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. 2025 May 8;25(1):543.
doi: 10.1186/s12884-025-07684-z.

Provision of recommended antenatal care services in Ethiopia: missed opportunity for screening and counselling

Abdulaziz Mohammed Hussen  1   2   3 , Martin Heine  4   5 , Maria Barreix  6 , Rosemary K Muliokela  6 , Tigest Tamrat  6 , Özge Tunçalp  7 , Binyam Tilahun  8   9 , Diederick E Grobbee  4 , Joyce L Browne  4
Affiliations

Provision of recommended antenatal care services in Ethiopia: missed opportunity for screening and counselling

Abdulaziz Mohammed Hussen et al. BMC Pregnancy Childbirth. .

Abstract

Background: Utilisation of Antenatal care (ANC) in Ethiopia has shown a steady increase in the last two decades, from 27% in 2000 to 74% in 2019. While it is encouraging to see more women attending and receiving ANC, attention to ensuring the quality of the ANC services provided to the visiting women is important. Therefore, this study aimed to assess the provision of recommended ANC services and to identify client related factors associated with the provision of the services.

Methods: The study was conducted using the 2019 Ethiopian Demographic and Health Survey (EDHS) data. Provision of recommended ANC services was assessed for the EDHS sub-set of 1573 women who had a live birth in the two years preceding the survey and at least one ANC visit. Four components of ANC (i.e. blood pressure measurement, blood and urine test, and counselling on signs of pregnancy complications) were used to measure the provision of recommended ANC services. Bivariable and multivariable analysis was performed to identify client related factors associated with the provision of recommended ANC services. An adjustment was made to account for the complex survey design throughout the analysis (weight, stratification, and clustering).

Results: About one in two women (49.7%; 95% CI: 44.6-55.0) reported receiving the four components of ANC during their pregnancy. Having a higher educational level (adjusted Odds Ratio [aOR] = 2.84; 95%CI: 1.15-6.97), being in the middle (aOR = 1.87;95% CI: 1.14-3.06), richer (aOR = 2.56; 95% CI: 1.46-4.49), and richest (aOR = 4.21;95% CI: 1.93-9.21) wealth quintiles, and having two to three (aOR = 5.40;95% CI: 2.00-14.60) and four or more (aOR = 13.45; 95% CI: 4.81-37.58) ANC visits were client related factors associated with the provision of recommended ANC services.

Conclusion: Despite the high ANC1 coverage, only one in two women reported receiving the four recommended services. To produce the desired health outcome from ANC utilisation, expanding the coverage should be accompanied by a strong focus on the contents and quality of care. Moreover, regardless of their educational and economic status, all women should receive all components of care as per the recommendations.

Keywords: Antenatal care (ANC); Antenatal care recommendations; Ethiopia; Maternal health; Pregnancy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study used a publicly available DHS data. The DHS received government permission and followed ethical practices for the primary data collection including asking informed consent from each participant and assuring confidentiality by omitting names and any personal identifiers [29]. Approval for our use of data was sought and received from the DHS Programme. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Provision of recommended ANC services in Ethiopia
Fig. 2
Fig. 2
Percentage of women who reported receiving the components of ANC in Ethiopia
Fig. 3
Fig. 3
ANC1 coverage and percentage of women who received the four ANC components across regions of Ethiopia
See this image and copyright information in PMC

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