The effect of antenatal care on use of institutional delivery service and postnatal care in Ethiopia: a systematic review and meta-analysis

Health care services during pregnancy and during delivery are important for the survival and wellbeing of both the mother and the infant so that increasing institutional deliveries is a basic concern for reducing maternal and neonatal mortality. This article was focused on assessing the trend of institutional delivery service and identifying associated factors using basic statistical tools. The analysis was based on the hypothetical data of 5753 women in reproductive age carefully managed from Ethiopian Mini Demographic and Health Survey (EMDHS) 2019. The trend of institutional delivery revealed a sharp increase from 26% in 2016 to 49.92% in 2019 based on DHS data of the respective years. The study identified variables such as region, place of residence, education level, sex of household head, wealth index, number of living children and antenatal care as highly significant determinants of institutional delivery service in Ethiopia. Institutional delivery service increases with better access to education, living in urban, being in better off wealth category, and following antenatal care visit. The study recommended that there should be well equipped health facilities for pregnant women at each stage.

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Evidence on the effect of gender of newborn, antenatal care and postnatal care on breastfeeding practices in Ethiopia: a meta-analysis andmeta-regression analysis of observational studies

BMJ Open ◽

10.1136/bmjopen-2018-023956 ◽

2019 ◽

Vol 9 (5) ◽

pp. e023956 ◽

Cited By ~ 2

Author(s):

Tesfa Dejenie Habtewold ◽

Nigussie Tadesse Sharew ◽

Sisay Mulugeta Alemu

Keyword(s):

Systematic Review ◽

Regression Analysis ◽

Antenatal Care ◽

Breast Feeding ◽

Postnatal Care ◽

Observational Studies ◽

Meta Analysis ◽

P Value ◽

Timely Initiation ◽

Breastfeeding Practices

ObjectivesThe aim of this systematic review and meta-analysis was to investigate the association of gender of newborn, antenatal care (ANC) and postnatal care (PNC) with timely initiation of breast feeding (TIBF) and exclusive breastfeeding (EBF) practices in Ethiopia.DesignSystematic review and meta-analysis.Data sourcesTo retrieve all available literature, PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases were systematically searched and complemented by manual searches. The search was done from August 2017 to September 2018.Eligibility criteriaAll observational studies including cross-sectional, case-control, cohort studies conducted in Ethiopia from 2000 to 2018 were included. Newcastle-Ottawa Scale was used for quality assessment of included studies.Data extraction and synthesisStudy area, design, population, number of mothers (calculated sample size and participated in the study) and observed frequency data were extracted using Joanna Briggs Institute tool. To obtain the pooled effect size, a meta-analysis using weighted inverse variance random-effects model was performed. Cochran’s Q X2test, τ2and I2statistics were used to test heterogeneity, estimate amount of total/residual heterogeneity and measure variability attributed to heterogeneity, respectively. Mixed-effects meta-regression analysis was done to identify possible sources of heterogeneity. Egger’s regression test at p value threshold ≤0.01 was used to examine publication bias. Furthermore, the trend of evidence over time was examined by performing a cumulative meta-analysis.ResultsOf 523 articles retrieved, 17 studies (n=26 146 mothers) on TIBF and 24 studies (n=17 819 mothers) on EBF were included in the final analysis. ANC (OR=2.24, 95% CI 1.65 to 3.04, p<0.001, I2=90.9%), PNC (OR=1.86, 95% CI 1.41 to 2.47, p<0.001, I2=63.4%) and gender of newborn (OR=1.31, 95% CI 1.01 to 1.68, p=0.04, I2=81.7%) significantly associated with EBF. ANC (OR=1.70, 95% CI 1.10 to 2.65, p=0.02, I2=93.1%) was also significantly associated with TIBF but not with gender of newborn (OR=1.02, 95% CI 0.86 to 1.21, p=0.82, I2=66.2%).ConclusionsIn line with our hypothesis, gender of newborn, ANC and PNC were significantly associated with EBF. Likewise, ANC was significantly associated with TIBF. Optimal care during pregnancy and after birth is important to ensure adequate breast feeding. This meta-analysis study provided up-to-date evidence on breastfeeding practices and its associated factors, which could be useful for breastfeeding improvement initiative in Ethiopia and cross-country and cross-cultural comparison.Trial registration numberCRD42017056768

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Knowledge on Intrapartum Danger Sign Influences Place of Delivery: The Case of Raya Kobo District, Northeastern Ethiopia

International Journal of Child Health and Nutrition ◽

10.6000/1929-4247.2021.10.02.1 ◽

2021 ◽

Vol 10 (2) ◽

pp. 44-50

Author(s):

Nigus Bililign Yimer ◽

◽

Misgan Legesse Liben

Keyword(s):

Maternal Health ◽

Health Services ◽

Antenatal Care ◽

Institutional Delivery ◽

Maternal Health Services ◽

District Health ◽

Delivery Service ◽

Danger Signs ◽

Study Participants ◽

Institutional Delivery Service

Background: A skilled birth attendance for every pregnant woman during childbirth is the most crucial intervention for improving maternal health. This study aimed to assess institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Raya Kobo district, Ethiopia. Methods: A community-based cross-sectional study was carried out in the Raya Kobo district of Amhara Regional State during March 2016. Logistic regression analysis was performed to assess the association between each independent variable and the outcome variable. Variables with a p-value <0.05 were considered significant. Results: A total of 493 mothers were included in the study, with a response rate of 95.4%. The mean (+SD) age of the study participants was 29.13 (±6.93) years. About 73% of the study participants had attended at least one antenatal care follow up for their last pregnancy, and 56.6% (95% CI: 52.0, 61.0%) gave birth at health institutions. Travelling for 30 minutes and less [AOR=2.95(1.89, 4.58)], attending antenatal care [AOR=6.0(3.55, 10.13)], having knowledge about intrapartum danger signs [AOR=2.48(1.44, 4.24)] and getting information from health extension workers (HEWs) regarding maternal health services were positively associated. Conclusion: The district health office should strengthen its effort to provide free ambulance accessibility and provide information on danger signs of intrapartum complications and the importance of using institutional delivery service to every mother who came to the antenatal clinic. Furthermore, the district health officials should focus on strengthening the capacity of HEWs in relation to maternal health services.

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Intention to use institutional delivery service and its predictors among pregnant women, North West Ethiopia: Using theory of planned behavior

PLoS ONE ◽

10.1371/journal.pone.0248697 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0248697

Author(s):

Abirham Ayana ◽

Ayenew Kassie ◽

Telake Azale

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Pregnant Women ◽

Institutional Delivery ◽

Behavioral Control ◽

Perceived Behavioral Control ◽

Intention To Use ◽

Rural Residence ◽

Delivery Service ◽

Institutional Delivery Service

Background Improving institutional delivery service is the most crucial strategies to reduce maternal and neonatal mortalities. In developing countries, only 50% of pregnant women deliver in health facilities and in Ethiopia only 48% of pregnant women deliver in health facilities. Maternal mortality remains the highest in Ethiopia. This study assessed intention to use institutional delivery service and its predictors among pregnant women using theory of planned behavior. Methods Community-based cross-sectional study was conducted among 645 Yilmana Densa District Pregnant women using multi-stage followed by cluster sampling technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with STATA version 14. Binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors. Results Intention of pregnant women to use institutional delivery service was 74.3% (CI; 70.71%, 77.6%). In the multivariable logistic regression; those who had 1–3 and 4 &above antenatal care 2.85(1.41, 5.75) and 3.14(1.16, 8.45) respectively, those who had past experience of institutional delivery (AOR = 3.39, 95%CI: 1.72, 6.71), parity of 1–3 and 4 & above % (AOR = 0.37, 0.19, 0.71) and (AOR = 0.25, 95%CI: 0.12, 0.55) respectively, rural residence (AOR = 0.51, 95%CI: 0.27, 0.96), favorable attitude (AOR = 2.93, 95%CI: 1.56, 5.50), favorable perceived behavioral control (AOR = 2.60, 95%CI: 1.44, 4.69) were factors significantly associated with intention to use institutional delivery service. Conclusion and recommendation Majority of the pregnant women were intended to deliver in the institution. Good Knowledge on institutional delivery, antenatal care visit, past experience of institutional delivery, rural residence, parity, attitude and perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation and behavioral change communication programs are required at all levels of health system to raise intention of residents towards institutional delivery.

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Exclusive breastfeeding practice in Ethiopia and its association with antenatal care and institutional delivery: a systematic review and meta-analysis

International Breastfeeding Journal ◽

10.1186/s13006-018-0173-x ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 13

Author(s):

Animut Alebel ◽

Cheru Tesma ◽

Belisty Temesgen ◽

Aster Ferede ◽

Getiye Dejenu Kibret

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Exclusive Breastfeeding ◽

Institutional Delivery ◽

Meta Analysis ◽

Breastfeeding Practice

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Effect of gender of new-born, antenatal care and postnatal care on breastfeeding practices in Ethiopia: Evidence from systematic review and meta-analysis of national studies

10.1101/405605 ◽

2018 ◽

Cited By ~ 3

Author(s):

Tesfa Dejenie Habtewold ◽

Nigussie Tadesse Sharew ◽

Sisay Mulugeta Alemu

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Postnatal Care ◽

Meta Analysis ◽

P Value ◽

List Type ◽

Optimal Care ◽

Timely Initiation ◽

New Born ◽

Breastfeeding Practices

AbstractObjectiveThe aim of this systematic review and meta-analysis was to investigate the association of gender of new-born, antenatal care (ANC) and postnatal care (PNC) with timely initiation of breastfeeding (TIBF) and exclusive breastfeeding (EBF) practice in Ethiopia.DesignSystematic review and meta-analysisMethodsPubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases systematically searched and complemented by manual searches to retrieve all available literature. Newcastle-Ottawa Scale (NOS) was used for quality assessment of included studies. Egger’s regression test at p-value threshold ≤ 0.01 was used to examine publication bias. Cochran’s Q X2 test, τ2, and I2 statistics were used to test heterogeneity, estimate amount of total/residual heterogeneity and measure variability attributed to heterogeneity respectively. A meta-analysis using a weighted inverse variance random-effects model was performed. The trend of evidence over time was evaluated by performing a cumulative meta-analysis. Furthermore, mixed-effects meta-regression analysis was done to identify possible sources of heterogeneity.ResultsOf 523 articles retrieved, 17 studies (N = 26,146 mothers) on TIBF and 27 studies (N = 17,819 mothers) on EBF were included in the final analysis. ANC (OR = 2.24, 95% CI 1.65 -3.04, p <0.001, I2 = 90.9%), PNC (OR = 1.86, 95% CI 1.41 - 2.47, p <0.001, I2 = 63.4%) and gender of new-born (OR = 1.31, 95% CI 1.01 - 1.68, p = 0.04, I2 = 81.7%) significantly associated with EBF. In addition, ANC (OR = 1.70, 95% CI 1.10 - 2.65, p = 0.02, I2 = 93.1%) was significantly associated with TIBF but not gender of new-born (OR = 1.02, 95% CI 0.86 -1.21, p = 0.82, I2 = 66.2%).ConclusionsIn line with our hypothesis, gender of new-born, ANC and PNC significantly associated with EBF. Likewise, ANC significantly associated with TIBF. Optimal care during pregnancy and after birth is important to ensure adequate breastfeeding. This meta-analysis study provided evidence on breastfeeding practices and its associated factors in Ethiopian context, which can be useful for cross-country and cross-cultural comparison and for breastfeeding improvement initiative in Ethiopia.Protocol registration and publication:CRD42017056768 and 10.1136/BMJOPEN-2017-017437Strengths and limitations of this studyThis systematic review and meta-analysis was conducted based on the registered and published protocol.Since it is the first study in Ethiopia, the information could be helpful for future researchers, public health practitioners, and healthcare policymakers.Almost all included studies were observational which may hinder causality inference.Perhaps the results may not be nationally representative given that studies from some regions are lacking.Based on the conventional methods of the heterogeneity test, a few analyses suffer from high between-study variation.

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Knowledge on Intrapartum Danger Sign Influences Place of Delivery: The Case of Raya Kobo District, Northeastern Ethiopia

International Journal of Child Health and Nutrition ◽

10.6000/1929-4247.2021.10.01.6 ◽

2020 ◽

Vol 10 (1) ◽

pp. 44-50

Author(s):

Nigus Bililign Yimer ◽

Misgan Legesse Liben ◽

Keyword(s):

Maternal Health ◽

Health Services ◽

Antenatal Care ◽

Institutional Delivery ◽

Maternal Health Services ◽

District Health ◽

Delivery Service ◽

Danger Signs ◽

Study Participants ◽

Institutional Delivery Service

Background: A skilled birth attendance for every pregnant woman during childbirth is the most crucial intervention for improving maternal health. This study aimed to assess institutional delivery service utilization and associated factors among mothers who gave birth in the last 12 months in Raya Kobo district, Ethiopia. Methods: A community-based cross-sectional study was carried out in the Raya Kobo district of Amhara Regional State during March 2016. Logistic regression analysis was performed to assess the association between each independent variable and the outcome variable. Variables with a p-value <0.05 were considered significant. Results: A total of 493 mothers were included in the study, with a response rate of 95.4%. The mean (+SD) age of the study participants was 29.13 (±6.93) years. About 73% of the study participants had attended at least one antenatal care follow up for their last pregnancy, and 56.6% (95% CI: 52.0, 61.0%) gave birth at health institutions. Travelling for 30 minutes and less [AOR=2.95(1.89, 4.58)], attending antenatal care [AOR=6.0(3.55, 10.13)], having knowledge about intrapartum danger signs [AOR=2.48(1.44, 4.24)] and getting information from health extension workers (HEWs) regarding maternal health services were positively associated. Conclusion: The district health office should strengthen its effort to provide free ambulance accessibility and provide information on danger signs of intrapartum complications and the importance of using institutional delivery service to every mother who came to the antenatal clinic. Furthermore, the district health officials should focus on strengthening the capacity of HEWs in relation to maternal health services.

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Association between antenatal care follow-up and institutional delivery service utilization: analysis of 2016 Ethiopia demographic and health survey

BMC Public Health ◽

10.1186/s12889-019-7854-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Eskezaiw Abebe ◽

Abdu Seid ◽

Getnet Gedefaw ◽

Zelalem T. Haile ◽

Gillian Ice

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Service Utilization ◽

Health Survey ◽

Institutional Delivery ◽

Wealth Index ◽

Household Wealth ◽

Delivery Service ◽

Institutional Delivery Service

Abstract Background Globally, the magnitude of maternal mortality is the major public health problem. Nearly all (99%) of maternal deaths occur in low- and middle-income countries. Of which 66% occur in sub-Saharan Africa. Institutional delivery under the hygienic environment with the necessary skills and equipment promotes to identify and treat complications, infections, and the death of the mother and baby. In Ethiopia, the utilization of maternal health services is very low. For instance, 62% of women had antenatal care utilization during pregnancy while only 26% of women utilize institutions for delivery in 2016. Therefore, this study examined the association between antenatal care follow up and intestinal delivery among a nationally representative woman in Ethiopia. Methods A cross-sectional study design was used to examine 7575 women from the 2016 Ethiopia Demographic and Health Survey. Both descriptive and inferential statistics were utilized. Variables in the bivariate logistic regression with p-value < 0.2 were entered into the multivariable logistic regression. Odds ratios and corresponding 95% confidence intervals (CI) were reported. In the multivariable analysis, variables with p-value < 0.05 were considered as statistically significant. Results The prevalence of institutional delivery service utilization for last childbirth was 11.3%. In comparison with women with no antenatal care visits, the multivariable odds ratio (95% confidence interval) of institutional delivery among those who attend one to three and four or more antenatal care visit were 2.49 (1.66, 3.74) and 3.90 (2.60, 5.84), respectively. Other factors significantly associated with institutional delivery include urban residence 2.25 (1.44, 3.51), complete primary education 3.22 (2.09, 4.98), complete secondary or higher education 1.59 (1.16, 2.17), poorer household wealth index 2.57 (1.57, 4.20), middle household wealth index 1.63 (1.05, 2.52), and richer household wealth index 1.56(1.03, 2.58). Conclusion Antenatal care follow-up was significantly associated with institutional delivery service utilization. As the number of antenatal care visits increased the odds of facility delivery increased. Thus, improved access and utilization of antenatal care can be an effective strategy to increase institutional deliveries and optimal maternal and child health outcomes.

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Postnatal care service utilization and associated factors in Ethiopia: A systematic review and Meta-analysis

10.21203/rs.2.10475/v1 ◽

2019 ◽

Author(s):

Bekalu Kassie ◽

Melaku Desta ◽

Habtamu Chanie ◽

Bekele Tesfaye ◽

Muluken Wubetu ◽

...

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Service Utilization ◽

Postnatal Care ◽

Associated Factors ◽

Care Service ◽

Meta Analysis ◽

Wealth Quintile ◽

Care Services

Abstract Background: In Ethiopia, literatures are not in agreement on magnitude of utilization of postnatal care service and factors are not well identified. Hence, this systematic review and meta-analysis aimed to engender pooled evidence of magnitude of postnatal care service utilization and associated factors. Methods: For this systematic review and meta-analysis international databases such as, HINARI, PubMed, Medline, EMBASE, Google scholar and Cochrane library were used for searching studies published from 2002 to 2018 in English language. The Modified Newcastle- Ottawa quality assessment scale was used to assess the quality of studies and meta-analysis was conducted using STATA version 14. Q statistics and I2 test were used to assess the heterogeneity. The random effect model was used to estimate the pooled utilization of postnatal care at 95%CI. Result: Total of 22 articles with total samples of 42,320 women were included to this review. The pooled prevalence of postnatal care service utilization in Ethiopia was 41.5% (95%CI: 28.51-54.52). Women who attended formal education (OR, 2.37, 95%CI: 1.13, 4.97), had middle level and above household’s wealth quintile (OR, 2.57, 95%CI: 1.31,5.05), had antenatal care visit (OR, 6.72, 95%CI: 4.16, 10.87), being multigravida (OR, 0.68, 95%CI: 0.53, 0.88) and gave birth in health institutions (OR, 3.86, 95%CI: 2.89, 5.16) were high likely to utilize postnatal care services while rural resident women (OR, 0.17, 95%CI: 0.05, 0.60) were less likely to utilize postnatal care services. Conclusion: Postnatal care service utilization in Ethiopia is low (41.5%). It is affected by educational status, residence, wealth quintile, gravidity, antenatal care follow up and place of delivery. Scale up the service and awareness for rural people, improving economic status of the household, improve antenatal care follow up, and promote institutional delivery are having paramount importance. Key words: Health care service utilization, Ethiopia, systematic review, Meta-analysis

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