scholarly journals Neonatal Mortality And Associated Factors Among Neonates Admitted In Public Hospitals, Afar Pastoral Region: A Health Facility Based Study

2019 ◽  
Author(s):  
abay woday ◽  
Yohannes Mekuria ◽  
Christine St Denis
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Health Facility ◽  
Medical Records ◽  
Associated Factors ◽  
Neonatal Resuscitation ◽  
Health Facilities ◽  
Public Hospitals ◽  
Assisted Delivery

Abstract Background: Neonatal mortality is a public health issue in developing countries, such as Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged. Subsequently, Afar in Ethiopia contributes the largest burden of under-five mortality when compared to other regions in the country. Regrettably, there is no current information to the rates and predictors of neonatal mortality for the region even for the health facilities. Thus, this study aims to assess neonatal mortality and associated factors in pastoral region, Afar region. Methods: A health facility-based retrospective cross-sectional study was conducted on 403 neonates admitted to the neonatal intensive care unit (NICU) from May 1st 2015 - May 2nd 2019. Medical records were reviewed and audited for both mothers and neonates to collect data using a standardized data extraction checklist. The medical records were selected using a systematic sampling technique. Binary logistic regression with odds ratio and 95% Confidence interval was calculated to assess the association between neonatal mortality and associated factors. Finally, the statistical significance level was declared at a p-value <0.05. Results: In this study, 391 medical records of neonates were included with the data complete rate of 97.02%. The prevalence of neonatal mortality was 14.6% (95% CI 11.0%-18.4%) with mortality rate of 35.5 per 1000 live births. A multivariable logistic regression showed that the lack of antenatal care (ANC) follow up (AOR = 5.92; 95%CI 2.34, 14.97: P<0.001), giving birth through cesarean section (AOR=3.52; 95%CI 1.22, 10.12: P<0.05), giving birth through assisted delivery (AOR=3.28 (1.14, 9.46): P<0.05), having a temperature less than 36.5oC within the first hour of admission (AOR= 5.89; 95%CI 2.32, 14.94: P<0.001), and perinatal asphyxia (AOR= 6.67; 95%CI 2.35, 18.89: P<0.001) were significantly associated with neonatal mortality. Conclusion: This study revealed that the rate of neonatal mortality is still too high compared to the studies conducted in non-pastoral regions of the nation. Thus, the health facilities should give due attention to improve antenatal care, neonatal resuscitation and follow the standard of care protocol for admitted neonates. Additional community based studies supported with qualitative methods are recommended.

Newborn Mortality And Its Associated Factors Among Neonates Admitted At Public Hospitals In Afar Region; A Health Facility Based Study

2019 ◽  
Author(s):  
abay woday ◽  
Yohannes Mekuria ◽  
Christine St Denis
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Health Facility ◽  
Medical Records ◽  
Associated Factors ◽  
Health Facilities ◽  
Public Hospitals ◽  
Afar Region ◽  
Assisted Delivery

Abstract Background: Neonatal mortality is a public health issue in developing countries, such as Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged. Subsequently, Afar in Ethiopia contributes the largest burden of under-five mortality when compared to other regions in the country. Regrettably, there is no current information to the rates and predictors of neonatal mortality for the region even for the health facilities. Thus, this study aims to assess neonatal mortality and associated factors in pastoral region, Afar region. Methods: A health facility-based retrospective cross-sectional study was conducted on 403 neonates admitted to the neonatal intensive care unit (NICU) from May 1st 2015 - May 2nd 2019. Medical records were reviewed and audited for both mothers and neonates to collect data using a standardized data extraction checklist. The medical records were selected using a systematic sampling technique. Binary logistic regression with odds ratio and 95% Confidence interval was calculated to assess the association between neonatal mortality and associated factors. Finally, the statistical significance level was declared at a p-value <0.05. Results: In this study, 391 medical records of neonates were included with the data complete rate of 97.02%. The prevalence of neonatal mortality was 14.6% (95% CI 11.0%-18.4%) with mortality rate of 35.5 per 1000 live births. A multivariable logistic regression showed that the lack of antenatal care (ANC) follow up (AOR = 5.92; 95%CI 2.34, 14.97: P<0.001), giving birth through cesarean section (AOR=3.52; 95%CI 1.22, 10.12: P<0.05), giving birth through assisted delivery (AOR=3.28 (1.14, 9.46): P<0.05), having a temperature less than 36.5oC within the first hour of admission (AOR= 5.89; 95%CI 2.32, 14.94: P<0.001), and perinatal asphyxia (AOR= 6.67; 95%CI 2.35, 18.89: P<0.001) were significantly associated with neonatal mortality. Conclusion: This study revealed that the rate of neonatal mortality is still too high compared to the studies conducted in non-pastoral regions of the nation. Thus, the health facilities should give due attention to improve antenatal care, neonatal resuscitation and follow the standard of care protocol for admitted neonates. Additional community based studies supported with qualitative methods are recommended.

scholarly journals Neonatal mortality and its associated factors among neonates admitted at public hospitals, pastoral region, Ethiopia: A health facility based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0242481
Author(s):  
Abay Woday Tadesse ◽  
Yohannes Mekuria Negussie ◽  
Setognal Birara Aychiluhm
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Cesarean Section ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Health Facility ◽  
Medical Records ◽  
Associated Factors ◽  
Birth Asphyxia ◽  
Afar Region

Background Neonatal mortality is a public health issue in, Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged in developing regions of the country. Regrettably, there is no single study to show the rates and predictors of neonatal mortality for Afar region. Thus, this study aims to assess neonatal mortality and associated factors in Afar region, Ethiopia. Methods A health facility-based cross-sectional study was conducted on 403 neonates admitted to the neonatal intensive care units (NICUs) from January 2015 to December 2019. Maternal and neonatal medical records were reviewed and audited using structured data extraction checklist. The data was collected by four trained nurses and midwives. The medical records were selected using a systematic random sampling technique. Bivariate and multivariable logistic regression analyses were done. Adjusted odds ratio with the corresponding 95% confidence interval were used to assess the association between neonatal mortality and the associated factors. Finally, the statistical significance level was declared at a p-value of less than 0.05. Results In this study, 391 medical records of newborns were included with the data complete rate of 97.02%. The prevalence of neonatal mortality was 57 (14.6%) [95% CI 11.0%-18.4%]. A multivariable logistic regression showed that lack of antenatal care (ANC) follow up [AOR = 4.69: 95%CI (1.77, 12.47)], giving birth through cesarean section [AOR 3.59, 95%CI (1.22, 10.55)], having admission temperature less than 36.5°C [AOR 10.75, 95%CI (3.75, 30.80)], birth asphyxia [AOR 7.16, 95%CI (2.22, 23.10)], and having a length of stay greater than five days in the hospital [AOR 0.23, 95%CI (0.08, 0.66)] were significantly associated with neonatal mortality. Conclusion This study revealed that the rate of neonatal mortality is still high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature at admission and birth asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention to improve antenatal care, intrapartum care and standardized care for admitted neonates. Furthermore, prospective studies are recommended.

scholarly journals Neonatal Mortality And Associated Factors In A Pastoral Region, Afar, Ethiopia: A Health Facility Based Study

2019 ◽  
Author(s):  
Abay Woday ◽  
Yohannes Mekuria ◽  
Christine St Denis
Keyword(s):  
Length Of Stay ◽  
Cesarean Section ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Health Facility ◽  
Medical Records ◽  
Associated Factors ◽  
Perinatal Asphyxia ◽  
Statistical Significance ◽  
Public Health Issue

Abstract Abstract Background: Neonatal mortality is public health issue in developing countries, such as Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged. Subsequently, Afar in Ethiopia contributes the largest burden of under-five mortality when compared to other regions in the country. Regrettably, there is no current information to the rates and predictors of neonatal mortality for the region. Thus, this study aims to assess neonatal mortality and associated factors in pastoral communities residing in Afar, Ethiopia. Methods: A health facility based retrospective cross sectional study was conducted on 403 neonates admitted to the neonatal intensive care unit (NICU) from May 1 st 2015 - May 2nd 2019. Medical records were reviewed and audited for both mothers and neonates to collect data using standardized data extraction checklist. The medical records were selected using a systematic random sampling technique. Binary logistic regression with odds ratio and 95% Confidence interval was calculated to assess the association between neonatal mortality and associated factors. Finally, the statistical significance level was declared at a p-value <0.05. Results: 391 medical records of newborns were included with data complete rate of 97.02%. The prevalence of neonatal mortality was 14.6% (95% CI 11.0%-18.4%). Lack of antenatal care (ANC) follow up (AOR = 4.69: 95%CI 1.77, 12.47), giving birth through cesarean section (AOR 3.59, 95%CI 1.22, 10.55), having a temperature less than 36.5 o C within the first hour of admission (AOR 10.75, 95%CI 3.75, 30.80), perinatal asphyxia (AOR 7.16, 95%CI 2.22, 23.10) and/or having a length of stay greater than five days in the hospital (AOR 0.23, 95%CI 0.08, 0.66) were significantly associated with neonatal mortality. Conclusion: This study revealed that the rate of neonatal mortality is still too high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature with in the first hour of admission and perinatal asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention for improving antenatal cares, intra-partum cares and standardized cares for admitted neonates. Additional prospective studies are recommended.

scholarly journals Maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260710
Author(s):  
Mulualem Silesh ◽  
Tesfanesh Lemma
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Associated Factors ◽  
Unplanned Pregnancy ◽  
Statistical Significance ◽  
Public Hospitals ◽  
Postpartum Women ◽  
Maternal Satisfaction ◽  
Intrapartum Care ◽  
Multivariable Logistic Regression

Background Maternal satisfaction is an essential indicator of the quality and the efficiency of the health care systems. At a time when efforts are being made globally to reduce maternal and neonatal mortality and morbidity, assessing maternal satisfaction is essential. There is a dearth of studies on maternal satisfaction with intrapartum care, particularly in the study area. This study aimed to assess maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia. Methods A facility-based cross-sectional study with a systematic random sampling technique was conducted from May1-30/ 2020. Data were entered into EpiData version 4.6 and analyzed using a statistical package for the social sciences version 25. Bivariate and multivariable logistic regression were employed. In multivariable logistic regression analysis, level of statistical significance was declared at variables with p < 0.05 and the strength of the association was measured by an adjusted odds ratio and 95% confidence interval. Result Of the total 394 participants, 111 (28.2%) [95% CI: 23.9, 32.5] of postpartum women were satisfied with the intrapartum care. Place of residence [AOR: 1.934; 95% CI (1.183, 3.162)], planned status of the pregnancy [AOR: 2.245; 95% CI, (1.212, 4.158)], number of antenatal care visit [AOR: 2.389; 95% (1.437, 3.974)] and duration of labour [AOR: 2.463; 95% (1.378, 4.402)] were factors significantly associated with maternal satisfaction with intrapartum care. Conclusion The proportion of maternal satisfaction with intrapartum care was low. Therefore, designing strategies to enhance maternal satisfaction by strengthening adherence to antenatal care visits, provision of family planning to prevent unplanned pregnancy, and strict utilization of partograph to prevent prolonged labour and childbirth-related complications are crucial.

Prevalence and Associated Factors of Disrespectful and Abusive Care During Childbirth Among Women who Gave Birth in Health Facilities in Hawassa city, Southern Ethiopia. A Cross - Sectional Study

2020 ◽  
Author(s):  
Bethel Tagesse ◽  
Alemu Tamiso ◽  
Kaleb Mayisso ◽  
Andualem Zenebe
Keyword(s):  
Health Facility ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Public Hospitals ◽  
Southern Ethiopia ◽  
Disrespect And Abuse ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: There is growing evidence that shows phenomena of disrespect and abuse (D&A) occurs globally even though the degree and severity is different across countries. The problem is getting attention in recent years especially in developing countries like Ethiopia. However, there is a paucity of studies assessing the magnitude of disrespect and abuse. This study was undertaken to determine the prevalence and associated factors of disrespectful and abusive care during childbirth in health facilities of Hawassa city, Southern Ethiopia.Methodology: A facility-based cross-sectional study was conducted in Hawassa city from February 8 - April 27, 2018. A total of 577 mothers from both public and private health facilities were randomly selected. Domains of D&A that were assessed were; physical abuse, verbal abuse, stigma and discrimination, failure to meet professional standards of care and poor rapport between women and providers. Multivariable binary logitmodel was used to examine the relationship between exposure and outcome variables. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) is used for summarizing the findings of the analysis.Result: The mean age of the respondents was 26.8 (SD± 4.4) years. Overall 46.9% [95% CI: (42.8-51)] reported experiencing three or more forms of disrespect and abusive care during childbirth in health facilities. In the logit model; the adjusted odds of D&A among births in public health facility is 12.9 times higher than birth those in private facilities [AOR=12.94 (95% CI: 5.87, 28.50)],mothers who had total delivery four and above had 4.7 times increased odds of encountering D&A [AOR=4.67 95% CI: 1.69, 12.89)].In contrast to mothers who had spontaneous vaginal delivery mothers who had instrumental delivery had 2.6 times increased chance of encountering D&A [AOR =2.63 (95% CI: 1.05, 6.59)].Conclusion: The prevalence of disrespect and abusive care in Hawassa health facilities during labor and delivery is high. Factors associated with D&A include the type of health facility, mode of delivery and parity. Therefore, national health strategies and policies should focus on combating D&A during maternal care. It is also recommended to give intensive training focusing on respectful maternity care especially in public hospitals by involving more female health care providers.

scholarly journals Utilization of Long-lasting Insecticide Treated Net and Associated Factors Among Pregnant Women in Awabel District,North-West Ethiopia, 2017

2021 ◽  
Author(s):  
Mengistie Kassahun Tariku
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Associated Factors ◽  
Positive Association ◽  
Outcome Variable ◽  
P Value ◽  
Cross Sectional ◽  
North West

Abstract BackgroundUtilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia.MethodsA community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. ResultsUtilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age ≥ 35 year [AOR= 3.67; 95% CI; 1.36-9.95], knowledge [AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN.ConclusionThis study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age ≥ year, knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which might increase utilization of LLITN.

scholarly journals Timely initiation of antenatal care and its associated factors among pregnant women in sub-Saharan Africa: A multicountry analysis of Demographic and Health Surveys

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262411
Author(s):  
Adugnaw Zeleke Alem ◽  
Yigizie Yeshaw ◽  
Alemneh Mekuriaw Liyew ◽  
Getayeneh Antehunegn Tesema ◽  
Tesfa Sewunet Alamneh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Regression Model ◽  
Health Facility ◽  
Associated Factors ◽  
Logistic Regression Model ◽  
Sub Saharan Africa ◽  
Timely Initiation ◽  
Sub Saharan ◽  
Ssa Countries

Background Timely initiation of antenatal care (ANC) is an important component of ANC services that improve the health of the mother and the newborn. Mothers who begin attending ANC in a timely manner, can fully benefit from preventive and curative services. However, evidence in sub-Saharan Africa (sSA) indicated that the majority of pregnant mothers did not start their first visit timely. As our search concerned, there is no study that incorporates a large number of sub-Saharan Africa countries. Thus, the objective of this study was to assess the prevalence of timely initiation of ANC and its associated factors in 36 sSA countries. Methods The Demographic and Health Survey (DHS) of 36 sSA countries were used for the analysis. The total weighted sample of 233,349 women aged 15–49 years who gave birth in the five years preceding the survey and who had ANC visit for their last child were included. A multi-level logistic regression model was used to examine the individual and community-level factors that influence the timely initiation of ANC. Results were presented using adjusted odds ratio (AOR) with 95% confidence interval (CI). Results In this study, overall timely initiation of ANC visit was 38.0% (95% CI: 37.8–38.2), ranging from 14.5% in Mozambique to 68.6% in Liberia. In the final multilevel logistic regression model:- women with secondary education (AOR = 1.08; 95% CI: 1.06, 1.11), higher education (AOR = 1.43; 95% CI: 1.36, 1.51), women aged 25–34 years (AOR = 1.20; 95% CI: 1.17, 1.23), ≥35 years (AOR = 1.30; 95% CI: 1.26, 1.35), women from richest household (AOR = 1.19; 95% CI: 1.14, 1.22), women perceiving distance from the health facility as not a big problem (AOR = 1.05; 95%CI: 1.03, 1.07), women exposed to media (AOR = 1.29; 95%CI: 1.26, 1.32), women living in communities with medium percentage of literacy (AOR = 1.51; 95%CI: 1.40, 1.63), and women living in communities with high percentage of literacy (AOR = 1.56; 95%CI: 1.38, 1.76) were more likely to initiate ANC timely. However, women who wanted their pregnancy later (AOR = 0.84; 95%CI: 0.82, 0.86), wanted no more pregnancy (AOR = 0.80; 95%CI: 0.77, 0.83), and women residing in the rural area (AOR = 0.90; 95%CI: 0.87, 0.92) were less likely to initiate ANC timely. Conclusion Even though the WHO recommends all women initiate ANC within 12 weeks of gestation, sSA recorded a low overall prevalence of timely initiation of ANC. Maternal education, pregnancy intention, residence, age, wealth status, media exposure, distance from health facility, and community-level literacy were significantly associated with timely initiation of ANC. Therefore, intervention efforts should focus on the identified factors in order to improve timely initiation of ANC in sSA. This can be done through the providing information and education to the community on the timing and importance of attending antenatal care and family planning to prevent unwanted pregnancy, especially in rural settings.

Utilization of Long-Lasting Insecticide Treated Net and Associated Factors Among Pregnant Women in Malarious Kebeles in Awabel District, North-West Ethiopia, 2017

2020 ◽  
Author(s):  
Mengistie Kassahun Tariku ◽  
Zewdu Dagnew ◽  
Sewnet Wongiel Misikir ◽  
Abebe Habtamu Belete
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Associated Factors ◽  
Outcome Variable ◽  
P Value ◽  
Cross Sectional ◽  
North West ◽  
North West Ethiopia

Abstract Background: Utilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia. Methods: A community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. Results: Utilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age [AOR= 3.67; 95% CI; 1.36-9.95], knowledge[AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN. Conclusion: This study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age , knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which increase utilization of LLITN. Key words : LLITN utilization, pregnant women, malarious kebeles, Awable, Ethiopia

scholarly journals Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257782
Author(s):  
Jesmin Pervin ◽  
Mahima Venkateswaran ◽  
U. Tin Nu ◽  
Monjur Rahman ◽  
Brian F. O’Donnell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Facility Delivery ◽  
Health Facilities ◽  
Community Level ◽  
Delivery Care ◽  
Multivariate Logistic Regression ◽  
Antenatal Care Visit ◽  
Care Visit

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.

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