Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey
BackgroundPrevious studies documented the existence of substantial inequalities in the utilization of maternal health services across different population subgroups in Ethiopia. Regularly monitoring the state of inequality could enhance efforts to address health inequality in the utilization of mate...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1431159/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841556753252089856 |
|---|---|
| author | Asebe Hagos Misganaw Guadie Tiruneh Melak Jejaw Kaleb Assegid Demissie Lemlem Daniel Baffa Demiss Mulatu Geberu Getachew Teshale Tesfahun Zemene Tafere |
| author_facet | Asebe Hagos Misganaw Guadie Tiruneh Melak Jejaw Kaleb Assegid Demissie Lemlem Daniel Baffa Demiss Mulatu Geberu Getachew Teshale Tesfahun Zemene Tafere |
| author_sort | Asebe Hagos |
| collection | DOAJ |
| description | BackgroundPrevious studies documented the existence of substantial inequalities in the utilization of maternal health services across different population subgroups in Ethiopia. Regularly monitoring the state of inequality could enhance efforts to address health inequality in the utilization of maternal health services. Therefore, this study aimed to measure the level of inequalities in the utilization of maternal health services in Ethiopia.MethodThe study used data from the Performance Monitoring for Action Ethiopia (PMA Ethiopia) dataset. Longitudinal data was collected from a weighted sample of 1966 postpartum women using multistage stratified cluster sampling techniques between November 2021 to October 2022. We assessed inequality in maternal health services using three indicators: antenatal care four (ANC), skilled birth attendants (SBA), and postnatal care (PNC). Age, economic status, education level, place of residence, and subnational regions were used as dimensions for measuring inequality. The analysis was conducted using Health Equity Assessment Toolkit Plus (HEAT Plus) software. We computed the summary measure of health inequality: Difference (D), Ratio (R), Population Attributable Risk (PAR), and Population Attributable Fraction (PAF).ResultThe simple summary measures of inequality difference (D) reported a high level of inequality in the utilization of maternal health services in ANC four, SBA, and PNC across economic, education, residence, and subnational regions. The difference (D) in maternal health service utilization between advantaged and disadvantaged population groups exceeded 20 percentage points in all four dimensions of inequality for the three maternal health indicators. Similarly, the complex summary measures of inequality (PAR and PAF) also showed high levels of inequality in the utilization of ANC four, SBA, and PNC across all four dimensions of inequality. However, there was no age-related inequality in the use of maternal health services.ConclusionA high level of socioeconomic and geographic area related inequality was observed in the utilization of ANC four, SBA, and PNC services in Ethiopia. Women from socioeconomically disadvantaged subgroups and women from disadvantaged geographic areas significantly lagged behind in the utilization of maternal health services. Therefore, implementing targeted interventions for the most disadvantaged groups can help to reduce inequality in accessing maternal health services. |
| format | Article |
| id | doaj-art-dfad5088858e475bb84d81421ad1254f |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-dfad5088858e475bb84d81421ad1254f2025-01-07T06:41:58ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14311591431159Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal surveyAsebe Hagos0Misganaw Guadie Tiruneh1Melak Jejaw2Kaleb Assegid Demissie3Lemlem Daniel Baffa4Demiss Mulatu Geberu5Getachew Teshale6Tesfahun Zemene Tafere7Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaBackgroundPrevious studies documented the existence of substantial inequalities in the utilization of maternal health services across different population subgroups in Ethiopia. Regularly monitoring the state of inequality could enhance efforts to address health inequality in the utilization of maternal health services. Therefore, this study aimed to measure the level of inequalities in the utilization of maternal health services in Ethiopia.MethodThe study used data from the Performance Monitoring for Action Ethiopia (PMA Ethiopia) dataset. Longitudinal data was collected from a weighted sample of 1966 postpartum women using multistage stratified cluster sampling techniques between November 2021 to October 2022. We assessed inequality in maternal health services using three indicators: antenatal care four (ANC), skilled birth attendants (SBA), and postnatal care (PNC). Age, economic status, education level, place of residence, and subnational regions were used as dimensions for measuring inequality. The analysis was conducted using Health Equity Assessment Toolkit Plus (HEAT Plus) software. We computed the summary measure of health inequality: Difference (D), Ratio (R), Population Attributable Risk (PAR), and Population Attributable Fraction (PAF).ResultThe simple summary measures of inequality difference (D) reported a high level of inequality in the utilization of maternal health services in ANC four, SBA, and PNC across economic, education, residence, and subnational regions. The difference (D) in maternal health service utilization between advantaged and disadvantaged population groups exceeded 20 percentage points in all four dimensions of inequality for the three maternal health indicators. Similarly, the complex summary measures of inequality (PAR and PAF) also showed high levels of inequality in the utilization of ANC four, SBA, and PNC across all four dimensions of inequality. However, there was no age-related inequality in the use of maternal health services.ConclusionA high level of socioeconomic and geographic area related inequality was observed in the utilization of ANC four, SBA, and PNC services in Ethiopia. Women from socioeconomically disadvantaged subgroups and women from disadvantaged geographic areas significantly lagged behind in the utilization of maternal health services. Therefore, implementing targeted interventions for the most disadvantaged groups can help to reduce inequality in accessing maternal health services.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1431159/fullinequalityinequitymaternal healthantenatal careskilled birth attendantpostnatal care |
| spellingShingle | Asebe Hagos Misganaw Guadie Tiruneh Melak Jejaw Kaleb Assegid Demissie Lemlem Daniel Baffa Demiss Mulatu Geberu Getachew Teshale Tesfahun Zemene Tafere Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey Frontiers in Public Health inequality inequity maternal health antenatal care skilled birth attendant postnatal care |
| title | Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey |
| title_full | Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey |
| title_fullStr | Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey |
| title_full_unstemmed | Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey |
| title_short | Inequalities in utilization of maternal health services in Ethiopia: evidence from the PMA Ethiopia longitudinal survey |
| title_sort | inequalities in utilization of maternal health services in ethiopia evidence from the pma ethiopia longitudinal survey |
| topic | inequality inequity maternal health antenatal care skilled birth attendant postnatal care |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1431159/full |
| work_keys_str_mv | AT asebehagos inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT misganawguadietiruneh inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT melakjejaw inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT kalebassegiddemissie inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT lemlemdanielbaffa inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT demissmulatugeberu inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT getachewteshale inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey AT tesfahunzemenetafere inequalitiesinutilizationofmaternalhealthservicesinethiopiaevidencefromthepmaethiopialongitudinalsurvey |