Browsing by Author "Shikur, Bilal(MD,MPH, Associate Professor)"

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    Trends in Inequalities in the Utilization of Antenatal Care (ANC) Services and its Associated Factors among Women Aged 15-49 Years in the Oromia Region, Ethiopia
    (Addis Abeba University, 2020-10) Tadesse, Endale; Mekonnen, Wubegzier(PhD, Associate Professor); Shikur, Bilal(MD,MPH, Associate Professor)
    Background: Although there is a significant improvement in maternal health service in recent years, inequalities in the utilization of ANC service remain to be a challenge in Oromia region. In this study, we aim to provide a comprehensive analysis to examine the trends in inequalities in the utilization of ANC service and its associated factors among women aged 15-49 years in Oromia region between 2000 -2016 EDHS. Methods: Women in the most recent birth data from regional representative surveys in Oromia region in the four consecutive EDHS rounds was used. Trends in inequalities of ANC service utilization were measured using a combination of RD, RR, CIX, SII, and RII,and is subsequently decomposed into contributing factors. Multivariable logistic regression analyses using GLM approach were carried out to identify the factors of ANC utilization. A p-value of < 0.05 and 95% CI was reported as a measure of magnitude of significance. Data analysis was done using STATA version 14 and Microsoft Excel© 2016. Result: Over 16 year period, the percentage of women who revieved ANC1+ and ANC+4 visits increased significantly from 27.3%, 10.2% in 2000 to 51%, 22.2% in 2016 EDHS respectively. Although ANC services showed an upward trend from 2000-2016, there was very low utilization of ANC services influenced by socio-demographic and economic factors in the region. Trends in RD and RR of any ANC use were analyzed. The overall CIX for any ANC services utilization among women significantly an increased trend from 0.79 in 2000 to 0.99 in 2016 EDHS. By contrasts, an estimate of CIX indicates declined significantly for wealth status from 0.279 in 2000 to 0.133 in 2016, education level from 0.247 in 2000 to 0.134 in 2016, and disparity of urban-rual areas decresed from -0.204 in 2000 to -0.062 in 2016) respectively. The RR &RII of any ANC services utilization with socioeconomic status was significantly decreased while the RR of wealth status &SII by educational level among women were slightly increased significantly between 2000-2016. Wealth status & women's education were the most significant contributors to inequality in ANC visits. Inequalities in use of ANC favoured advantageous women over their counterparts. The findings of the present study shows that these disparities continue to persist in the region. Conclusion: The findings show that utilization of any ANC services is very low. The findings of the study show that there was inequality in any ANC service utilization in Oromia region. The socioeconomic factors such as residence, level of education , and economic status were the determinants of inequality. There is a need to increase the availability, accessibility and affordability of health services to all women, especially for the disadvantaged, uneducated and those who live in hard-to reach rural areas in the study area. Finally, the regional government should scale up of strategies that are pro-poor to increase ANC service provision in underserved areas are crucial.