Background
Methods
Study design and setting
Sample size and sampling
Data collection and tools
Measures
Data analysis
Ethical considerations
Results
Characteristics of participants
Characteristics | Attended four ANC visits | Delivered by skilled provider | Total (n = 500) | ||
---|---|---|---|---|---|
No (n = 263) | Yes (n = 237) | No (n = 335) | Yes (n = 165) | ||
District | |||||
Wolisso | 55.2 | 56.2 | 52.5 | 63.5 | 55.6 |
Goro | 15.0 | 16.5 | 15.2 | 16.7 | 15.7 |
Wonchi | 29.9 | 27.3 | 32.3 | 19.7 | 28.7 |
Urban residence | 7.1 | 21.9 | 2.2 | 42.7 | 13.8 |
Non Oromo ethnicity | 10.3 | 17.1 | 10.1 | 21.5 | 13.4 |
Household size | |||||
2–3 | 13.2 | 21.1 | 10.9 | 31.5 | 16.8 |
4–5 | 33.2 | 37.0 | 35.0 | 34.9 | 34.9 |
>5 | 53.6 | 41.9 | 54.1 | 33.6 | 48.3 |
Wealth index quintile | |||||
Lowest | 26.5 | 11.8 | 25.4 | 6.0 | 19.8 |
Second | 19.4 | 21.1 | 24.6 | 9.0 | 20.2 |
Middle | 23.7 | 15.5 | 24.3 | 9.0 | 19.9 |
Fourth | 18.8 | 21.8 | 18.0 | 25.6 | 20.2 |
Highest | 11.6 | 29.8 | 7.7 | 50.3 | 19.9 |
Age in years | |||||
15–24 | 21.4 | 32.2 | 22.8 | 35.0 | 26.3 |
25–29 | 34.5 | 40.5 | 38.6 | 33.7 | 37.2 |
30–34 | 22.2 | 14.3 | 19.4 | 16.7 | 18.6 |
35–49 | 22.0 | 13.0 | 19.2 | 14.6 | 17.9 |
Parity | |||||
1 | 15.5 | 24.8 | 12.5 | 37.8 | 19.8 |
2–3 | 28.0 | 30.9 | 29.1 | 30.0 | 29.3 |
4–5 | 32.1 | 30.0 | 36.2 | 18.5 | 31.1 |
>5 | 24.4 | 14.3 | 22.2 | 13.7 | 19.8 |
Woman’s education level | |||||
None | 59.4 | 43.8 | 60.3 | 32.3 | 52.3 |
Primary | 33.9 | 41.2 | 34.8 | 43.4 | 137.2 |
Secondary/higher | 6.7 | 15.0 | 4.9 | 24.3 | 10.5 |
Partner’s education level | |||||
None/no partner | 27.2 | 17.9 | 28.5 | 9.2 | 23.0 |
Primary | 57.2 | 56.4 | 59.5 | 50.2 | 56.8 |
Secondary/higher | 15.6 | 25.7 | 12.0 | 40.6 | 20.2 |
Marital status | |||||
Married | 95.9 | 97.0 | 95.7 | 198.3 | 96.4 |
Single | 4.1 | 3.0 | 4.3 | 1.7 | 3.6 |
Religion | |||||
Orthodox Christian | 54.0 | 49.2 | 53.0 | 48.9 | 51.8 |
Protestant | 22.7 | 26.3 | 23.0 | 27.7 | 24.4 |
Muslim | 23.3 | 24.5 | 24.0 | 23.4 | 23.8 |
Knows the required number of ANC visits | 34.9 | 65.4 | 41.8 | 66.3 | 48.8 |
Knows ≥3 pregnancy danger signs | 19.4 | 27.9 | 19.3 | 33.3 | 23.3 |
Time to nearest health facility | |||||
<30 min | 25.3 | 44.2 | 22.1 | 63.4 | 33.9 |
30–59 min | 24.2 | 23.1 | 26.6 | 16.5 | 23.7 |
≥60 min | 50.5 | 32.7 | 51.3 | 20.1 | 42.4 |
Perceived quality of care at nearest facility | |||||
Average/poor/don’t know | 44.2 | 34.2 | 43.5 | 30.0 | 39.7 |
Good | 44.8 | 46.4 | 46.3 | 43.6 | 45.5 |
Excellent | 11.0 | 19.4 | 10.1 | 26.4 | 14.8 |
Maternal health attitude score tertiles | |||||
Poor | 47.4 | 23.9 | 41.2 | 25.5 | 36.7 |
Medium | 27.0 | 32.6 | 30.6 | 27.1 | 29.6 |
Good | 25.5 | 43.5 | 28.2 | 47.4 | 33.7 |
Attended at least 4 ANC visits | -- | -- | 36.2 | 68.9 | 45.5 |
Had any pregnancy/delivery problem | -- | -- | 17.4 | 24.5 | 19.4 |
Well prepared for the birth of the baby | -- | -- | 6.9 | 29.4 | 13.4 |
Final decider on delivery place | |||||
Woman alone | -- | -- | 48.3 | 23.1 | 41.1 |
Partner/other family member alone | -- | -- | 34.0 | 60.3 | 41.5 |
Woman and partner together | 17.7 | 16.6 | 17.4 |
Determinants of antenatal care use
Characteristics | Unadjusted OR (95 % CI) | P valuei | Adjusted ORa (95 % CI) | P valuei |
---|---|---|---|---|
District | 0.820 | |||
Wolisso | 1 | -- | ||
Goro | 1.08 (0.58–2.01) | -- | ||
Wonchi | 0.89 (0.47–1.69) | -- | ||
Urban residence | 3.69 (2.21–6.17) | <0.001 | 1.62 (0.84–3.14) | 0.145 |
Non Oromo ethnicity | 1.79 (0.98–3.26) | 0.058 | 1.41 (0.78–2.54) | 0.241 |
Household size | 0.017 | 0.867 | ||
2–3 | 2.04 (1.29–3.25) | 1.14 (0.66–1.94) | ||
4–5 | 1.43 (0.91–2.24) | 1.16 (0.61–2.21) | ||
>5 | 1 | 1 | ||
Wealth index quintile | 0.001 | 0.015 | ||
Lowest | 1 | 1 | ||
Second | 2.44 (1.45–4.11) | 2.29 (1.27–4.15) | ||
Middle | 1.46 (0.75–2.85) | 1.10 (0.50–2.41) | ||
Fourth | 2.59 (1.50–4.47) | 1.96 (1.04–3.68) | ||
Highest | 5.74 (2.90–11.36) | 3.53 (1.69–7.39) | ||
Age in years | 0.001 | 0.003 | ||
15–24 | 1 | 1 | ||
25–29 | 0.78 (0.50–1.21) | 0.81 (0.47–1.38) | ||
30–34 | 0.43 (0.27–0.69) | 0.37 (0.21–0.66) | ||
35–49 | 0.39 (0.24–0.64) | 0.42 (0.25–0.72) | ||
Parity | 0.030 | 0.936 | ||
1 | 1 | 1 | ||
2–3 | 0.69 (0.42–1.13) | 0.98 (0.54–1.76) | ||
4–5 | 0.58 (0.36–0.96) | 1.07 (0.49–2.31) | ||
>5 | 0.37 (0.20–0.67) | 0.89 (0.352.31) | ||
Woman’s education level | 0.003 | 0.313 | ||
None | 1 | 1 | ||
Primary | 1.65 (1.07–2.56) | 1.00 (0.56–1.76) | ||
Secondary/higher | 3.01 (1.70–5.33) | 0.74 (0.40–1.35) | ||
Partner’s education level | 0.015 | 0.770 | ||
None/no partner | 1 | 1 | ||
Primary | 1.49 (0.86–2.59) | 0.95 (0.49–1.84) | ||
Secondary/higher | 2.48 (1.33–4.62) | 0.80 (0.34–1.86) | ||
Marital status | 0.514 | |||
Married | 1 | -- | ||
Single | 0.72 (0.26–1.99) | -- | ||
Religion | 0.566 | |||
Orthodox Christian | 1 | -- | ||
Protestant | 1.27 (0.80–2.03) | -- | ||
Muslim | 1.16 (0.71–1.87) | -- | ||
Knows number of required ANC visits | 3.53 (2.40–5.18) | <0.001 | 2.75 (1.89–4.01) | <0.001 |
Knows ≥3 pregnancy danger signs | 1.61 (1.04–2.49) | 0.032 | 0.90 (0.60–1.35) | 0.605 |
Time to nearest facility | 0.013 | 0.367 | ||
<30 min | 1 | 1 | ||
30–59 min | 0.55 (0.29–1.03) | 0.63 (0.31–1.29) | ||
≥60 min | 0.37 (0.20–0 .69) | 0.64 (0.32–1.29) | ||
Perceived quality of care at nearest facility | 0.035 | 0.220 | ||
Average/poor/don’t know | 1 | 1 | ||
Good | 1.34 (0.81–2.21) | 1.46 (0.93–2.31) | ||
Excellent | 2.28 (1.21–4.31) | 1.72 (0.85–3.48) | ||
Maternal health attitude score tertiles | <0.001 | 0.033 | ||
Poor | 1 | 1 | ||
Medium | 2.39 (1.54–3.69) | 1.88 (1.11–3.18) | ||
Good | 3.37 (1.93–5.86) | 2.20 (1.22–3.98) |
Determinants of skilled birth attendant at delivery
Characteristics | Unadjusted OR (95 % CI) | P valuei | Adjusted ORa (95 % CI) | P valuei |
---|---|---|---|---|
District | 0.554 | |||
Wolisso | 1 | -- | ||
Goro | 0.91 (0.26–3.13) | -- | ||
Wonchi | 0.51 (0.14–1.81) | -- | ||
Urban residence | 32.80 (12.40–86.74) | <0.001 | 7.31 (2.88–18.55) | <0.001 |
Non Oromo ethnicity | 2.42 (0.62–9.49) | 0.195 | -- | |
Household size | <0.001 | 0.939 | ||
2–3 | 4.63 (2.77–7.75) | 0.79 (0.15–4.10) | ||
4–5 | 1.60 (1.04–2.48) | 0.79 (0.15–4.10) | ||
>5 | 1 | 1 | ||
Wealth index quintile | <0.001 | 0.004 | ||
Lowest | 1 | 1 | ||
Second | 1.54 (0.68–3.53) | 0.76 (0.36–1.61) | ||
Middle | 1.55 (0.67–3.61) | 0.69 (0.19–2.49) | ||
Fourth | 6.00 (2.63–13.69) | 3.47 (1.46–8.25) | ||
Highest | 27.46 (8.48–88.89) | 8.94 (2.45–32.61) | ||
Age in years | 0.026 | 0.262 | ||
15–24 | 1 | 1 | ||
25–29 | 0.57 (0.37–0.87) | 0.60 (0.28–1.27) | ||
30–34 | 0.56 (0.37–0.86) | 0.54 (0.30–0.99) | ||
35–49 | 0.50 (0.26–0.96) | 0.61 (0.27–1.38) | ||
Parity | <0.001 | 0.003 | ||
1 | 1 | 1 | ||
2–3 | 0.34 (0.20–0.58) | 0.30 (0.10–0.90) | ||
4–5 | 0.17 (0.10–0.28) | 0.17 (0.06–0.44) | ||
>5 | 0.20 (0.09–0.45) | 0.21 (0.07–0.66) | ||
Woman’s education level | <0.001 | 0.241 | ||
None | 1 | 1 | ||
Primary | 2.33 (1.47–3.70) | 0.52 (0.24–1.11) | ||
Secondary/higher | 9.27 (3.01–28.48) | 0.66 (0.19–2.22) | ||
Partner’s education level | <0.001 | 0.468 | ||
None/no partner | 1 | 1 | ||
Primary | 2.49 (1.51–4.46) | 0.67 (0.36–1.26) | ||
Secondary/higher | 10.37 (5.16–20.85) | 0.63 (0.25–1.60) | ||
Marital status | 0.079 | 0.034 | ||
Married | 1 | 1 | ||
Single | 0.39 (0.13–1.13) | 0.22 (0.06–0.87) | ||
Religion | 0.804 | |||
Orthodox Christian | 1 | -- | ||
Protestant | 1.30 (0.58–2.91) | -- | ||
Muslim | 1.05 (0.40–2.76) | -- | ||
Knows required number of ANC visits | 2.74 (1.85–4.05) | <0.001 | 2.65 (1.47–4.76) | 0.002 |
Knows ≥3 pregnancy danger signs | 2.08 (1.16–3.75) | 0.016 | 0.67 (0.30–1.52) | 0.322 |
Time to nearest facility with maternity | 0.001 | 0.023 | ||
<30 min | 1 | 1 | ||
30–59 min | 0.22 (0.10–0.45) | 0.48 (0.23–0.96) | ||
≥60 min | 0.14 (0.05–0.37) | 0.35 (0.15–0.82) | ||
Perceived quality of care at nearest facility | 0.002 | <0.001 | ||
Average/poor/don’t know | 1 | 1 | ||
Good | 1.36 (0.81–2.31) | 1.73 (0.87–3.47) | ||
Excellent | 3.77 (1.89–7.49) | 6.45 (2.77–15.01) | ||
Maternal health attitude score tertiles | 0.004 | 0.104 | ||
Poor | 1 | 1 | ||
Medium | 1.43 (0.81–2.53) | 0.50 (0.24–1.01) | ||
Good | 2.72 (1.58–4.66) | 0.61 (0.31–1.25) | ||
Attended at least 4 ANC visits | 3.91 (2.57–5.94) | <0.001 | 1.41 (0.93–2.17) | 0. 105 |
Had a pregnancy/delivery related problem | 1.54 (0.92–2.60) | 0.090 | 2.94 (1.31–6.61) | 0.011 |
Final decision maker on delivery place | <0.001 | 0.002 | ||
Woman alone | 1 | 1 | ||
Partner/other family member alone | 1.97 (1.02–3.79) | 4.76 (2.16–10.47) | ||
Woman and partner together | 3.71 (2.45–5.63) | 3.92 (1.64–9.36) | ||
Well prepared for delivery of baby | 5.59 (2.42–12.85) | <0.001 | 4.71 (1.68–13.18) | 0.005 |