal Care clinics (ANC) and laboratories to determine the extent of underutilization, contributing factors, and bottlenecks in the cascade of care from first ANC visit, test uptake, to availability of test results and appropriate clinical management. METHODS:At 16 health facilities, pregnant women attending for their first ANC visit were consecutively recruited and information was prospectively collected on the request, execution, results and clinical management of seven nationally recommended laboratory screening tests for normal pregnancy: hemoglobin concentration (Hb), syphilis serology, HIV serology, determination of proteinuria (PU), determination of blood group and Rhesus factor, Emmel test to detect sickle cell disease, and glycaemia. Health facility staff were interviewed on human resource capacity, management of the ANC and the laboratory, and availability and use of guidelines. RESULTS:Of 1246 ANC attendants, 400 (32%) had complete results. Completeness varied between facilities from 0-99%. In multilevel logistic regression analysis of women nested in facilities, complete uptake was lower if women started ANC later in pregnancy; very low in rural ANC attendants who ever delivered compared to urban primigravidae (OR 0.064; 95%CI 0.00-0.52); and higher if the facility routinely recommended all seven tests. In the cascade from test request to clinical management, the most frequent bottleneck was non-execution of requested tests, while unavailability of results for executed test was uncommon (<2%). Overall, of 525 abnormal test results 97(18%) had a record of adequate clinical management. CONCLUSION:Our study illustrates challenges to test uptake even when laboratory testing capacity is in place, with large differences between facilities, and underscores the importance of management, policy, and the importance of considering local context in order to improve service delivery to expectant mothers.

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Dataset Information

Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia.

Background

Method

Result

Conclusion

Publications

Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia.

Similar Datasets

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