Uncovering spatial variation in maternal healthcare service use at subnational level in Jimma Zone, Ethiopia.

ABSTRACT:

Background

Analysis of disaggregated national data suggest uneven access to essential maternal healthcare services within countries. This is of concern as it hinders equitable progress in health outcomes. Mounting an effective response requires identification of subnational areas that may be lagging behind. This paper aims to explore spatial variation in maternal healthcare service use at health centre catchment, village and household levels. Spatial correlations of service use with household wealth and women's education levels were also assessed.

Methods

Using survey data from 3758 households enrolled in a cluster randomized trial geographical variation in the use of maternity waiting homes (MWH), antenatal care (ANC), delivery care and postnatal care (PNC) was investigated in three districts in Jimma Zone. Correlations of service use with education and wealth levels were also explored among 24 health centre catchment areas using choropleth maps. Global spatial autocorrelation was assessed using Moran's I. Cluster analyses were performed at village and household levels using Getis Ord Gi* and Kulldorf spatial scan statistics to identify cluster locations.

Results

Significant global spatial autocorrelation was present in ANC use (Moran's I?=?0.15, p value?=?0.025), delivery care (Moran's I?=?0.17, p value?=?0.01) and PNC use (Moran's I?=?0.31, p value ConclusionsSub-national variation in maternal healthcare services exists in Jimma Zone. There was relatively higher poverty and lower education in areas where service use cold spots were identified. Re-directing resources to vulnerable sub-groups and locations lagging behind will be necessary to ensure equitable progress in maternal health.

SUBMITTER: Kurji J 

PROVIDER: S-EPMC7394677 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature