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. 2024 Nov 18;19(11):e0313893.
doi: 10.1371/journal.pone.0313893. eCollection 2024.

Spatial patterns and predictors of missing key contents of care during prenatal visits in Ethiopia: Spatial and multilevel analyses

Aklilu Habte Hailegebireal  1 , Habtamu Mellie Bizuayehu  2 , Yordanos Sisay Asgedom  3 , Jira Wakoya Feyisa  4
Affiliations

Spatial patterns and predictors of missing key contents of care during prenatal visits in Ethiopia: Spatial and multilevel analyses

Aklilu Habte Hailegebireal et al. PLoS One. .

Abstract

Background: Quality Antenatal Care (ANC) is considered if pregnant women have access to essential services that align with the best evidence-based practice. Although several studies have been conducted on ANC uptake in Ethiopia, they have focused on the timing and number of visits and the level of complete uptake of care contents according to the WHO recommendation remains scarce. Hence, this study aimed to assess the magnitude of missing care content during ANC visits, its spatial variations, and individual- and community-level determinants in Ethiopia.

Methods: The study was conducted using the 2016 Ethiopian Demographic and Health Survey and included a total weighted sample of 4,771 women who gave birth within five years before the survey. Spatial analysis was carried out using Arc-GIS version 10.7 and SaTScan version 9.6 statistical software. Spatial autocorrelation (Moran's I) was checked to determine the non-randomness of the spatial variation in the missing contents of care. Multilevel multivariable logistic regression analysis was performed using STATA version 16. The adjusted odds ratio (aOR) with its corresponding 95% CI was used as a measure of association.

Results: The prevalence of missing full contents of ANC in Ethiopia was 88.2% (95% CI: 87.2, 89.0), with significant spatial variations observed across regions. Missing essential contents of care was higher among women who live in rural areas (aOR = 1.68, 95% CI: 1.47, 2.71), not completed formal education (aOR = 1.94, 95% CI:1.24, 3.02), late initiation of ANC (aOR = 3.05, 95% CI:1.59, 6.54), attended only one ANC (aOR = 4.13, 95% CI: 1.95, 8.74), and not having a mobile phone (aOR = 1.44, 95% CI: 1.07, 1.95).

Conclusion: The level of missing care content during prenatal visits was high in Ethiopia, with significant spatial variation across regions. Health systems and policymakers should promote early initiation and encourage multiple visits to provide optimal care to pregnant women. In addition, it is vital to focus on enhancing education and healthcare infrastructure in rural parts of the country.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schematic presentation of the sampling procedure and sample size determination for the study.
Fig 2
Fig 2. Spatial distribution of missing ANC contents in Ethiopia, EDHS 2016.
Fig 3
Fig 3. The global spatial autocorrelation of missing ANC contents in Ethiopia, EDHS 2016.
Fig 4
Fig 4. Hot spot and cold spot analysis of missing ANC contents across regions in Ethiopia, EDHS 2016.
Fig 5
Fig 5. Ordinary Kriging interpolation of the spatial distribution of missing ANC contents in Ethiopia, EDHS 2016.
See this image and copyright information in PMC

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