摘要 :
Receiving quality antenatal care (ANC) from skilled providers is essential to ensure the critical health circumstances of a pregnant woman and her child. Thus, this study attempted to assess which risk factors are significantly as...
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Receiving quality antenatal care (ANC) from skilled providers is essential to ensure the critical health circumstances of a pregnant woman and her child. Thus, this study attempted to assess which risk factors are significantly associated with the timing of antenatal care and the number of items of antenatal care content received from skilled providers in recent pregnancies among mothers in Ethiopia. The data was extracted from the Ethiopian Demographic and Health Survey 2016. A total of 6645 mothers were included in the analysis. Multilevel mixed-effects logistic regression analysis and multilevel mixed Negative binomial models were fitted to find the factors associated with the timing and items of the content of ANC services. The 95% Confidence Interval of Odds Ratio/Incidence Rate Ratio, excluding one, was reported as significant. About 20% of the mothers initiated ANC within the first trimester, and only 53% received at least four items of antenatal care content. Being rural residents (IRR?=?0.82; 95%CI: 0.75–0.90), wanting no more children (IRR?=?0.87; 95%CI: 0.79–0.96), and the husband being the sole decision maker of health care (IRR?=?0.88; 95%CI: 0.81–0.96), were associated with reduced items of ANC content received. Further, birth order of six or more (IRR?=?0.74; 95%CI: 0.56–0.96), rural residence (IRR?=?0.0.41; 95%CI: 0.34–0.51), and wanting no more children (IRR?=?0.61; 95%CI: 0.48–0.77) were associated with delayed antenatal care utilization. Rural residences, the poorest household wealth status, no education level of mothers or partners, unexposed to mass media, unwanted pregnancy, mothers without decision-making power, and considerable distance to the nearest health facility have a significant impact on delaying the timing of ANC visits and reducing the number of items of ANC received in Ethiopia. Mothers should start an antenatal care visit early to ensure that a mother receives all of the necessary components of ANC treatment during her pregnancy. The third Sustainable Development Goals prioritizes maternal mortality reduction, intending to lower the worldwide maternal mortality rate to 70 per 100,000 live births by 2030. Regular antenatal care from a skilled provider reduces maternal mortality by 20%. The overall quality of ANC service is determined collectively by the timing of ANC, and the contents of ANC received. Though there is an increase in ANC visits and the quality of services received, only 74% of women who gave birth in 2019 received antenatal care from a skilled provider, ranging from 85% in the urban to 70% in the rural. Thus, the quality and content of care might remain poor while the coverage of ANC visits is high. Therefore, it is necessary to analyze the levels and risk factors that affect the timing of ANC visits and contents to assess the quality of ANC services. This is the focus of the current study's research. In this study, nationally representative data from the 2016 Ethiopian Demographic and Health Survey was employed. Our study shows that rural residences, the poorest wealth quintile, no education level, unexposed to mass media, unwanted pregnancy, without decision-making power, and being far from the nearest health facility were found to be factors that hinder early initiation of ANC visits and reduce the number of items of ANC received. In conclusion, we ought to initiate an ANC visit early for a frequent antenatal care visit so that a mother will receive the necessary ANC components.
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摘要 :
Stunting or chronic undernutrition is a significant public health problem in Ethiopia. In 2019, 37% of Ethiopian children under-5 were stunted. Stunting results from a complex interaction of individual, household and social (envir...
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Stunting or chronic undernutrition is a significant public health problem in Ethiopia. In 2019, 37% of Ethiopian children under-5 were stunted. Stunting results from a complex interaction of individual, household and social (environmental) factors. Improving the mother’s overall care is the most important determinant in reducing the stunting levels in developing countries. We aimed to determine the most important maternal factors associated with stunting and quantify their effects. This study used data from the nationally representative 2016 Ethiopian Demographic Health Survey (EDHS). Common maternal factors were first selected and analyzed using Pearson’s chi-square of association followed by multiple logistic regression. To quantify the effect of a unit change of a predictor variable a model for the continuous maternal factors was developed. All analyses were carried out using IBM SPSS? Version 23. Higher maternal educational level, better maternal autonomy, average or above maternal height and weight, having at least 4 antenatal care (ANC) clinic visits, and delivering in a health facility were significantly associated with lower severe stunting levels. Unemployed mothers were 23% less likely (p?=?0.003) to have a stunted child compared with employed mothers. Mothers delivering at home had 32% higher odds of stunting (p?=?0.002). We found that short mothers (<?150?cm) were 2.5 more likely to have stunted children when compared with mothers above 160?cm. Every visit to the ANC clinic reduces stunting odds by 6.8% (p?< 0.0001). The odds of stunting were reduced by 7% (p?=?0.028) for every grade a girl spent in school. A unit increase in Body Mass Index (BMI) reduced the odds of stunting by 4% (p?=?0.014) and every centimeter increase in maternal height reduced the odds of stunting by 0.5% (p?=?0.01). Maternal education, number of antenatal care visits, and place of delivery appear to be the most important predictors of child stunting in Ethiopia.. Therefore, educating and empowering women, improving access to family planning and ANC services, and addressing maternal malnutrition are important factors that should be included in policies aiming to reduce childhood stunting in Ethiopia.
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