Investigating Inequalities and Assessment of the Determinant Factors in Postnatal care service Utilization in Ethiopia
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Date
2019-10
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Addis Abeba University
Abstract
Background: Postnatal care is an important care which is given to the mother and her child
to prevent and reduce maternal and child mortality. Despite the importance of the care for the
mother and her child, there are considerable disparities in postnatal care utilization across
many geographical locations, maternal socioeconomic, and demographic factors in many
Sub-Saharan Africa.
Objectives: To investigate inequalities and assess the determinant factors in postnatal care
service utilization among reproductive women in Ethiopia using the 2016 Ethiopia
demographic health survey data.
Methods: The study utilized data from the fourth round Ethiopia Demographic and Health
Survey (EDHS). The dataset was accessed from EDHS website upon registering to the
website. Education and wealth-related inequalities were assessed by concentration curve and
concentration index. The measured inequality also decomposed into its contributing factors
using Erregers method of analysis. In addition to this, population attributable risk, difference,
and ratio were used to assess the inequality after running Binary logistic regression and
multi-collinearities were checked by using variance inflation factor (VIF=1.5).
Result: PNC utilization within the first two days in Ethiopia in 2016 was only 16%. Complex
summary measures suggest Maternal level of Education and wealth related inequalities in
PNC were significantly high in 2016: with concentration indies of 0.166 and 0.2089
respectively. Simple summary measures also revealed wealth status, 4+ ANC visit, delivery by
CS, use of internet and region were significantly predict inequalities in Postnatal care
utilization.
Conclusion: There is a significant inequality in Postnatal care utilization in Ethiopia.
Maternal wealth status, maternal level of Education, frequency of ANC visits, use of internet,
Region and C-Section delivery are the dominant inequality contributors in the utilization of
PNC services within those critical hours after birth.
Recommendation: Policy makers should focus on the implementation of the strategies to
adequately address the observed inequalities in postnatal care utilization among women.
Strategies should focus on the key population subgroups.
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Keywords
Postnatal care, Inequality, Education, Concentration curve, concentration index and Ethiopia Demographic Health Survey.