Factors associated with maternal utilization of health facilities for delivery in Ethiopia

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Study Justification:
– Ethiopia has made progress in reducing maternal mortality rates, but challenges remain in improving the utilization of health facility delivery services.
– Limited evidence exists on the factors associated with health facility delivery in Ethiopia.
– Understanding the correlates of facility delivery among urban and rural women is crucial for addressing maternal mortality.
Study Highlights:
– The overall prevalence of health facility delivery in Ethiopia is low at 17.1%.
– Education, wealth status, frequency of antenatal care visits, and mother’s age at first birth are significantly associated with women’s choice of place of delivery.
– Urban women with primary and secondary/higher level education have higher odds of delivering at a health facility.
– Women from the richest households have higher odds of delivering at a health facility.
– Women who have at least four antenatal care visits have increased odds of delivering at a health facility.
– Urban women who were over 18 years old at their first childbirth have significantly higher odds of choosing to deliver at a health facility.
Recommendations for Lay Reader and Policy Maker:
– Address sociodemographic and wealth inequities to promote the utilization of facility delivery in both urban and rural areas.
– Improve access to education as a strategy to meet maternal health-related goals.
– Treat education as a multipronged strategy to improve maternal health outcomes.
– Consider providing free healthcare access as a strategy to achieve universal coverage of essential maternal healthcare services.
Key Role Players Needed to Address Recommendations:
– Ministry of Health
– Local government authorities
– Non-governmental organizations (NGOs)
– Community health workers
– Health facility staff
– Educators and schools
Cost Items to Include in Planning Recommendations:
– Education programs and initiatives
– Infrastructure development for health facilities
– Training and capacity building for healthcare providers
– Outreach and awareness campaigns
– Monitoring and evaluation systems
– Support for community health workers
– Research and data collection activities

Background: As a signatory of the Millennium Development Goals, Ethiopia has made significant achievements towards meeting the maternal mortality related goals since 1990. Despite that, the country is still experiencing unacceptably high maternal mortality rates, and challenges to improving the coverage and utilisation of health facility delivery services which represent a key strategy to combat maternal mortality. Currently, there is limited evidence on the factors associated with health facility delivery in Ethiopia. Therefore, the objective of this study was to identify the correlates of facility delivery among urban and rural women in Ethiopia. Methods: This was a cross-sectional study based on data from the 2011 Ethiopian Demographic and Health Survey. Participants were 7540 women aged between 15 and 49 years with a history of at least one birth. The outcome variable was place of delivery. Data were analyzed using bivariate and multivariable regression techniques. Results: The overall prevalence of health facility delivery was 17.1% (1447/7540). In the multivariable regression analysis, education, wealth status, frequency of antenatal care visits and mother’s age at first birth were found to be significantly associated with women’s choice of place of delivery. Among urban women, those who had primary and secondary/higher level education had increased odds of delivering at a health facility compared with those without formal education. Those who were from the richest households had higher odds of delivering at a health facility compared with those in the lowest class. In urban and rural areas, compared with those who had no ANC visits, those who had at least four visits also had increased odds of delivering at a health facility. In the urban areas, those who were over 18 years old at their first childbirth had significantly higher odds of choosing to deliver at a health facility. Conclusion: Findings show that the prevalence of healthy facility delivery in Ethiopia is remarkably low. Addressing the sociodemographic and wealth inequities can help promote the utilisation of facility delivery in both urban and rural areas. Policy-makers should consider improving access to education as a strategy to meet maternal health related goals and treat education as a multipronged strategy. Providing free healthcare access could be one strategy to achieve the universal coverage of essential maternal healthcare services.

The study “Factors associated with maternal utilization of health facilities for delivery in Ethiopia” provides several recommendations to improve access to maternal health. These recommendations include:

1. Address sociodemographic and wealth inequities: The study suggests that addressing education and wealth disparities is crucial to improving access to maternal health. Providing equal opportunities for education and economic empowerment can help reduce inequities in women’s choice of place of delivery.

2. Increase frequency of antenatal care (ANC) visits: The study found that women who had at least four ANC visits were more likely to deliver at a health facility. Encouraging and facilitating regular ANC visits can promote the utilization of facility delivery services.

3. Improve access to education: The study highlights that women with primary and secondary/higher level education were more likely to deliver at a health facility compared to those without formal education. Improving access to education can be an effective strategy to meet maternal health goals.

4. Provide free healthcare access: The study suggests that providing free healthcare access can help achieve universal coverage of essential maternal healthcare services. Removing financial barriers can encourage more women to seek care at health facilities for delivery.

Implementing these recommendations is expected to improve access to maternal health services and contribute to a reduction in maternal mortality rates in Ethiopia.
AI Innovations Description
The recommendation to improve access to maternal health based on the study “Factors associated with maternal utilization of health facilities for delivery in Ethiopia” includes the following:

1. Address sociodemographic and wealth inequities: The study found that education and wealth status were significantly associated with women’s choice of place of delivery. To improve access to maternal health, it is important to address these inequities by providing equal opportunities for education and economic empowerment.

2. Increase frequency of antenatal care (ANC) visits: The study found that women who had at least four ANC visits had increased odds of delivering at a health facility. Encouraging and facilitating regular ANC visits can help promote the utilization of facility delivery services.

3. Improve access to education: The study found that women with primary and secondary/higher level education had higher odds of delivering at a health facility compared to those without formal education. Policy-makers should consider improving access to education as a strategy to meet maternal health goals.

4. Provide free healthcare access: The study suggests that providing free healthcare access could be a strategy to achieve universal coverage of essential maternal healthcare services. Removing financial barriers can encourage more women to seek care at health facilities for delivery.

By implementing these recommendations, it is expected that access to maternal health services will improve, leading to a reduction in maternal mortality rates in Ethiopia.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, the following methodology can be used:

1. Data collection: Collect data on sociodemographic factors, wealth status, education level, frequency of antenatal care visits, and place of delivery from a representative sample of women in Ethiopia. This can be done through surveys or by accessing existing data sources such as the Ethiopian Demographic and Health Survey.

2. Analysis: Analyze the collected data using appropriate statistical techniques, such as regression analysis, to determine the associations between the factors and women’s choice of place of delivery. This will help quantify the impact of each factor on access to maternal health services.

3. Scenario modeling: Create different scenarios based on the recommendations. For example, simulate the impact of addressing sociodemographic and wealth inequities by providing equal opportunities for education and economic empowerment. This can be done by adjusting the education and wealth status variables in the dataset and analyzing the resulting changes in the likelihood of delivering at a health facility.

4. Evaluate the impact: Compare the outcomes of the different scenarios to assess the potential impact of each recommendation on improving access to maternal health. This can be done by calculating the odds ratios or probabilities of delivering at a health facility under each scenario and comparing them to the baseline scenario.

5. Sensitivity analysis: Conduct sensitivity analysis to assess the robustness of the results. This can involve varying the assumptions or parameters used in the analysis to see how sensitive the results are to different inputs.

6. Interpretation and reporting: Interpret the findings and report the results, highlighting the potential impact of each recommendation on improving access to maternal health. Provide clear and concise information on the magnitude of the effects and any limitations of the analysis.

By following this methodology, policymakers and stakeholders can gain insights into the potential impact of implementing the recommendations and make informed decisions to improve access to maternal health in Ethiopia.

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