Factors Influencing the Utilization of Antenatal Care Services in Ethiopia: Application of Zero-inflated Negative Binomial Model

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Addis Ababa University


Pregnancy and delivery are still the leading causes of maternal mortality and morbidity among women of reproductive age in developing countries. Antenatal care is an important determinant of high maternal mortality and one of the basic components of maternal care on which the life of mothers and babies depend. The objective of this study was to identify and examine factors that affect utilization of antenatal care services using the 2011 Ethiopia Demographic and Health Survey data. The study analyzed the number of antenatal care utilization of mothers aged 15 to 49 years who have used antenatal care in their last pregnancy period. Zero-inflated negative binomial model was used to explore the major factors influencing utilization of antenatal care services in Ethiopia. More than 55% of the mothers did not use antenatal care services; more than 77% of the women utilized antenatal care less than four times. More than half of the women (52%) who had access of health services used at least four antenatal care visits. For such data the zero- inflated negative binomial model is more appropriate, and it was used to analyze the data. Place of residence was found to be significantly associated with use of antenatal care services. Also age of mothers, woman's educational level, employment status, mass media exposure, religion and access of health services were all significant predictors for the use of antenatal care. Accordingly, all possible efforts must be made to increase women's educational level. Tn addition, it is necessary to initiate programs to promote pregnant women to start receiving antenatal care early.



Factors Influencing the Utilization of Antenatal Care Servicesin Ethiopia