Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation

BACKGROUND: Although Ethiopia had made a significant change in maternal morbidity and mortality over the past decades, it remains a major public health concern. World Health Organization designed maternal continuum of care to reduce maternal morbidity and mortality. However, majority of the mothers...

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Autores principales: Alamneh, Tesfa Sewunet, Teshale, Achamyeleh Birhanu, Yeshaw, Yigizie, Alem, Adugnaw Zeleke, Ayalew, Hiwotie Getaneh, Liyew, Alemneh Mekuriaw, Tessema, Zemenu Tadesse, Tesema, Getayeneh Antehunegn, Worku, Misganaw Gebrie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032438/
https://www.ncbi.nlm.nih.gov/pubmed/35452475
http://dx.doi.org/10.1371/journal.pone.0266490
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author Alamneh, Tesfa Sewunet
Teshale, Achamyeleh Birhanu
Yeshaw, Yigizie
Alem, Adugnaw Zeleke
Ayalew, Hiwotie Getaneh
Liyew, Alemneh Mekuriaw
Tessema, Zemenu Tadesse
Tesema, Getayeneh Antehunegn
Worku, Misganaw Gebrie
author_facet Alamneh, Tesfa Sewunet
Teshale, Achamyeleh Birhanu
Yeshaw, Yigizie
Alem, Adugnaw Zeleke
Ayalew, Hiwotie Getaneh
Liyew, Alemneh Mekuriaw
Tessema, Zemenu Tadesse
Tesema, Getayeneh Antehunegn
Worku, Misganaw Gebrie
author_sort Alamneh, Tesfa Sewunet
collection PubMed
description BACKGROUND: Although Ethiopia had made a significant change in maternal morbidity and mortality over the past decades, it remains a major public health concern. World Health Organization designed maternal continuum of care to reduce maternal morbidity and mortality. However, majority of the mothers didn’t utilize the maternal continuum of care. Therefore, this study aimed to assess the spatial distribution of incomplete utilization of maternal continuum of care and its associated factors in Ethiopia. METHODS: This study was based on 2016 Demographic and Health Survey data of Ethiopia. A total weighted sample of 4,772 reproductive aged women were included. The study used ArcGIS and SaTScan software to explore the spatial distribution of incomplete utilization of maternal continuum of care. Besides, multivariable Generalized Estimating Equation was fitted to identify the associated factors of incomplete utilization of maternal continuum of care using STATA software. Model comparison was made based on Quasi Information Criteria. An adjusted odds ratio with 95% confidence interval of the selected model was reported to identify significantly associated factors of incomplete utilization of maternal continuum of care. RESULTS: The spatial analysis revealed that incomplete utilization of maternal continuum of care had significant spatial variation across the country. Primary clusters were detected at Somali, North-Eastern part of Oromia, and East part of Southern Nation Nationalities while secondary clusters were detected in the Central Amhara region. In multivariate GEE, rural residency, secondary education, higher education, Protestant religious follower’s, Muslim religious follower’s, poorer wealth index, richer wealth index, richest wealth index, currently working, having barriers for accessing health care, and exposure for mass media were significantly associated with incomplete utilization maternal continuum of care. CONCLUSION: Incomplete utilization of maternal continuum of care had significant spatial variations in Ethiopia. Residence, wealth index, education, religion, and barriers for health care access, mass media exposure, and currently working were significantly associated with incomplete utilization of maternal continuum of care. Therefore, public health interventions targeted to enhance maternal service utilization and women empowerment in hotspot areas of incomplete utilization of maternal continuum of care are crucial for reducing maternal morbidity and mortality.
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spelling pubmed-90324382022-04-23 Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation Alamneh, Tesfa Sewunet Teshale, Achamyeleh Birhanu Yeshaw, Yigizie Alem, Adugnaw Zeleke Ayalew, Hiwotie Getaneh Liyew, Alemneh Mekuriaw Tessema, Zemenu Tadesse Tesema, Getayeneh Antehunegn Worku, Misganaw Gebrie PLoS One Research Article BACKGROUND: Although Ethiopia had made a significant change in maternal morbidity and mortality over the past decades, it remains a major public health concern. World Health Organization designed maternal continuum of care to reduce maternal morbidity and mortality. However, majority of the mothers didn’t utilize the maternal continuum of care. Therefore, this study aimed to assess the spatial distribution of incomplete utilization of maternal continuum of care and its associated factors in Ethiopia. METHODS: This study was based on 2016 Demographic and Health Survey data of Ethiopia. A total weighted sample of 4,772 reproductive aged women were included. The study used ArcGIS and SaTScan software to explore the spatial distribution of incomplete utilization of maternal continuum of care. Besides, multivariable Generalized Estimating Equation was fitted to identify the associated factors of incomplete utilization of maternal continuum of care using STATA software. Model comparison was made based on Quasi Information Criteria. An adjusted odds ratio with 95% confidence interval of the selected model was reported to identify significantly associated factors of incomplete utilization of maternal continuum of care. RESULTS: The spatial analysis revealed that incomplete utilization of maternal continuum of care had significant spatial variation across the country. Primary clusters were detected at Somali, North-Eastern part of Oromia, and East part of Southern Nation Nationalities while secondary clusters were detected in the Central Amhara region. In multivariate GEE, rural residency, secondary education, higher education, Protestant religious follower’s, Muslim religious follower’s, poorer wealth index, richer wealth index, richest wealth index, currently working, having barriers for accessing health care, and exposure for mass media were significantly associated with incomplete utilization maternal continuum of care. CONCLUSION: Incomplete utilization of maternal continuum of care had significant spatial variations in Ethiopia. Residence, wealth index, education, religion, and barriers for health care access, mass media exposure, and currently working were significantly associated with incomplete utilization of maternal continuum of care. Therefore, public health interventions targeted to enhance maternal service utilization and women empowerment in hotspot areas of incomplete utilization of maternal continuum of care are crucial for reducing maternal morbidity and mortality. Public Library of Science 2022-04-22 /pmc/articles/PMC9032438/ /pubmed/35452475 http://dx.doi.org/10.1371/journal.pone.0266490 Text en © 2022 Alamneh et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Alamneh, Tesfa Sewunet
Teshale, Achamyeleh Birhanu
Yeshaw, Yigizie
Alem, Adugnaw Zeleke
Ayalew, Hiwotie Getaneh
Liyew, Alemneh Mekuriaw
Tessema, Zemenu Tadesse
Tesema, Getayeneh Antehunegn
Worku, Misganaw Gebrie
Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation
title Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation
title_full Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation
title_fullStr Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation
title_full_unstemmed Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation
title_short Barriers for health care access affects maternal continuum of care utilization in Ethiopia; spatial analysis and generalized estimating equation
title_sort barriers for health care access affects maternal continuum of care utilization in ethiopia; spatial analysis and generalized estimating equation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032438/
https://www.ncbi.nlm.nih.gov/pubmed/35452475
http://dx.doi.org/10.1371/journal.pone.0266490
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