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Timing And Adequate Attendance Of Antenatal Care Visits Among Women In Ethiopia Pdf

timing and adequate attendance of antenatal care visits among women in ethiopia pdf

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Background: Improving maternal health in Ethiopia is a major public health challenge. International studies indicate that it is possible to improve maternal health outcomes through action on the Social Determinants of Health SDH.

Timing and adequate attendance of antenatal care visits among women in Ethiopia

Background: Unintended pregnancy has direct relation with poor utilization of maternal health care services and also associated with unhealthy behaviors during pregnancy.

Few studies have examined the association between unintended pregnancy and maternal health behaviors during pregnancy in developing countries including Ethiopia. The purpose of the study was to determine the association of unintended pregnancy with use of antenatal care during pregnancy among pregnant women in Hadiya zone, southern Ethiopia.

Methods: Community based cross sectional study design was employed in Hadiya zone, southern Ethiopia in Study participants were selected by simple random sampling technique. A structured interviewer administered questionnaire was used to collect data. Descriptive, bivariate and multivariate logistic regression was employed to identify the independent effect of unintended pregnancy on the outcomes of interest.

The level of significance was confirmed if p-value was less than 0. Results: More than one third Unintended pregnancy was significantly associated with use of antenatal care. Conclusion: This study finding showed an association between unintended pregnancy and ANC use during pregnancy. Women with unintended pregnancy were less likely to use antenatal care and more likely to delay initiation of antenatal care. Longitudinal studies are recommended on relationship between unintended pregnancy and ANC use.

Introduction Pregnancy is a happy event for the woman, husband, family, and community when it is wanted or intended. But millions of women around the world become pregnant unintended. Unintended pregnancy is when it is either mistimed That is, they occurred earlier than desired or unwanted That is, they occurred when no children, or no more children were desired at the time of conception 1.

Women across the world experience unintended pregnancies irrespective of their development status. In Africa, from a total of Of these, 50 percent ended in abortion, 13 percent ended in miscarriage, and 38 percent resulted in an unplanned birth 2. The situation is not different from less developed countries in Ethiopia; women suffer from problem of unintended pregnancy. About women die from preventable causes related to pregnancy and delivery around the world every day. One target under Sustainable Development Goal SDG 3 is to reduce the global maternal mortality ratio to less than 70 per births 6.

Therefore, reducing maternal mortality is closely related to prevention of unintended pregnancy 1. Unintended pregnancy results in unsafe abortion that is one of the direct causes of maternal mortality and morbidity 7. It leads to induced abortions that can have deleterious consequences for women living in countries where abortions are generally unsafe 8.

Pregnancy is a crucial time to promote healthy behaviors and parenting skills. World Health Organization WHO recommends that adequate antenatal care for a normal pregnancy that has no complications should comprise four Antenatal care ANC visits, with the first occurring within the first trimester Antenatal care provides an opportunity to deliver interventions for providing health education, improving maternal nutrition and encouraging skilled attendance at birth.

Early enrollment in ANC is a widely accepted and recommended behavior for pregnant women to improve pregnancy outcome and late enrollment is viewed as a behavior that places women at increased risk of poor pregnancy outcome. Pregnancies that are unintended result in unhealthy behaviors or continue unhealthy behaviors during pregnancy Thus, unintended pregnancy has direct relation with poor utilization of maternal health care services during pregnancy like delayed initiation of, or low attendance at antenatal care visits Even though the studies were conducted in developed countries, limited findings from developing country studies suggested that unintended pregnancy has association with unhealthy maternal behaviors during pregnancy such as use of illicit drugs, smoking, and drinking alcohol Besides, women with unintended pregnancies have less attention to pregnancy related complications.

And they have low social support and lower scores for self-care behaviors such as use of supplements Folic acid or multivitamin , vaccination and nutrition Consequently, these problems increase obstetric complications such as unfavorable pregnancy outcome, maternal morbidity and mortality, premature birth, low birth weight, neonatal death, and infant abuse There are few literatures that focus on the association of unintended pregnancy and antenatal care utilization in developing countries, particularly in Ethiopia.

Thus, this study aimed to examine whether unintended pregnancy influences antenatal care utilization during pregnancy. Methods Study setting and design: A community based cross sectional study design was conducted in Hadiya zone from March 13, to April 13, Hadiya zone was divided into 10 rural Woreda and two administrative towns with total of kebeles from which of them rural and 26 of them were urban.

Hadiya zone hosts a total of 1,, populations with a total area of The study was conducted from March 13 to April 13, The sample size for prevalence of unintended pregnancy was determined using single population proportion formula. Multi-stage stratified sampling technique was used. Hadiya zone was stratified as rural districts and town administrations. One town administration and 3 districts were randomly selected from among 2 town administration and 10 districts, respectively.

Three districts namely Gibe, Misha and Mirab Badewacho were randomly selected by lottery method for cost and logistic reasons. In the same way, thirteen kebeles 5 from Gibe, 5 from Misha and 3 from Mirab Badewacho were selected.

Three kebeles from Hossana town administrations were included in the study to represent the urban communities. A total of sixteen kebeles from both rural and urban districts were selected by lottery method. The list of pregnant mothers was obtained by conducting census in each selected kebele. Based on population size, a sampling frame which enlists all eligible pregnant mothers was prepared and women were randomly selected to be included in the study and interviewed in their home by using health extension workers.

Kebele is the smallest administrative unit in Ethiopia. The data were collected using a pre-tested structured interviewer administered questionnaire which was developed from EDHS and other similar literatures. It was translated from English to local language Hadiyisa and back to English. Face validation of questionnaire was determined. Ten data collectors and three supervisors, who were qualified with Diploma in nursing and BSc.

The data collectors and the supervisors were trained for two days on questionnaire, approach to the interviewees, details of interviewing techniques, respect and maintaining privacy and confidentiality of the respondents. The collected data was checked for completeness, accuracy, clarity and consistency by the principal investigator.

Measurements: ANC use refers to use of antenatal care during this pregnancy. Women were asked whether they had used ANC during current pregnancy. The variable was measured by binary variable "yes" for those who use and "no" for not using. Moreover, information was collected on time of initiation of ANC visits to determine whether women started early within the first trimester or initiated late in the second trimester and the third trimester.

WHO recommends adequate care for a woman without complications including four ANC visits, with the first visit occurring in the first trimester or before 12 weeks of gestation but not later than 16 weeks The answers were; 1 wanted then intended, 2 wanted to happen later mistimed, 3 did not want at all unwanted.

Unwanted and mistimed pregnancies were then grouped together as unintended pregnancies. Wealth index was used as a measure of socio-economic status of mothers. It was calculated from ownership of the following household resources including radio, television, electricity, bicycle, motorcycle, car, type of floor, type of wall material, type of roof material, toilet facilities, farm land, and of domestic animals such as cattle, sheep, goats, and mule.

Five principal components with eigenvalues greater than one were summed to obtain wealth index values after Principal Component Analysis PCA was run 18, The resulting index was then divided into three categories representing poor, middle and wealthy.

The women were asked "who in her family usually has the final say on the following decisions" of 1 use family planning, 2 number of children, 3, obtaining health care for yourself, 4 visits to family or relatives and 5 large household purchases 20, Then a composite index of women's autonomy in household decision making was obtained.

Each autonomy indicator was coded as a binary variable 0, 1 where 0 represents a low level of decision making and category 1 represents a relatively high level of decision making Decisions were made by either woman alone or with husband jointly. Based on these values, the overall score was found to be 8. Therefore, those women who scored half of the total score, i. Data processing and analysis: The data on each coded questionnaire were entered into Epidata version 3. Then, the entire data were exported to SPSS version 21 statistical packages for analysis.

Descriptive analysis was done to compute frequencies, percentage and cross tabulations. Bivariate analysis was performed to select variables for multivariate analysis. Hence, variables with p-value Ethical consideration: Ethical approval was obtained from ethical review committee of Jimma University, Institute of Health.

Support letter was obtained from department of population and family health. The necessary permission was obtained from Hadiya zone health department, and selected Woreda health offices and kebele administrative offices. All the study participants were informed about the purpose of the study, their right to refuse and assured confidentiality and informed verbal consent was obtained prior to the interview.

The respondents mean age was A majority of study participants were married , Majority of the respondents were from Hadiya ethnic group , Five hundred four In terms of educational status of women, Access to health information or health services: From a total of respondents, Concerning to distance to nearest health facility, Reproductive health related characteristics: From the total pregnant women interviewed, The median age of women in their first pregnancy was 21 years with IQR of 3.

In this study, Prevalence of unintended pregnancy: In this study, from the total pregnant women interviewed, Unintended pregnancy and maternal antenatal care use during pregnancy: Among the study participants, Of those who received ANC, Only about 4.

Besides the fourth antenatal care visit, Out of antenatal care attendants, Multivariate associations of unintended pregnancy and antenatal care use: Factors that were associated with antenatal care use on bivariate analysis using enter method at the level of P value less than 0.

Social Determinants of Antenatal Care Service Use in Ethiopia: Changes Over a 15-Year Span

Metrics details. Timely initiation of antenatal care can avoid pregnancy related problems and save lives of mothers and babies. In developing nations, however, only half of the pregnant mothers receive the recommended number of antenatal care visits, and start late in their pregnancy. Thus, the study was conducted to assess the magnitude of timely initiation of antenatal care and factors associated with the timing of antenatal care attendance in Axum in which studies regarding this issue are lacking. An institution based cross-sectional study mixed with qualitative approach was conducted.

Timing and adequate attendance of antenatal care visits among women in Ethiopia

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Yaya and G.

Background: Unintended pregnancy has direct relation with poor utilization of maternal health care services and also associated with unhealthy behaviors during pregnancy.

Although ANC services are increasingly available to women in low and middle-income countries, their inadequate use persists. This suggests a misalignment between aims of the services and maternal beliefs and circumstances. Owing to the dearth of studies examining the timing and adequacy of content of care, this current study aims to investigate the timing and frequency of ANC visits in Ethiopia. Data was obtained from the nationally representative Ethiopian Demographic and Health Survey EDHS which used a two-stage cluster sampling design to provide estimates for the health and demographic variables of interest for the country.

Box , Arba Minch, Ethiopia. Box , Jimma, Ethiopia. To assess the timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, south Ethiopia. Facility based cross-sectional study employing both quantitative and qualitative methods was conducted from February to March, , in Arba Minch Town and Arba Minch District.

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2 Comments

  1. Tricia G.

    16.05.2021 at 16:46
    Reply

    Studies examining the prevalence of ANC utilizations in Ethiopia revealed inadequate ANC visits with few pregnant women receiving ANC.

  2. Garland L.

    17.05.2021 at 11:56
    Reply

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