Geographic differences in maternal and child health care utilization in four Ethiopian regions; a cross-sectional study.
Int J Equity Health
; 18(1): 173, 2019 11 12.
Article
em En
| MEDLINE
| ID: mdl-31718658
ABSTRACT
BACKGROUND:
Maternal and child health (MCH) care utilization often vary with geographic location. We analyzed the geographic distribution and determinants of utilization of four or more antenatal care visits, health facility delivery, child immunization, and care utilization for common childhood illnesses across four Ethiopian regions.METHODS:
A cross-sectional community-based study was employed with two-staged stratified cluster sampling in 46 districts of Ethiopia. A total of 6321 women (13-49 years) and 3110 children below the age of 5 years residing in 5714 households were included. We performed a cluster analysis of the selected MCH care utilization using spatial autocorrelation. We identified district-specific relationships between care coverage and selected factors using geocoded district-level data and ordinary least squares and hotspot analysis using Getis Ord Gi*.RESULTS:
Of the 6321women included in the study, 714 had a live birth in the 12 months before the survey. One-third of the women (30, 95% CI 26-34) had made four or more antenatal visits and almost half of the women (47, 95% CI 43-51) had delivered their most recent child at a health facility. Nearly half of the children (48, 95% CI 40-57) with common childhood illnesses (suspected pneumonia, diarrhoea, or fever) sought care at the health facilities. The proportion of fully immunized children was 41% (95%, CI 37-45). Institutional delivery was clustered at district level (spatial autocorrelation, Moron's I = 0.217, P < 0.01). Full immunization coverage was also spatially clustered (Moron's I = 0.156, P-value < 0.1). Four or more antenatal visits were associated with women's age and parity, while the clustering of institutional delivery was associated with the number of antenatal care visits. Clustering of full immunization was associated with household members owning a mobile phone.CONCLUSIONS:
This study showed evidence for geographic clustering in coverage of health facility deliveries and immunization at the district level, but not in the utilization of antenatal care and utilization of health services for common childhood illnesses. Identifying and improving district-level factors that influenced these outcomes may inform efforts to achieve geographical equitability and universal health coverage.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Serviços de Saúde da Criança
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Pesquisas sobre Atenção à Saúde
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Cobertura Vacinal
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Serviços de Saúde Materna
Tipo de estudo:
Observational_studies
/
Prevalence_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
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Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article